Bishop Frank J. Dewane of Venice, Florida, Chairman of the U.S. Bishops’ Committee on Domestic Justice and Human Development, issued a statement in June about a discussion draft of health reform legislation that was then before the Senate, the Better Care Reconciliation Act.  He praised its life protections: “The Bishops value language in the legislation recognizing that abortion…

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We do not know whether Senate Republicans will pass the latest plan to replace Obamacare. But something must be done. Families cannot continue to pay ever-higher premiums. President Trump promised to repeal and replace the law, and he clearly cares about the issue. Something must give. What will that be? One way forward is the…

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Arizona Gov. Doug Ducey heads to Washington this week to attend the Conservative Political Action Conference. The Washington Examiner asked him to preview his main priorities regarding Obamacare replacement and what they should know about Arizona’s healthcare challenges. He said, “The damage from Obamacare is clear: Insurance markets have been wrecked; premiums have soared; and…

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Obamacare enrollees will face varying rate hikes depending on which state they live in. Insurers in some states had underpriced their products in the first few years of the marketplaces set up under President Obama’s health care law and now are trying to make up for their losses with big cost increases. The highest AVERAGE premium increases…

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The consensus is the ACA failed to reduce healthcare costs. If we are to make healthcare affordable for everyone, the answer is not going to come from a President Hillary Clinton or a President Donald Trump. Instead, the solution can be found if we send healthcare back to the states where experimentation and innovative public…

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In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them. But these state officials…

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Earlier this week, news surfaced that some HealthCare.gov users may have received an incorrect subsidy or Medicaid eligibility determination from the Marketplace. According to reports, HealthCare.gov has been counting Social Security income received by children when calculating the Modified Adjusted Gross Income (MAGI) for a household. Once calculated, MAGI is then used to help determine a household’s eligibility for Medicaid or subsidized private insurance. By including a child’s Social Security Income in a household’s income, the Federally-facilitated Marketplace (FFM) likely increased the overall household income, which could have resulted in some persons either not qualifying for Medicaid or an inaccurate tax credit determination. While CMS has acknowledged the error, the agency has so far not given an indication of how many households may be impacted.

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Breaking with normal tradition, we’re going to open this week’s update with national trends before moving into updates at the federal and state levels. This week there was an interesting report from the Kaiser Family Foundation that estimated that 50 percent of households receiving financial assistance to purchase private health insurance on the Marketplaces will have to return a portion of that subsidy when they file their tax returns as part of the tax credit reconciliation process. Repayments will, in most cases, be deducted from an enrollee’s refund check and the Kaiser report estimates that the average repayment will be $794. Roughly seven percent of enrollees could owe a repayment of between $2,000 and $5,000 and two percent could have to repay more than $5,000. A slightly smaller percentage of households, 45 percent, are estimated to receive additional money with their tax refund because they received underpayments in tax credits, with the average refund estimated to be $773.

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The Affordable Care Act (ACA), like President Clinton’s health plan in the 1990s, made the mistake of trying to achieve coast-to-coast health care coverage with a system that essentially looks the same everywhere. That approach was always going to be a challenge. US health care is an enormous and complex economy in its own right. If the US health system were a separate national economy, for instance, it would be the fifth largest economy in the world – larger than the entire economy of France or of Britain. The idea that a single piece of legislation could successfully reorganize the world’s fifth largest economy was a fantasy, especially when the bill had to go through the congressional sausage-making machine.

It’s true that the ACA gave Americans a choice of plan on federal or state-run exchanges. But the ACA still sought a template for insurance rules, benefits and other structural features that would be the same from Vermont to Texas and Florida to Alaska. That was unwise.

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“Despite Obamacare’s strong national enrollment numbers, several states are at risk for big premium hikes.

Each state is its own insurance market, and they had wildly different experiences during Obamacare’s first open-enrollment window. So although nationwide statistics are important for judging the law’s political success, the substantive tests for the law’s future mostly lie with the states—and some of them aren’t looking so hot.”

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