Articles on the implementation of ObamaCare.

The three key questions to ask of any Medicaid financing proposal that ends the open-ended federal reimbursement are: 1) what is the level of federal commitment? 2) how are the funds divided among the states? and 3) how are state incentives affected? Sensible Medicaid reform must accomplish two aims: reduce the unsustainable trajectory of federal and state Medicaid spending, and produce better outcomes for people most in need of public assistance. Although much more work needs to be done, the House task force proposal would take steps to accomplish both aims.

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The healthcare plan released today by House Speaker Paul Ryan offers a modern refashioning of the consumer empowerment that has formed the foundation of conservative policymaking. This turns principally on an expansion of health savings accounts and other elements that reshape the healthcare benefit into a defined contribution of money that consumers can own and control, and that becomes more portable. The idea is that people can own their own coverage and take it with them, even as they move around and between different insurance pools and jobs.
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The Department of Health and Human Services will up their direct outreach to uninsured young adults, who they hope will enroll in the Affordable Care Act exchanges and help stabilize the markets.

HHS on Tuesday announced steps the department will take during the upcoming open enrollment period to enhance their outreach to people between ages 18 and 35 who they hope will purchase insurance policies on the federal exchanges. The announcement is the latest in a string of expected steps the department is announcing this month to strengthen the marketplace.

The department hopes to increase the number of young and healthy adults enrolled on the exchanges to improve the risk pools, which would help lower costs for all marketplace consumers.

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House Speaker Paul Ryan’s policy plan for health care, as expected, leans heavily on market forces, more so than the current system created by Obamacare. The proposal contains a host of previously proposed Republican ideas on health care, many of which are designed to drive people to private insurance markets.

Importantly for conservatives, as part of a full repeal of the Affordable Care Act, the current law’s mandates for individuals and insurers would disappear under the GOP plan. It would overhaul Medicare by transitioning to a premium support system under which beneficiaries would receive a set amount to pay for coverage. The plan also would alter Medicaid by implementing either per capita caps or block grants, based on a state’s preference.

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Oscar Health was going to be a new kind of insurance company. Started in 2012, just in time to offer plans to people buying insurance under the new federal health care law, the business promised to use technology to push less costly care and more consumer-friendly coverage.

“We’re trying to build something that’s going to turn the industry on its head,” Joshua Kushner, one of the company’s founders, said in 2014, as Oscar began to enroll its first customers.

These days, though, Oscar is more of a case study in how brutally tough it is to keep a business above water in the state marketplaces created under the Affordable Care Act. And its struggles highlight a critical question about the act: Can insurance companies run a viable business in the individual market?

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Alaska, one of the reddest states in the country, is essentially bailing out its insurance market to prevent Obamacare from collapsing.

A bill passed by the heavily GOP state Legislature to shore up its lone surviving Obamacare insurer is awaiting the signature of Gov. Bill Walker, a Republican-turned-independent who was endorsed two years ago by former vice presidential candidate Sarah Palin. The legislation, originally proposed by Walker, sets up a $55 million fund — financed through an existing tax on all insurance companies — to subsidize enrollees’ costs as the state struggles with Obamacare price spikes and an exodus by all except one insurance company.

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Policymakers are keeping their eyes on the 2016 Social Security and Medicare trustees’ report to see if the White House will stand by its projection that Medicare will be solvent until 2030. The Congressional Budget Office estimates funds (PDF) for the program will dry up in 2026.

Also of interest is whether the trustees will call for the creation of an Independent Payment Advisory Board called for in the Affordable Care Act to reign in Medicare costs if they grew faster than a set rate. But the board, called the death panel by ACA opponents, has not yet been created. There hasn’t been the need, and some say, the willingness to expend the political capital.

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Obamacare has invented a dangerous new way to hide federal spending, including more than $100 billion designed to look like tax cuts.

In defiance of standard United States government accounting practices (and the government’s standard definitions of terms), Obamacare labels its direct outlays to insurance companies “tax credits” (not outlays)—even though they don’t actually cut anyone’s taxes. In this way, Obamacare is masking some $104 billion in federal spending over a decade.

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Maryland’s health cooperative filed a lawsuit Monday seeking to block the federal government from requiring it to pay more than $22 million in fees for a program designed to cover insurance company shortfalls.

The lawsuit by Evergreen Health Cooperative Inc. is the latest twist in the saga of health insurance co-ops set up under the Affordable Care Act to compete against larger, established insurers.

The co-ops were supposed to help keep premiums down by injecting competition into the industry. Instead, 13 of 23 startups that launched successfully have since collapsed, forcing more than 700,000 consumers to seek new insurance. A number of co-op officials have said they were hurt by the federal program because of a formula it used to spread out risk, which they say hurts them while benefiting large, already established insurance companies.

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California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act, making the state the first in the country to offer that kind of coverage.

The law lets the state request a waiver from the federal government that will be needed to allow unauthorized immigrants to purchase unsubsidized insurance through Covered California, the state’s healthcare exchange.

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