“Single-payer” is a broadly popular slogan that papers over intraparty disagreements and wrenching policy choices. A recent survey by Kaiser found that initial support for single-payer dropped by about a third when supporters were told of criticisms that it might increase their taxes, give the government “too much control” over health care or eliminate the ACA. Each of those critiques would probably be made prominently by Republican opponents of the policy.
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This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers’ risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the costs and complexity of administration. These effects warrant careful consideration by policymakers as they consider measures to achieve stability in the individual market in the long term.
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How do you define “single payer”? A common theme is to give government a dominant role in the pricing and possibly delivery of services—supporters often assert that some measure of cost would be reduced. The Urban Institute’s Health Policy Center says that Bernie Sanders’ previous proposal in 2016 would have increased federal costs by $32 trillion over the next decade. Even Democrats would have a hard time getting support for this unprecedented expansion of federal spending. In spite of the superficial allure of Medicare for all, Democrats are not eager to upend the health system that President Obama created.
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A recent poll demonstrates the strong bipartisan support for quick action to protect coverage choices and affordability. According to the poll conducted in August, 76% of all registered voters support bipartisan legislation to help make insurance markets more stable, to ensure coverage choices and to keep premiums in check; this includes 78% of Democrats, 73% of independent and 76% of Republicans.
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Lawmakers and policy experts are honing in on a small handful of policies — mostly, different forms of federal funding and regulatory flexibility — as the Senate tries its hand at a bipartisan Affordable Care Act fix.
The first of several Senate HELP Committee hearings on the individual market included topics such as funding the cost-sharing subsidies, and expanding regulatory waivers for states. A handful of other policy ideas, including direct government payments to help offset the costs of expensive patients, were also discussed.
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A bipartisan group of senators has palpable momentum but little time to make good on a bid to shore up Obamacare insurance markets, even as conservative Republicans press a parallel attempt to make good on their promise to repeal the health care law.
The stabilization effort, led by Republican Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.), could yield the first bipartisan Obamacare bill since the law was passed seven years ago. It could also provide some measure of certainty for insurance companies that have until Sept. 27 to make final decisions about whether to participate in Obamacare markets next year.
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A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules.
In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces.
Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers.
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Congressional Democrats may be tempted to think they shouldn’t negotiate with Republicans on health care because, so far, the GOP has shown itself incapable of fulfilling its commitment to repeal and replace the Affordable Care Act (ACA). “Why rescue Republicans from their failure?” the thinking goes.
This is a short-sighted perspective. Yes, the GOP effort has stalled, but, absent some kind of bipartisan deal which brings more stability and consensus to health policy, it is still possible that Republicans will succeed in pushing substantial changes on their own, despite strong opposition from Democrats.
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Govs. John Kasich of Ohio (R) and John Hickenlooper of Colorado (D) announced Monday that they have reached an agreement on a bipartisan proposal to stabilize ObamaCare markets.
The governors, who have been calling for bipartisanship on healthcare in a series of recent interviews, are not yet releasing the details of their stabilization plan.
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Sen. Lamar Alexander will hold bipartisan hearings in early September in a last minute attempt to assure insurers of the federal government’s commitment to the individual market, and pave the way for states to ask for flexibility on insurance benefits.
Alexander, R-Tenn., is looking to drum up support for a “bipartisan way to get a limited result that actually helps people” after tumultuous months of heated debate over whether to repeal-and-replace the Affordable Care Act that ultimately handed the Republicans a defeat.
Alexander wants to extend cost-sharing reduction payments through 2018, and change a section of the ACA to give states more flexibility.
The timing will be difficult, he said, but necessary.
He preferred a repeal, but now wants to make sure that insurers don’t have a reason to decide last minute to pull out of the exchange
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