Articles on the implementation of ObamaCare.
A battle is brewing in the courts over the Trump administration’s move to let states impose work requirements for recipients of Medicaid, the health insurance program for the poor. Advocacy groups are gearing up to sue the administration, arguing that it doesn’t have the power to allow work requirements and other rules for Medicaid without action from Congress.
But the administration is defending the legality of the shift. When unveiling guidance Thursday on the work requirements, top Medicaid official Seema Verma said the administration has “broad authority” under current law to allow states to make changes through waivers.
. . .
A day after the Trump administration announced that it would allow states to compel poor people on Medicaid to work or get ready for jobs, federal health officials on Friday granted Kentucky permission to impose those requirements.
Becoming the first-in-the-nation state to move forward with the profound change to the safety-net health insurance program is a victory for Kentucky’s Republican governor, Matt Bevin, who during his 2015 campaign for office vowed to reverse the strong embrace of the Affordable Care Act by his Democratic predecessor.
. . .
The Trump Administration is on a mission to rescue health-care markets and consumers from ObamaCare’s shrinking choices and higher prices. Witness the Labor Department’s proposal to allow small businesses to band together to provide insurance on equal footing with corporations and unions.
The share of workers at small businesses with employer-sponsored health benefits has dropped by a quarter since 2010 as insurance costs have ballooned in part due to government mandates. About 11 million workers employed by small businesses are uninsured. Some businesses have dropped their workers onto state insurance exchanges where premiums are subsidized by taxpayers.
. . .
The skyrocketing cost of insurance and diminishing plan choices have driven Americans away from the marketplaces — not presidential malfeasance.
Even before open enrollment started November 1, Obamacare’s proponents tried to lower the public’s expectations and shift blame for the coming drop in enrollees. They predicted that President Trump’s decision to cut Obamacare’s advertising and outreach budget from $100 million to $10 million — as well as his decision to shorten the open enrollment period from 12 to six weeks — would lead to lower enrollment.
The truth is, the administration’s gymnastics have little impact on whether people purchase coverage. Those decisions are dictated by simple things like the price of a plan and how much they value the benefits it provides.
. . .
State lawmakers in Maryland are looking to replace ObamaCare’s individual mandate, which was repealed by Republicans in Congress last month.
A proposal in Maryland would require people to pay a penalty for not having insurance. The money, though, could be used as a down payment for a health insurance plan.
People would also have the option to pay the penalty and get nothing in return.
. . .
The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate.
The CMS cited the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House’s Office of Management and Budget to continue collecting data annually from exchange plans about their enrollees’ risk profiles.
In an earlier version of the request submitted to the executive branch last month, the agency estimated there were 2,400 issuers in the individual and small group markets.
. . .
In a major policy shift that could affect millions of low-income people, the Trump administration said Thursday it is offering a path for states that want to seek work requirements on Medicaid recipients.
Seema Verma, head of the Centers for Medicare and Medicaid Services, said work and community involvement can make a positive difference in people’s lives and in their health.
The administration’s latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on “able-bodied” adults. Technically, those waivers would be “demonstration projects.” In practical terms, they would represent new requirements for beneficiaries in those states.
. . .
In a bid to expand access to affordable healthcare coverage, the Trump administration early Thursday rolled out proposed rules that would allow more small businesses and self-employed workers to band together to buy insurance.
The rule is part of the administration’s objective to encourage competition in the health insurance markets and lower the cost of coverage. But some experts say expanding access to these “association health plans,” which aren’t subject to many of the same regulations and consumer protections as other health plans sold under the Affordable Care Act, could weaken the individual health insurance market.
Democrats won a wave election in Virginia a month ago, not only winning the gubernatorial race but at least coming close to taking control of the legislature. Recounts are continuing in three races that could put Republicans in the minority, an astounding defeat for a party that assumed that they could maintain their position by doubling down on Donald Trump. Ralph Northam arguably has a broad mandate to pursue the Democratic agenda in the Old Dominion, but he tells the Washington Post that he wants to de-escalate the bitter partisanship first.
. . .
Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are about to lock horns over Obamacare — part of a House-Senate clash that needs to be resolved by Friday to avert a government shutdown.
McConnell promised moderate GOP Sen. Susan Collins of Maine that he would prop up President Barack Obama’s signature health law in a must-pass, year-end spending bill — so long as she backs tax reform. But Ryan’s more conservative conference is flatly rejecting that idea and urging the Wisconsin Republican to stand firm against his Senate counterpart.
. . .