The Trump administration and Republican leaders in Congress are pledging to turn their attention toward tax reform after their failure to pass a repeal and replacement of the Affordable Care Act. But Republicans can still improve health care and lower costs if they change the treatment of employer-sponsored health insurance plans in tax reform.

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Major bipartisan accomplishments in federal policy feel like a rarity these days. But it was just over 20 years ago that the parties came together to pass significant, positive reforms to our nation’s cash assistance program for families in poverty. The 1996 welfare-reform law, passed by a Republican Congress and signed by President Bill Clinton, significantly strengthened work requirements in a new program, now known as Temporary Assistance for Needy Families (TANF). In the years following the law’s enactment, child-poverty rates dropped significantly and employment among poor mothers increased, while teen pregnancy and abortion rates continued to fall. Policies that encouraged work succeeded in achieving the intended, positive result: fewer Americans in poverty and more Americans providing for themselves.
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Despite the setbacks of the past eight months, including the inability of Republicans to agree on a single alternative to the ACA, it is still not too late for this Congress to pass health care reform legislation.

At this point in the Obama administration’s first term, the ACA hadn’t been passed – not even out of committee – and Democrats weren’t the least bit united either. That had, and that point in time, three separate bills – quite different from each other – going through different House committees, and three additional very different bills going through three different Senate committees. In addition, there were numerous other proposals introduced by various Democrats, which had been sidelined by their own leadership.

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While Republicans were trying and failing to repeal Obamacare, Democrats in Congress were quietly lining up behind a single-payer health plan that, as written, would fundamentally reshape American health care for every single person in the country.

That plan has now gained the backing of 60 percent of House Democrats, the most support a single-payer plan has ever enjoyed in Congress, and Sen. Bernie Sanders (I-VT) is planning a national campaign for a similar proposal in early September.

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A majority of voters back the idea of tying Medicaid eligibility to employment status as the Trump administration weighs whether to give more states the power to impose work requirements on the government health program.

In an Aug. 10-14 Morning Consult/POLITICO poll, 1,997 registered voters were asked whether they generally support requiring individuals to have a job in order to be eligible for the program. Fifty-one percent of voters said they support that proposal, while 37 percent said they oppose it. The survey has a margin of error of plus or minus 2 percentage points.

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“Medicaid for All” has suddenly become the darling of the health reform crowd. Nevada almost became the first state in the nation to adopt Medicaid for All this year — until Gov. Brian Sandoval vetoed the plan in June. Other states, including Massachusetts and Minnesota, are looking into it.

These Medicaid-for-All plans would let anyone “buy into” the program. Middle-class families could pay government-set premiums for Medicaid coverage. They would get guaranteed health benefits at government-subsidized prices. And given that the program pays healthcare providers less than private insurance, Medicaid for All might even rein in health spending — or so the thinking goes.

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Suppose you wanted to sabotage Obamacare and could not get Congress to help. Short of repeal legislation, the next best strategy would be to cut off funds to health insurers—in other words, starve the beast. That should work, right?

Surprisingly not, according to a new report from the Congressional Budget Office (CBO). Responding to a request from House Democrats, CBO considered what could happen to health coverage, insurance premiums, and taxpayer cost if the federal government stopped paying insurers for cost-sharing reductions (CSRs). Under CBO’s scenario, the federal government would stop making payments to insurers totaling $118 billion between 2018 and 2026. As a result, the federal deficit would rise (not fall) by $194 billion, low-income individuals would pay about the same (not more) for coverage, and more people (not fewer) would be insured.

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Democrats are ready to go on the health care offensive. And Sen. Brian Schatz (D-HI) may have a new plan for them to do it.

In an interview with Vox, Schatz revealed that he’s preparing a new bill that could grant more Americans the opportunity to enroll in Medicaid by giving states the option to offer a “buy-in” to the government program on Obamacare’s exchanges.

His proposal would expand the public health insurance program from one that covers only low-income Americans to one open to anyone seeking coverage, depending on what each state does.

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Andy Thorburn, a health insurance executive who is plugging $2 million into a bid to replace Rep. Edward R. Royce (R-Calif.), is the latest Democrat pushing the party to embrace single-payer health care — even in swing districts. In a video announcement, Thorburn paints the contest as a referendum on health care, between a Republican who voted for the repeal of the Affordable Care Act and a Democrat who wants to move, eventually, to “Medicare for all.”

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A fast-approaching deadline for insurers to commit to selling health plans next year under the Affordable Care Act is pressuring Republican lawmakers to decide quickly whether to shore up the law and ease the path for insurers or continue efforts to roll it back.

Lawmakers returning to the Capitol from recess on Sept. 5 will have only 12 legislative days to decide whether to pass a bipartisan bill aimed at bolstering the ACA’s markets before insurers must commit to participating in the law’s exchanges in 2018. At the same time, a plan from Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) that would largely topple most of the ACA is gaining traction among Republicans.

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