The Center for American Progress’s new “Medicare Extra for All” proposal is a repackaged version of the congressional Democrats’ 2009’s “public option” proposal. It imagines that large savings can be generated by extending Medicare’s price controls for hospital care, beyond the elderly and disabled, to the purchase of hospital care for other patients. Individuals and employers would be allowed to buy into the system, to take advantage of these discounted rates. Yet, the monopoly power which has inflated prices for hospital care provided to privately funded patients is a deliberate product of policy, intended to sustain the solvency of hospitals in counties across the United States, which would be unviable in a competitive market.
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Riding a wave of enthusiasm from progressive Democrats, supporters of single-payer have effectively made it a front-and-center issue in California’s 2018 elections. It’s been discussed in virtually every forum with the candidates running for governor, emerged as a point of contention in some legislative races, and will likely be a rallying cry at the upcoming California Democratic Party convention. Advocates of the single-payer system know that it’s not going to happen now, it’s not going to happen tomorrow, but long-term, they hope to make single-payer a reality.
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Insurer participation and competition in Obamacare declined again in 2018 at both the state and county levels. In 2017, nearly one-third of counties (32.8 percent) had only one insurer offering exchange coverage. In 2018, more than half (51.3 percent) of all counties face that situation. Many insurers have exited the exchanges; ones that remain offer higher premiums and narrow network plans. The emerging norm appears to be one in which major metropolitan areas have two or three insurers offering exchange coverage, while less-populous areas have only one. A health insurance monopoly offering overly expensive coverage that pays for only a very limited set of providers is deeply unattractive, especially to customers who previously enjoyed choice in both their insurance and medical care. Not surprisingly, consumers are looking to Congress and the President for help in escaping the soaring costs and shrinking choices that characterize the ACA exchanges.

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New analysis from Avalere finds that plans with more restrictive networks, including health maintenance organizations (HMOs) and exclusive provider organizations (EPOs), continue to dominate the exchange market, with 73% of the 2018 market comprised of restrictive network plans, up from 68% in 2017 and 54% in 2015. Avalere analysis also found that deductibles for the most popular type of plan on the exchange—silver plans—will climb in 2018, to an average of $3,937, up from $3,703 in 2015, and each following year they will increase.
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People who bought policies from Centene, a large for-profit health insurance company, filed a federal lawsuit on Thursday claiming the company does not provide adequate access to doctors in 15 states. “Members have difficulty finding–and in many cases cannot find–medical providers,” who will accept patients covered under policies sold by Centene, according to the lawsuit filed in federal court in Washington State.

“People signed up for insurance and they ‘discovered there were no doctors,”’said Seth Lesser, a partner at the law firm of Klafter Olsen & Lesser who is representing some of the policyholders.

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Public health-care entitlements in the U.S. have traditionally been designed to supplement rather than to supplant privately purchased health insurance. About 40% of the entitlement funds disbursed under the Affordable Care Act (ACA), however, have gone to individuals who already had private coverage. This displacement of private-sector spending by public-sector activity is called “crowd-out.” While the ACA has reduced the share of the American population without health insurance, its spending has been poorly-targeted to fill gaps in care, and 28 million remain uninsured.

This paper reviews estimates of ACA crowd-out and examines the potential for block grants to allow states to target assistance at individuals otherwise lacking coverage. Under such a reform, the same level of federal funding could do more to expand access to care and to provide protection from catastrophic medical costs for those who need help the most.

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GOP leaders from both chambers of Congress want reinsurance. But they want it in different ways.

And with two different Republican measures on the table, each handling the mechanics differently, the big question is: Which one will win out if congressional Republicans go through with their plan to address stabilization in an upcoming spending bill.

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Sen. Bernie Sanders will hold an online town-hall meeting next Tuesday regarding his single-payer health-care legislation. Mr. Sanders calls it “Medicare for All.” But the text of the bill itself reveals a more accurate name: Medicare for None. The Orwellian way in which Mr. Sanders characterizes his plan speaks to the larger problem facing the left, whose plans for health care remain so radical that speaking of them honestly would prompt instant repulsion from most voters.

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Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) met Wednesday to discuss the path forward for their bipartisan legislation aimed at stabilizing ObamaCare, aides in both parties said.

The legislation’s future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached.

Murray and other Democrats, though, want significant changes to the bill, saying that it needs to be redone now that Republicans have destabilized health insurance markets by repealing ObamaCare’s individual mandate in the tax-reform bill last month.

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Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS). On March 14, 2017, the CMS sent a letter to state governors that signaled a willingness to use Section 1115 authority to support work requirements and the alignment of Medicaid programs with private insurance policies.

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