Legislation to expand Medicaid in Virginia failed Thursday after a state Senate panel voted on party lines to defeat the measure.

The state’s Education and Health Committee voted down the bill 8-7. The bill can be brought up at another time, but if the committee doesn’t take further action, the bill is dead.

The bill, sponsored by state Sen. Emmett Hanger (R), would have directed the state’s secretary of Health and Human Resources to submit a Medicaid expansion waiver to the federal government.

. . .

  • Health care is at the top of a group of issues that voters want 2018 midterm candidates to talk about, but it’s a much higher priority for Democratic voters (39 percent) and independent voters (32 percent) than Republican voters (13 percent); and a lower priority than other issues among voters living in areas where there are competitive 2018 House, Senate, or Governor races.

. . .

GOP leaders from both chambers of Congress want reinsurance. But they want it in different ways.

And with two different Republican measures on the table, each handling the mechanics differently, the big question is: Which one will win out if congressional Republicans go through with their plan to address stabilization in an upcoming spending bill.

. . .

The less-explored question involves why Obamacare’s overall combination of taxpayer subsidies, expanded insurance programs, health benefits requirements, AND coverage mandates had so much less of an effect than the law’s architects envisioned.

It turns out that many of the nominally uninsured still have other alternatives to health care than just through heavily-subsidized Medicaid and exchange-based insurance. You might call such uncompensated care either an option for “implicit insurance” or a hidden tax on acquiring more formal coverage.

Health policy researchers Amy Finkelstein, Neale Mahonem and Matthew Nolowidigdo unravel the puzzle in a recent National Bureau of Economic Research paper. They explain why there is less “demand” than expected for the increased “supply” of subsidized coverage for lower income individuals and more limited take up of subsidized coverage than once predicted.

. . .

Republicans in Congress and the Trump administration failed to fulfill their commitment to repeal and replace the Affordable Care Act (ACA) in 2017, but they did succeed in repealing the tax penalties enforcing the law’s individual mandate, starting in 2019.

The GOP still might try again to fully repeal and replace the ACA in 2018, perhaps with a modified version of the Graham-Cassidy legislation. However, with Republicans now down to a 51-seat majority in the Senate and some House and Senate members facing difficult mid-term elections this November, it will be even more challenging to get a sweeping rollback of the ACA through Congress in 2018 than it was in 2017.

. . .

Democrats and activists fought off Obamacare repeal last year by stoking public outrage and stirring protests. Now they want to make the health law the defining issue in 2018 races at the congressional, state and local levels. The grassroots groups at the forefront of the Obamacare fight are expanding their focus to rally opposition to virtually all Republican efforts to alter the health care system, hoping to capitalize on the backlash to repeal and turn it into a wave of victories come November.

. . .

Concerned about soaring health care costs, Idaho on Wednesday revealed a plan that will allow insurance companies to sell cheap policies that ditch key provisions of the Affordable Care Act.

It’s believed to be the first state to take formal steps without prior federal approval for creating policies that do not comply with the Obama-era health care law. Health care experts say the move is legally dubious, a concern supported by internal records obtained by The Associated Press.

. . .

The Trump administration is exploring ways to allow more Americans toqualify for exemptions from the Affordable Care Act’s individual mandate, which goes away in 2019 but is still in effect this year. The Centers for Medicare and Medicaid Services is reportedly working on guidance that would expand “hardship” exemptions from the mandate that would apply this year, meaning they could be cited by filers preparing their 2018 taxes next year.

. . .

 

Thousands of Medicaid recipients in Mississippi would be required to work to be eligible for the program if the Trump administration approves a controversial state waiver request that recently opened for public comment.

The proposal is likely to set off a firestorm of criticism from Democrats and health advocates, who argue that work requirements, combined with Mississippi’s strict Medicaid eligibility requirements, will result in thousands of people losing their coverage.

. . .

Sen. Ted Cruz, R-Texas, on Wednesday said Republicans needed to “finish the job” on repealing and replacing Obamacare in 2018, and he is pushing his colleagues to use one last reconciliation bill before the midterms to deliver on their long-running promise.

In a meeting with the Washington Examiner in his Senate offices, Cruz said he has had long conversations with the Republican senators who blocked legislation last time around, and still thinks they can get something across the finish line. He also said there has been talk of asking the Congressional Budget Office to rescore repeal legislation now that the individual mandate is off the books, which is expected to drive down the CBO’s estimate of the number of individuals who would be uninsured under Republican legislation.

. . .