What are the prospects for action on the Affordable Care Act (ACA) during the next Congress and presidential administration? There is no easy answer to that question in this unusual election year, although one’s first reaction might be “not much.” As Larry Leavitt, MPP, noted in the JAMA Forum recently, the presidential platforms suggest fundamentally different, maybe even irreconcilable, approaches.
At the risk of being proven wrong, it also seems reasonable to assume that there will continue to be a political standoff in practice next year, with neither party able to push through its preferred solutions for health care.
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The latest data from the Centers for Disease Control suggests that the number of uninsured has declined roughly 22 million since 2013, and 17.8 million since 2010 (darn you, financial crisis!). And today we got data from the Census Bureau, which suggests that the number of uninsured people has fallen from 13.3 percent to 9.1 percent since 2013, or by about 12.8 million. There are other surveys too. But we hardly need more numbers.
How can everyone get such different answers? Well, for one thing, methodologies differ.
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Obamacare used the law’s vast authority to get control over the design and composition of health benefits. Clintoncare will try to use these same administrative riggings to get power over the pricing of these products and services. To rescue President Obama’s struggling health-care law, Hillary Clinton has proposed resurrecting the “public option.” This failed idea—a government-run health-care plan to compete with private insurers—can’t save Obamacare. But introducing it across the country would move the U.S. much closer to the single-payer system progressives have always longed for.
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This week, the Georgia Chamber of Commerce released a new plan to impose more of Obamacare on their state. The Chamber acknowledged that their “guiding principle” in crafting the Medicaid expansion plan was simply to “take advantage of all federal dollars available.” As such, they’re lobbying for policymakers to expand Medicaid to a new welfare class of more than 700,000 able-bodied adults.
Although the “plan” has few details – so far it consists solely of two PowerPoint slides – one thing is certain: it will be a more costly way to expand Obamacare that combines some of the most expensive aspects of other expansion plans from around the country.
Five Senators are questioning Aetna’s decision to retreat from nearly a dozen Obamacare markets next year and how the decision is tied to the federal government’s attempt to block its proposed merger with Humana, which is being challenged by a Department of Justice antitrust lawsuit.
Sens. Elizabeth Warren (D-Mass.), Bernie Sanders (I-Vt.), Ed Markey (D-Mass.), Sherrod Brown (D-Ohio) and Bill Nelson (D-Fla.) sent a letter to Aetna CEO Mark Bertolini Thursday questioning the insurers’ change in perspective about its participation in the Obamacare exchanges this summer after the Department of Justice sued to block the proposed merger.
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Just over 50 percent of Americans disapprove of the Affordable Care Act, according to a Gallup poll released Thursday.
Among people surveyed in the poll, 51 percent said they disapproved of the law, while 44 percent said they approved of it. It’s a slight increase in disapproval of the law since the spring, when a Gallup poll found 49 percent of people disapproved of the law and 47 percent of people approved of it. Overall, Gallup polls have found people have been more pessimistic than optimistic about the law for the past three years.
Significant spikes in premiums, insurer dropouts and persistently low enrollment numbers are combining to make this fall’s sign-up period a crossroads for the Obama administration’s signature health law. Federal officials characterize the turbulence as temporary. At the same time, the administration is making a push in its final months to shore up the law by trying to sign up healthy people who are critical to the law’s sustainability but have so far rejected insurance. That push will take place against a backdrop of elections that will shape the law’s future.
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President Obama and his Democratic allies are seizing on the exodus of private insurers from ObamaCare markets to renew their push for a so-called “public option” — but Republicans say more “government intervention” is not the answer to the latest Affordable Care Act woes.
A public option — or insurance plan offered by the government — had been written into early versions of the bill but failed to make the final cut in the law signed by Obama in March 2010.
But with many states seeing private insurers exit ObamaCare markets amid concerns over cost and other factors, Democrats see a silver lining to what critics are calling another ObamaCare crisis — a reason to bring the option back.
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In its quest to remake the nation’s health care system, the Obama administration has urged doctors and hospitals to band together to improve care and cut costs, using a model devised by researchers at Dartmouth College.
But Dartmouth itself, facing mounting financial losses in the federal program, has dropped out, raising questions about the future of the new entities known as accountable care organizations, created under the Affordable Care Act.
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The Chicago Tribune editorial board lays out a succinct explanation of why the Affordable Care Act is failing: The law hasn’t tamed U.S. medical costs, the penalties for going uncovered are low compared to skyrocketing premiums, the law has straitjacketed insurers into providing soup-to-nuts policies, and too many carriers simply can’t cover expenses, let alone turn a profit, in such a rigidly controlled system. Is Obamacare plunging in a so-called insurance death spiral? Is the market so unstable that plans are doomed to get more and more expensive, driving more Americans and more insurers out of the market until Obamacare thuds to the pavement? The next president and Congress need to reckon with Obamacare’s failures or wait for the thud.
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