Here’s a strange paradox: Health-care costs have increased by an unsustainable rate of about 8.5% each year over the past decade, according to PwC’s Health Research Institute. Already, the average employer-based family health insurance plans costs more than $18,000 annually.

But Medicare spending has been relatively stable. Over the past three years, the program’s payouts to hospitals have increased by only 1% to 3% a year, roughly even with inflation. The prices paid for some core services, such as ambulance transportation, have actually gone down.

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The Oct. 26 editorial “Health-care reform that pays off” unfairly maligned a bill introduced by two committee chairmen as “dismantling major pieces of Obamacare.” It does nothing of the sort.

Like the bill proposed by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) that the editorial praised, a bill from Sen. Orrin Hatch (R-Utah) and Rep. Kevin Brady (R-Tex.) would appropriate money for cost-sharing-reduction subsidies. That’s not nearly enough to provide relief to consumers, who are leaving health-insurance markets in droves. Gallup reported that the uninsurance rate in the third quarter of 2017 reached its highest level since 2014, as the Affordable Care Act makes insurance unaffordable.

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Federal health officials are proposing changes to rules for coverage sold through the ACA’s insurance marketplaces that, starting in 2019, would let states alter the benefits that health plans must provide and limit enrollment help for consumers. In envisioning a larger role for states in setting benefits, the draft rule would still require ACA plans to cover 10 categories of medical services. But for the first time, any state could adopt benefits standards already in use by another state—or rewrite its own standards.

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