•Avik Roy’s Transcending Obamacare reform proposal retains a number of core features of the Affordable Care Act, even while promising to modify them at the margins.
•Despite the plan’s initial aversion to political risk, Roy places several longshot bets on proposed policy reform results.
•The plan strives too narrowly to ensure that high-deductible health insurance will be the dominant (or, perhaps, exclusive) form of exchange-based coverage and neglects or avoids a number of other reform opportunities. It is also prone to overly optimistic fiscal projections, insufficient details, and ad hoc revisions that fail to hold together.
WASHINGTON, D.C. — Healthcare costs and lack of money or low wages rank as the most important financial problems facing American families, each mentioned by 14% of U.S. adults. Fewer Americans than a year ago cite the high cost of living or unemployment, and the percentage naming oil or gas prices is down from 2012.
Gallup has been asking Americans about the most important financial problem facing their family in an open-ended format for the past 10 years. Healthcare this year has returned to the top of the list for the first time since early 2010, when the Affordable Care Act, or “Obamacare,” was signed into law. Still, Americans viewed it as an even bigger financial problem in 2007, when a range of 16% to 19% said it was most important.
Earlier this month The Foundation for Government Accountability conducted a poll of 500 voters from the November 4th, 2014 general election in the State of Tennessee and found that when they know the facts about expansion, they do not support it in the Volunteer State.
When respondents were told that proposed Medicaid expansion is paid for with $716 billion in cuts to seniors on Medicare, nearly 80 percent of poll respondents were less likely to support Medicaid expansion.
By Avik Roy On March 4, the Supreme Court will hear oral arguments in King v. Burwell, the case that many pundits claim will “blow up Obamacare.” That’s an exaggeration; whatever the High Court decides, Obamacare will remain entrenched in federal law. But if the Supremes do end up ruling against the Obama administration—a distinct possibility—they will be giving Congress a uniquely important opportunity to reshape the Affordable Care Act in far-reaching ways. Here’s how that could work.
New York Times correspondent Abby Goodnough asks if the latest legal challenges to ObamaCare are signaling a divide within the party or are Republicans still recovering from getting burned when the ACA went to the Supreme Court last time?”
About 5 million middle-income people in 36 states currently are receiving subsidies for health insurance through the federal exchanges. Since 87 percent of them are receiving subsidies to purchase coverage, many likely would no longer be able to afford coverage.
Ms. Goodenough reports that after the health overhaul law was passed in 2010, Republicans on both the state and federal level spoke with one voice flatly rejecting ObamaCare. However, in the years following ObamaCare’s passage while the majority of governor’s still remain critical of the law, nine governors have expanded their Medicaid programs and four more governors are considering Medicaid expansion this year at the urging of hospitals and business groups.
In the past months, a number of conservative groups and political leaders have filed Amicus briefs in the King vs. Burwell challenge that will be heard by the Supreme Court on March 4. As a result, Ms. Goodenough reports that new attention is being drawn to the divisions within the Republican Party over the law. . Almost two dozen briefs were filed on behalf of the plaintiffs in the King case, but she says “shockingly few state officials” signed on.
One of the few exceptions was the Amicus brief filed by the Galen Institute which had 19 Republican state legislators in Tennessee and two in Ohio join. Other notable briefs include one filed by six Republican state attorneys general- in Alabama, Georgia, Nebraska, Oklahoma, South Carolina and West Virginia. Divides in the party can be seen within states like Florida where Senator Marco Rubio who signed a brief with 14 members of Congress, but Florida’s Republican Attorney General, Pam Bondi, did not join in the States brief.
By Kimberly Leonard
Grace Brewer says she never thought she would be without health insurance at this stage of her life. “I’m a casualty of Obamacare,” says Brewer, 60, a self-employed chiropractor in the Kansas City, Kansas, area.
She wanted to keep the catastrophic health insurance plan she once had, which she says fit her needs. But under the Affordable Care Act, the government’s health care reform law, the plan was discontinued because it did not comply with the law’s requirements, and her bills doubled to more than $400 a month. “I wanted a minimal plan and I’m not allowed to have it,” she says. “That seems like an encroachment on my freedom.”
By Tevi Troy
The Affordable Care Act, otherwise known as ObamaCare, has had a tough run of it since being signed into law nearly five years ago. It has faced constitutional challenges, voters ousting congressional Democrats who supported it, and the disastrous rollout of its federal website in October 2013. This past fall, supporters launched a public-relations campaign dedicated to the proposition that things were finally going well for ObamaCare’s 7 million sign-ups, but their campaign was derailed when the Obama administration admitted that it had added 400,000 dental patients to the roster of health-insurance enrollees to falsely claim it had reached the 7 million number.
By Grace-Marie Turner
The Internal Revenue Service usurped its authority and overturned longstanding norms of federalism in ruling that health insurance subsidies could be available through federally-created exchanges, the Galen Institute and state legislators argued in an Amicus brief submitted Monday in the pending King v. Burwell lawsuit.
The U.S. Supreme Court will hear arguments in the case on March 4, and a decision is likely by June.
The Department of Health and Human Services (HHS) is looking for vendors to run its “National Data Warehouse,” a database for “capturing, aggregating, and analyzing information” related to beneficiary and customer experiences with Medicare and the federal Obamacare marketplaces. Although the database primarily consists of quality control metrics related to individuals’ interactions with customer service, potential contractors are to “[d]emonstrate … experience with scalability and security in protecting data and information with customer, person-sensitive information including Personal Health Information and Personally Identifiable information (personal health records, etc.).” Vendors are also instructed that one of the requirements of a possible future contract would be “[e]nsuring that all products developed and delivered adhere to Health Insurance Portability and Accountability Act (HIPAA) compliance standards.”
The new Republican Congress may not be able to repeal and replace Obamacare entirely, but it could make substantial progress by targeting the health law’s key structural components.
This November’s electoral wave reopened and widened the strategic playing field for critics of the Affordable Care Act (ACA). Republican control of both houses of Congress, plus larger majorities of state governors and state legislatures present both opportunities and challenges to move beyond rhetorical opposition and advance changes in national health policy. Initial speculation tends to focus more on tactical considerations on Capitol Hill: which items are easiest to pass in the Senate, how to use budget reconciliation, and which votes will “look good” politically even if vetoed by President Obama.