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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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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Medicaid payments to hospitals and other providers play an important role in these providers’ finances, which can affect beneficiaries’ access to care. Medicaid hospital payments include base payments set by states or health plans and supplemental payments. Estimates of overall Medicaid payment to hospitals as a share of costs vary but range from 90% to 107%. While base Medicaid payments are typically below cost, the use of supplemental payments can increase payments above costs.  Changes related to expanded coverage under the Affordable Care Act as well as other changes related to Medicaid supplemental payments could have important implications for Medicaid payments to hospitals.  This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion as well as payment policy changes on hospital finances.

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Former House Speaker Newt Gingrich remembers the day 23 years ago when Hillary Clinton, notebook in hand, came to see him and other senior Republicans to talk about “Hillarycare.”

It was early 1993. Clinton, on behalf of her husband, then-President Bill Clinton, was leading a healthcare reform drive that vaulted her onto the national stage.

Hillarycare would famously collapse after a fierce debate. In interviews with Reuters, some participants looked back on it as a crucible for the Democratic presidential front-runner that helped shape her approach to politics and governing.

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Next year’s premiums for health coverage under the Affordable Care Act could rise more than in past years in most markets and declines might be rare, according to a preliminary analysis of insurers’ plans.

Overall, premiums for a popular type of plan — the second-lowest silver plan — could rise 10 percent on average next year in 14 major metropolitan areas, according to an analysis released Wednesday by the Kaiser Family Foundation. Kaiser based its projections on insurers’ preliminary rates filed with state regulators, which remain subject to state or federal review. (KHN is an editorially independent program of the foundation.)

Last year, premiums for the second-lowest silver plan in those metro areas rose 5 percent after state insurance departments signed off, Kaiser said.

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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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About 1,000 health care economists from around the country descend on Philadelphia this week for the biennial conference of the American Society of Health Economists.

Think of it as Woodstock for health geeks who will, over several days, present nearly 550 papers covering insurance, hospital mergers and a host of other issues.

Of all those, Obamacare will be the jam that gets played over and over with 78 papers focused on some aspect of the law.

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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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