Standing in front of Air Force One in Cincinnati with two small-business owners, President Trump recounted how they “have had their lives completely upended by the disaster known as Obamacare.” One saw her choice of doctors shrink while her premiums and out-of-pocket costs soared, he said. The other has curtailed new investments in his company to maintain employees’ health benefits. The president’s comments came following a White House visit with GOP congressional leaders in which the president said he was confident Senate Majority Leader Mitch McConnell (R., Ky.) could “get a bill across the finish line this summer” that would overturn much of the 2010 health law and enact Republican measures in its place.

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The Congressional Budget Office is not politically biased. But its work is beset by challenges that run much deeper than that: They are structural, and require us to think about both the CBO and the larger congressional budget process in which it plays a part in terms of institutional reform. When legislation is built around eccentricities in the CBO model, as Obamacare was in some key respects, the CBO finds itself confronted with some very strange problems. One is the tendency of the CBO to model competition as having minimal effect on costs while modeling price controls to be efficient and effective. Competition is obviously much more difficult to model than mandates and price controls, but the agency’s experience with Medicare Advantage and the Medicare prescription-drug benefit suggests that it tends to significantly understate the effects of competition — which obviously has consequences for its scoring of reforms intended to increase the market orientation of the health-care system.
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Senate Republicans are struggling to agree on health reform, and the biggest divide concerns Medicaid. The problem is that too many seem to accept the liberal line that reform inevitably means kicking Americans off government coverage.

This narrative serves the liberal goal of scaring the public to preserve ObamaCare, but center-right and even liberal states have spent more than a decade improving a program originally meant for poor women and children and the disabled. Even as ObamaCare changed Medicaid and exploded enrollment, these reforms are working, and the House bill is designed to encourage other states to follow.

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One of the nation’s biggest health insurers says it will not return to Ohio’s public insurance exchanges next year, a decision that could open more holes in the Affordable Care Act’s increasingly thin system for helping people buy coverage.

The move announced Tuesday by Anthem could leave shoppers in 20 counties without an option for buying individual coverage on the exchange unless another insurer steps in.

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Boosting enrollment is also important for stabilizing the individual insurance market. Currently, under the ACA, the markets are less stable than they could be, or should be, because there are too few younger and healthier enrollees. Automatic enrollment would boost enrollment into insurance among this group of potential customers, and thus help create a more balanced risk pool.

We believe that automatically enrolling Americans eligible for tax credits into no-premium health plans should be an important component of a renewed effort at health reform. Many of the uninsured who do not make plan selections on their own can be enrolled into plans that provide true insurance against significant or catastrophic health events.

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According to Robert Wood Johnson Foundation data that looks at state markets where all insurers must sell plans that meet Obamacare standards, regardless of how they’re purchased, more than half of the 22 million people who buy their own insurance use Obamacare marketplaces, where most of them get a federal tax credit to help pay for coverage. The rest buy directly from an insurer or broker, and they do not get a tax credit. Supporters of the Affordable Care Act hoped the law would spur more competition among insurers across the country. But so far, the law has not delivered on that promise, especially in states that never had much competition. Even before Obamacare, there have always been two distinct markets: states that still have plenty of competition and states that rely heavily on one or two insurers. In 15 states, eight or more insurers offer Obamacare plans. They are mostly the same ones where no single insurer had a dominant share of the market in 2013, before the law was enacted. But the 19 states that currently have fewer than five carriers statewide are all ones where a single insurer had more than half of the overall market before Obamacare.

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In a new book aimed at anyone who wants to have the knowledge to evaluate what people are saying in the state and national health care debates, nationally known health policy expert Greg Scandlen provides clear, concise, common sense explanations of why generally accepted health policy ideas fail the reality test. A good guide to separating fact from fiction in the ideological battleground of US health care policy, Myth Busters: Why Health Reform Always Goes Awry provides the basic information needed to evaluate policy proposals and a useful roadmap for unwinding the policy mistakes of the past.

The book covers 30 health care myths, ideas widely believed to be true even though they are false. Unfortunately, these myths underlie the policy initiatives at the root of the last 50 years of US health care reform failure.

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Hundreds of miles from the health care debate that will begin again this week in Congress, lobstermen here are out in force, bees are furiously pollinating the state’s famous blueberries and part-time workers are preparing for another summer tourist season.

As a result of their short-term spike in income, many of Maine’s working class will likely lose some or all of their health insurance subsidy, a feature of the federal health care law, which has been a complicated blessing for the citizens of Maine.

Senator Susan Collins, Republican of Maine, has spent a lot of time thinking about how to deal with these “subsidy cliffs,” even as her party’s leaders press for the wholesale repeal of the Affordable Care Act, President Barack Obama’s signature domestic achievement.

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Sen. Bill Cassidy got cheers on late-night television for calling for an Obamacare replacement plan that would pass what he calls “the Jimmy Kimmel test” — that is, cover children like the comedian’s son recently born with a congenital heart defect.

To hear him tell it, he’s the one in Congress fighting to keep President Donald Trump’s promises to his base. On the campaign trail, Cassidy argues that Trump consistently promised a health care plan that would reduce premiums, eliminate mandates, ensure continuous coverage and protect people with pre-existing conditions. Any GOP plan, he says, needs to meet that bar.

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President Trump’s recent 2018 budget proposal, which includes roughly $800 billion in cuts to Medicaid over the next decade, has led to howls of outrage from Democrats.

Senate Minority Leader Chuck Schumer, D-N.Y., said last week that the cuts would “carry a staggering human cost.” Sen. Bernie Sanders, I-Vt. has called them “just cruel.”

Medicaid’s defenders claim that it’s a bargain for patients and taxpayers alike. As Sen. Schumer put it, “Medicaid has always benefitted the poor. That’s a good thing.” A recent issue brief from the Kaiser Family Foundation, meanwhile, concludes, “Medicaid is cost-effective.”

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