The Oct. 26 editorial “Health-care reform that pays off” unfairly maligned a bill introduced by two committee chairmen as “dismantling major pieces of Obamacare.” It does nothing of the sort.

Like the bill proposed by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) that the editorial praised, a bill from Sen. Orrin Hatch (R-Utah) and Rep. Kevin Brady (R-Tex.) would appropriate money for cost-sharing-reduction subsidies. That’s not nearly enough to provide relief to consumers, who are leaving health-insurance markets in droves. Gallup reported that the uninsurance rate in the third quarter of 2017 reached its highest level since 2014, as the Affordable Care Act makes insurance unaffordable.

. . .

Federal health officials are proposing changes to rules for coverage sold through the ACA’s insurance marketplaces that, starting in 2019, would let states alter the benefits that health plans must provide and limit enrollment help for consumers. In envisioning a larger role for states in setting benefits, the draft rule would still require ACA plans to cover 10 categories of medical services. But for the first time, any state could adopt benefits standards already in use by another state—or rewrite its own standards.

. . .

The Trump administration on Friday proposed new health insurance regulations that could affect basic benefits required by the Affordable Care Act, but not for a couple of years.

Loosening “Obamacare” benefit requirements was a major sticking point for congressional Republicans in thus-far fruitless efforts to repeal the law.

The complex new plan from the administration would give states a potential path to easing some requirements.
. . .

President Trump’s decisions on cost-sharing subsidies have contributed to the law’s rising premiums and the resulting rise in subsidies. But he’s not responsible for all of this. Competition, for example, took a big hit last year — when President Obama was still in charge.

. . .

The Affordable Care Act seems here to stay, including its incentives for health-care industry consolidation. Big Government drives bigger business. The latest evidence is CVS Health Corp.’s mooted $66 billion bid for insurer Aetna Inc., as companies look for ways to make money beyond being regulated utilities.

Data released this week from data.healthcare.gov show that choice in the types of plans available on the Exchanges continued to diminish between 2017 and 2018. There has been diminished choice in the number of insurers and level of competition. In 2017,142 of the 420 rating areas on which data.healthcare.gov maintains information had just one issuer. For 2018, 179 of the rating areas will have just one issuer.

. . .

When the GOP released their “Framework” for tax reform last month, official Washington got excited that they could finally chew on all sorts of wonky tax details. They will get even more excited when the full package is out this week. That’s why it was very disappointing to read that Senate Finance Committee Republicans were considering keeping the death tax in place.

That would be a grievous error.
. . .

It took longer than expected, but the Trump administration finally moved earlier this month to provide broad exemptions to the Obama administration’s notorious HHS contraceptive mandate. The mandate requires employers sponsoring health-insurance plans to cover contraceptives, including some products that induce abortions, for all workers enrolled in their plans. The Trump administration issued two interim final regulations providing ready pathways for employers with religious or moral objections to get out from under the requirement.

. . .

Insurers selling Affordable Care Act plans have a compelling new pitch: free health insurance.

When sales of plans on the law’s exchanges begin Nov. 1, a growing number of consumers around the country will be able to get coverage for 2018 without paying any monthly premium, according to health insurers and an analysis of newly available federal data.

In nearly all of the 2,722 counties included in the data, some consumers will be able to obtain free health insurance because they qualify for larger federal premium subsidies that cover the full cost of a plan, according to the new analysis.
. . .

The Alexander-Murray compromise is a good first attempt at bipartisanship, but it is flawed. Democrats want to fund the cost-sharing reduction subsidies through 2019. If this plan is agreed to, Democrats will have no incentive to continue negotiating until after the 2018 midterms and the GOP would lose its opportunity to make more progress on health care.
. . .