With time running out for the Obama administration to prove the success of the Affordable Care Act, officials are aggressively targeting a group that could help turn things around: young people.

Federal health officials announced Tuesday they will comb tax records to find 18-34 year-olds who paid the penalty stipulated under President Barack Obama’s health act for not buying health insurance and reach out to them directly with emails to urge them to avoid even higher penalties scheduled for this year. They also plan to heavily advertise the enrollment campaign, including a promotion with trendy ride-sharing service Lyft to offer discounted rides to enrollment events.

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Paul Ryan has gotten his often fractious House Republicans to endorse an outline of a plan to replace Obamacare, although not yet an actual piece of legislation. While the outline contains many of the health policies conservatives sought even before Obamacare, those policies may have particular appeal against the backdrop of the health-care system Obamacare has created.

In the past Republicans have argued about how to reform tax policy on health care: Should employer-provided coverage remain untaxed, or should this tax break end? Should people without access to such coverage get a tax credit or a tax deduction? The House plan lets the tax break stay — avoiding the political disaster that a less compromising free-market plan would have courted — but trims it for the most expensive plans.

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House Republicans have estimates from the Congressional Budget Office on how their health care plan, released Wednesday, would affect the federal deficit. They’re just not releasing them.

The 37-page white paper doesn’t include cost and savings estimates, according to a senior GOP aide, because Republicans may want to break up the plan into smaller bills and some of the numbers depend on major decisions yet to be made.

Health analysts say there’s another reason for not offering estimates — it keeps Republicans from publicly making tough decisions about tradeoffs between cost savings and coverage. These decisions could open them up to harsh criticism from Democrats and would likely divide members of the GOP caucus itself.

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Minnesota’s largest health insurer, Blue Cross and Blue Shield of Minnesota, has decided to stop selling health plans to individuals and families in Minnesota starting next year.

The insurance carrier’s parent company, which goes by the same name, will continue to sell a much more limited offering on the individual market through its Blue Plus HMO.

The insurer explained extraordinary financial losses drove the decision.

“Based on current medical claim trends, Blue Cross is projecting a total loss of more than $500 million in the individual [health plan] segment over three years,” BCBSM said in a statement.

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ObamaCare officials are partnering with the IRS to help drive down uninsured rates among young people.

For the first time, the federal tax agency is working with the Department of Health and Human Services (HHS) to reach out directly to taxpayers who paid the required fee last year because they lacked coverage.

About 45 percent of people who paid the fee — or claimed an exemption, like financial hardship — were under 35, according to HHS.
The planned mailings will lay out options for coverage and include details about how to qualify for federal subsidies. HHS will also again partner with the ride-hailing service Lyft, which will offer discounts to customers who attend open enrollment sessions.

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Is the new House Republican plan to replace Obamacare politically viable? Two factors weigh in the plan’s favor: First, after the administration sold Obamacare as a program for middle-class families who were anxious about losing their coverage if something went wrong, Democrats delivered a plan that made a lot of middle-class families worse off, and few of them better off. Second, the continuing problems in the insurance exchanges mean we remain at risk of seeing the number of uninsured start to march back upward, as unsubsidized consumers start to drop their high-priced, high-deductible, narrow-network insurance.

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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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A House Republican alternative to Obamacare is coming this week, and some reports suggest it will include a refundable tax credit to subsidize health insurance. This would present some tough political and policy choices about whether and how to pay for a new program of tax credits.

Changing the tax treatment of employer-provided health insurance could provide one of the largest potential sources of financing for a new refundable credit. It also would bring hefty trade-offs. On the political side, capping the deductibility of employer-based health plans to finance refundable credits that are considered government spending would not please some Republicans. Put another way: Repealing Obamacare’s tax increases to replace them with other revenue increases is unlikely to go over well with conservative voters.

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Democrats should push for universal health coverage ahead of the November election, several health care advocates urged the committee drafting the Democratic National Committee’s platform at a recent session focused on health policy.

Their liberal health care proposals echo a similar theme from an environment-themed session the same day, in which activists criticized DNC members for not pushing harder on climate change.

The hearing was part of a series of regional events held by the Democratic Platform Drafting Committee “designed to engage every voice in the party.”

Too many people are still uninsured six years after the passage of the Affordable Care Act, said many of the advocates who spoke before the committee in Phoenix on Friday. Still more are underinsured, they said, and people are struggling to pay for rising premiums and to afford prescription drugs.

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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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