Dr. Ezekiel Emanuel, recently described in the Chicago Tribune as “a trusted ally of former President Barack Obama and chief architect of the Affordable Care Act” has proposed in this week’s Journal of the American Medical Association (JAMA) a new “Affordability Index” to measure trends in the affordability of employer-provided health coverage.  Tracking the affordability of employer-sponsored insurance (which I will shorthand as ESI) is certainly worthwhile and important given that over half of the nation’s population relies on such coverage.

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Californians better get comfortable. The wait time to see a doctor in the Golden State may be about to skyrocket.

Last week, California Assembly Speaker Anthony Rendon and a select committee of representatives held two days of hearings in Sacramento on Senate Bill 562 — the Healthy California Act — which promises to enroll all Californians in a government-run, single-payer healthcare system.

The controversial bill passed the state Senate on June 1. But Speaker Rendon “parked” it because he said it did not give enough details on cost and coverage. The California Nurses Association is pushing hard for the Assembly to pass the bill early next year. It is unclear whether Governor Brown would sign it.

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Conservatives are attempting to revive efforts to gut Obamacare’s individual mandate as part of the Republican overhaul of the tax code.

But the House’s top tax writer, while leaving the door open to a measure President Donald Trump supports, said Friday that such a move would complicate the tax package’s prospects, particularly in the Senate.

“The president feels very strongly about including this at some step before the final process,” House Ways and Means Chairman Kevin Brady said of mandate repeal during a POLITICO Playbook interview. “No decisions have been made.”

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President Trump recently tweeted that GOP tax-writers should include a repeal of the Affordable Care Act’s individual mandate in their tax reform legislation. This is a singularly bad idea that most Republicans are likely to reject. (Senators Tom Cotton and Rand Paul are exceptions, having seconded Trump’s suggestion.) It would be irrational and unproductive at this point to import the fractious political combat associated with health-care reform into tax negotiations that are already loaded with controversies.

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Republicans are looking under every seat cushion to finance tax cuts and the political bribes that Members of Congress are demanding for their votes. One surprising potential “pay for,” believe it or not, would be repealing ObamaCare’s individual mandate.

The IRS administers the mandate, which ObamaCare euphemistically dubbed an “individual responsibility payment.” But Chief Justice John Roberts called it a tax to declare it constitutional, so a policy and fiscal nexus exists.

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Although a median-income US family of four with employer-based health insurance saw its gross annual income increase from $76,000 in 1999 to $99,000 in 2009 (in current dollars), this gain was largely offset by increased spending to pay for health care. Monthly spending increases occurred in the family’s health insurance premiums (from $490 to $1,115), out-of-pocket health spending (from $135 to $235), and taxes devoted to health care (from $345 to $440). After accounting for price increases in other goods and services, the family had $95 more in monthly income to devote to nonhealth spending in 2009 than in 1999. By contrast, had the rate of health care cost growth not exceeded general inflation, the family would have had $545 more per month instead of $95—a difference of nearly $5,400 per year. Even the $95 gain was artificial, because tax collections in 2009 were insufficient to cover actual increases in federal health spending. As a result, we argue, the burdens imposed on all payers by steadily rising health care spending can no longer be ignored.

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The Maryland Health Care Commission has launched a new online pricing tool that allows state residents to compare the costs of several common procedures.

The “Wear the Cost” initiative provides prices from hospitals in the state for hip replacements, knee replacements, hysterectomies and vaginal births. The calculations are based on commercial insurer data from 2014 and 2015. Development support on the project was provided by the Altarum Institute.

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The Trump administration has prepared an executive order that would unravel Obamacare’s individual mandate, but has put it on hold to see whether it might be included in the Republican tax bill instead, a GOP senator told the Washington Examiner.

According to the senator, an executive order is sitting with the Office of Management and Budget waiting for approval. President Trump decided to delay the executive order after Sen. Tom Cotton, R-Ark., pushed for the inclusion of the individual mandate repeal in the tax bill, and has been supportive of its inclusion in statements he has made on Twitter.

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House Speaker Paul Ryan said he was confident the House would pass the GOP’s tax reform legislation before its self-imposed Thanksgiving deadline, adding a repeal of Obamacare’s individual mandate could still be included in the final version of the proposal.

“Yes, we are on track for moving this through the House before Thanksgiving, that’s our plan,” Ryan told “Fox News Sunday” in an interview taped Friday. “We expect our friends in the Senate to be about a week behind us.”

Ryan said doing away with the controversial individual mandate measure in the Affordable Care Act was still on the negotiation table among House Republicans.

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It is generally assumed that the biggest obstacle to a national health plan like Medicare for All will be the large tax increase needed to pay for it. But new polling shows another challenge: Almost half of the American people don’t know that they would have to change their current health insurance arrangements if there was a single-payer plan.

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