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.

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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.

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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.
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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.

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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.
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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.
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The Trump executive order calls for broadening the definition of a “bona fide group or association” to allow a greater number of small employers that are members of local chambers of commerce or a national trade association to form fully insured “large group” or self-insured “group” association health plans.Association health plans are by definition required to provide adequate coverage, and additional federal protections apply, including fiduciary responsibilities, a rigorous appeals process, and prohibitions against basing premium rates on an individual participant’s health condition.

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In the Wall Street Journal, Sens. Lamar Alexander (R-TN) and Mike Rounds (R-SD) write that their bipartisan bill is the short-term solution to reduce health-insurance premiums and avoid chaos in the individual market so 18 million Americans won’t be hurt. After eight years of ObamaCare speeches and votes but zero legislative victories, they argue that their bill actually could make conservative ideas law. It would permanently roll back some restrictions on states and allow anyone to buy a lower-cost catastrophic plan. To achieve these conservative victories, cost-sharing reduction payments should be expanded for two more years.
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Republicans should focus on revisions and improvements to the state-innovation-waiver provision in the A.C.A. As part of that provision, Section 1332 allows states to receive federal financial support in a lump sum and to waive or revise many of Obamacare’s most noteworthy provisions, including its mandates, the structure and administration of subsidies provided by it, and covered benefits. In return for this flexibility, states must certify that the changes will still result in coverage that is as comprehensive, affordable and widespread as that provided for under the law.

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