A group of health policy analysts have collaborated on a set of proposals for replacing the Affordable Care Act (ACA) and also reforming other major portions of health care delivery, such as the tax treatment of employer-sponsored health insurance, Medicaid, Medicare, and Health Savings Accounts. Because so much attention has been paid to the repeal of the ACA by those who have opposed it, we believe it is important to focus on a serious proposal that could both replace this law and provide additional measures of reform, especially to the health care entitlement programs.
We believe our reform agenda represents such a proposal. Furthermore, none of us regards the pre-ACA health care system as an acceptable alternative.
More than 2 million existing customers with insurance under the Affordable Care Act have had coverage renewed automatically for 2016 by HealthCare.gov, after they ignored government warnings to shop around to avoid surprise spikes in prices of health plans. According to data released Tuesday, 8.2 million people already have chosen — or have been automatically assigned to — health coverage next year through the federal insurance exchange.
A group of state insurance commissioners is developing a proposal to limit the amount that health insurers might have to pay out under the Affordable Care Act’s risk adjustment program, New Mexico Insurance Superintendent John Franchini told SNL.
The plan would install a so-called circuit breaker to prevent companies from paying more than 2% of their premium revenue into the program each year. That boundary would make insurers’ financial obligations more predictable and avoid the kinds of surprise payouts that contributed to the destabilization of several health plans in 2015.
Using data from 49 states and Washington, D.C., the Commonwealth Fund analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. They examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance.
For people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average,
Despite advice to shop around before selecting a plan, consumers may find that getting answers about drug coverage can be an exercise in frustration, despite a federal health law requirement that insurers provide lists of the prescription medications included in their plans.
That’s because many treatments — particularly intravenous treatments like those used in cancer, hemophilia or multiple sclerosis — are covered under a separate part of an insurance plan, not the pharmacy benefit.
On December 14, former Secretary of the Department of Health and Human Services Kathleen Sebelius made news by calling the decisions of Kansas and Missouri to turn down the Medicaid expansion contained in the Affordable Care Act “morally repugnant and economically stupid.”
Heated political rhetoric does not alter the fact that a state’s decision to expand Medicaid involves complicated tradeoffs.
The Senate voted overwhelmingly today 65-33 in favor a $1.8 trillion package of spending bills and tax breaks, sending the legislation to President Obama’s desk for his signature. Included in the two bills are provisions trimming some of the levies that help finance ObamaCare. A tax on medical devices would be suspended for two years, a levy on health insurers would stop for a year and a tax on higher-cost insurance policies would be postponed two years until 2020.
It has been called into question whether it’s true that Sen. Marco Rubio is responsible for the provision (inserted into last year’s annual spending bill and now again into this year’s) that requires the risk-corridor program in ObamaCare to be budget neutral. Like this year’s giant spending law, last year’s omnibus bill was the result of a leadership-driven process that drew on substantive expertise from the relevant committee staffs but did not much involve most members of either house. But Rubio was without question the first and most significant congressional voice on this subject, and if he hadn’t done the work he did, the risk-corridor neutralization provision would not have been in last year’s (or this year’s) budget bill.
In a big package of tax and spending legislation that Congress is likely to approve this week, Republicans have forced President Obama to swallow three changes that undermine his signature health care law, including a two-year delay of a tax on high-cost insurance plans provided by employers to workers.
In an interview on Wednesday, Mr. Obama’s first budget director, Peter R. Orszag, a leading supporter of the Cadillac tax, said, “The two-year delay is likely to be equivalent to repeal of the tax because people will expect it to be deferred again and again.”
The Cadillac tax contained in the Affordable Care Act represented an attempt to remedy a major problem with health care and tax policy – the exclusion of the cost of employer-sponsored insurance from both income and payroll taxes. Regardless of political leanings, economists generally agree that the exclusion causes employers to offer overly expansive insurance. This depresses wages and increases overall health care spending. Moreover, the exclusion provides a disproportionate benefit to the wealthy.