Due to the inexorable aging of the country—and equally unstoppable growth in medical spending—it was long obvious that health-care jobs would slowly take up more and more of the economy. But in the last quarter, for the first time in history, health care has surpassed manufacturing and retail, the most significant job engines of the 20th century, to become the largest source of jobs in the U.S.

In 2000, there were 7 million more workers in manufacturing than in health care. At the beginning of the Great Recession, there were 2.4 million more workers in retail than health care. In 2017, health care surpassed both.

. . .

The Trump Administration is on a mission to rescue health-care markets and consumers from ObamaCare’s shrinking choices and higher prices. Witness the Labor Department’s proposal to allow small businesses to band together to provide insurance on equal footing with corporations and unions.

The share of workers at small businesses with employer-sponsored health benefits has dropped by a quarter since 2010 as insurance costs have ballooned in part due to government mandates. About 11 million workers employed by small businesses are uninsured. Some businesses have dropped their workers onto state insurance exchanges where premiums are subsidized by taxpayers.

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The skyrocketing cost of insurance and diminishing plan choices have driven Americans away from the marketplaces — not presidential malfeasance.

Even before open enrollment started November 1, Obamacare’s proponents tried to lower the public’s expectations and shift blame for the coming drop in enrollees. They predicted that President Trump’s decision to cut Obamacare’s advertising and outreach budget from $100 million to $10 million — as well as his decision to shorten the open enrollment period from 12 to six weeks — would lead to lower enrollment.

The truth is, the administration’s gymnastics have little impact on whether people purchase coverage. Those decisions are dictated by simple things like the price of a plan and how much they value the benefits it provides.

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State lawmakers in Maryland are looking to replace ObamaCare’s individual mandate, which was repealed by Republicans in Congress last month.

A proposal in Maryland would require people to pay a penalty for not having insurance. The money, though, could be used as a down payment for a health insurance plan.

People would also have the option to pay the penalty and get nothing in return.

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The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate.

The CMS cited the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House’s Office of Management and Budget to continue collecting data annually from exchange plans about their enrollees’ risk profiles.

In an earlier version of the request submitted to the executive branch last month, the agency estimated there were 2,400 issuers in the individual and small group markets.

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Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) met Wednesday to discuss the path forward for their bipartisan legislation aimed at stabilizing ObamaCare, aides in both parties said.

The legislation’s future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached.

Murray and other Democrats, though, want significant changes to the bill, saying that it needs to be redone now that Republicans have destabilized health insurance markets by repealing ObamaCare’s individual mandate in the tax-reform bill last month.

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In “Is Obamacare Harming Quality? (Part 1),” Michael Cannon explains that new research shows that Obamacare is not working how it is supposed to work in theory: The law’s preexisting conditions provisions create perverse incentives for insurers to reduce the quality of coverage; those provisions are reducing the quality of coverage relative to employer plans; and the erosion in quality is likely to accelerate in the future. In this post, he explains why regulators cannot fix this problem, and why providing sick patients secure access to quality health care requires allowing consumers to purchase health plans not subject to Obamacare’s preexisting conditions provisions.

. . .

Cannon offers new research showing that Obamacare’s preexisting condition provisions create perverse incentives for insurers to reduce the quality of coverage, reducing the quality of coverage relative to employer plans.  The erosion in quality is likely to accelerate in the future. In a follow-up post, he explains why regulators cannot fix this problem and why providing sick patients secure access to quality health care requires allowing consumers to purchase health plans not subject to Obamacare’s preexisting conditions provisions.

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Congress has no choice but to revisit the issue of health reform, and leaders have the greatest opportunity by tackling Medicaid. In 2016 the federal government spent $42 billion on ObamaCare’s exchanges. It spent $358 billion on Medicaid. States and localities pitched in another $208 billion, for a total national Medicaid expenditure of $566 billion in 2016. The growth in spending on health-care entitlements like Medicaid and Medicare threatens to overwhelm the Treasury, starving the federal government of the funds it needs to pay for everything else, including education, welfare and national defense.

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In a major policy shift that could affect millions of low-income people, the Trump administration said Thursday it is offering a path for states that want to seek work requirements on Medicaid recipients.

Seema Verma, head of the Centers for Medicare and Medicaid Services, said work and community involvement can make a positive difference in people’s lives and in their health.

The administration’s latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on “able-bodied” adults. Technically, those waivers would be “demonstration projects.” In practical terms, they would represent new requirements for beneficiaries in those states.

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