The orderly transition to a more stable and affordable health-care system is merely beginning. Too much significance is attributed to Republicans adding the word “repair” to their vocabulary, as if this represents a policy change. The insurance markets really do need repair, and doing nothing isn’t realistic amid ObamaCare’s downward spiral. Uncertainty is inevitably priced into premiums, and benefits and rates for 2018 started to be designed and set months ago. They’ll be approved by regulators in the spring, so Mr. Trump’s HHS picks, Tom Price and Seema Verma, need to move fast to bring more predictability to the markets.
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The Trump administration is considering major changes to Obamacare that may help convince insurers to remain in the law’s marketplaces while Congress drafts a replacement plan — but the proposals may also limit enrollment and increase costs for older Americans, according to documents obtained by POLITICO.
The administration is looking to alter rules around insurers charging older customers more, how much cost they can shift onto customers, and who’s allowed to sign up outside the standard enrollment window. They represent changes that the industry had previously asked the Obama administration to make.
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Two of the top Republicans in Congress on Monday said they are pushing ahead with the plan to begin repealing ObamaCare this spring, despite any confusion caused by President Trump saying the process could spill into next year.
House Ways and Means Committee Chairman Kevin Brady (R-Texas) told reporters that he is working off of Speaker Paul Ryan’s (R-Wis.) timeline of moving repeal legislation by the end of March.
“That’s the timetable I’m working off of,” Brady said.
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Obamacare repeal and replace is going to turn into a huge tax cut. Those reading the tea leaves would do well to consult two sources as to how and why: the 2015 repeal bill, and the House GOP “Better Way” health care blueprint. Just as in the 2015 bill, which was vetoed by President Obama, Congress aims to repeal all of the 20 major new or higher taxes in Obamacare. It’s important that this repeal be effective at the beginning of 2017, both to get rid of negative Obamacare taxes as soon as possible and to lower the current law’s revenue baseline for tax reform.
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Trump administration officials have a lot of work ahead of them, but also a tremendous opportunity to make history. Returning the executive branch to its proper role under the Constitution will also spur Congress to enact reforms that make health care better, more affordable, and more secure.
Michael F. Cannon, Director of Health Policy at the Cato Institute, outlines 14 ways Trump-administration officials can restore the Constitution’s limits on executive power, provide relief to Americans suffering under Obamacare, and hasten repeal.
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Conservative Republicans, worried about growing voices within the party advising or accepting a slower pace for repealing the Affordable Care Act, are redoubling their push to speed the GOP’s long-desired goal.
President Donald Trump on Sunday became the latest top Republican to sound cautious notes about the party’s ability to rapidly repeal large swaths of the 2010 health law and enact its own vision. He told Fox News’s Bill O’Reilly that “maybe it’ll take until sometime into next year,” saying repeal and replacement was “statutorily” difficult to accomplish quickly.
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In his first post, Conover argued that drawing inferences from observational studies about whether covering the uninsured will save lives is a fool’s errand . Quasi-experimental studies hypothetically provide a better tool for figuring out whether insurance coverage reduces mortality risks. Unfortunately, the two studies we have available are very unreliable instruments for figuring this out.
That said, based on the two studies reviewed, Conover cannot rule out the possibility of “excess deaths” in the event some people lost coverage as a result of repeal-and-replace efforts. Ironically, because the lion’s share of coverage gains under Obamacare has been through Medicaid, the New York study arguably is the most appropriate one to use to determine the effects of repeal. However, it is less credible than the Massachusetts study in terms of how much confidence anyone should have in its results.
In short, beware of anyone who claims we will lose 1 life for every 435 newly uninsured. 1 life for every 830 people is more believable, but even that is exaggerated and is far more likely to apply to those gaining private coverage than those enrolling in Medicaid. Unfortunately, the current state of science does not provide a very solid basis for guessing how much this estimate is inflated.
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Obamacare proponents have been increasingly shameless in trotting out scare statistics to convince people that the GOP wants to “make America sick again:”
Two Harvard professors–who, not uncoincidently, are diehard single payer advocates–are lamenting that “repealing the Affordable Care Act will kill more than 43,000 people annually”
False claims about the adverse effects of repealing Obamacare on mortality that are grounded in observational studies result from:
- Grossly exaggerating the number of people who would actually lose coverage. This exaggeration of lost coverage occurs even in the worst-case scenario that Obamacare is not replaced.
- “Excess” mortality estimates related to lack of coverage that are both upward-biased and unreliable by nature due to the inability of researchers to account for unmeasured influences.
- Inappropriate extrapolation of results to populations (e.g., Medicaid) not included in the original study.
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As Republicans consider paring back the Affordable Care Act’s federal mandates, they face a difficult question: What does health insurance need to cover?
The 2010 health law created a new set of federal requirements for plans sold to individuals and small businesses, including a list of 10 benefits, among them prescription drugs, mental-health services and laboratory tests. It also mandated that plans cover preventive services such as vaccinations at no cost to enrollees.
The rules, along with other minimum standards set by the law, were meant to ensure that consumers had strong protections and weren’t surprised by unexpected gaps or limits in their coverage. But that also contributed to making individual insurance more expensive in many cases.
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Senate Democrats have pummeled Rep. Tom Price, President Trump’s pick to lead the Department of Health and Human Services, for supporting Medicaid block grants, but it’s a policy unlikely to win a place in Republicans’ Obamacare repeal-and-replace plan.
If Republicans succeed in making significant changes to Medicaid, they more likely would turn to a more moderate per-capita system embraced by a wider swath of Republicans. Like block grants, a per-capita system would limit federal contributions, but it would allow federal assistance to rise with enrollment growth.
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