Maine made history earlier this month by becoming the first state to adopt Obamacare’s Medicaid expansion via ballot initiative. The vote could inspire progressive activists in other states to push for similar referenda.

Expanding Medicaid to cover childless, able-bodied adults would blow a hole in state budgets while yielding few, if any, public health gains. That’s because Medicaid provides such low-quality care that its beneficiaries often experience worse health outcomes than people with no health insurance.

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The Affordable Care Act (ACA) set substantial new federal requirements for health insurance plans and the insurers that provide them. These requirements significantly altered the way insurance is regulated, which was traditionally left to the states. The ACA included in Section 1332 the option for states to apply for a waiver from many of these regulations. However, the myriad stipulations tied to these 1332 State Innovation Waivers limit states’ ability to regain control of their own insurance regulations. Further, states have no guarantee they will be granted a waiver, even if they meet all of the ACA’s requirements for obtaining one.

In response to these issues, two Senate committees have introduced (or at least drafted) legislation that would solve many of the problems that states have had obtaining 1332 waivers. In addition to easing some standards and shortening timeframes for decisions, the bills also provide a standard path for states to gain these waivers in certain circumstances.

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Bishop Frank J. Dewane of Venice, Florida, Chairman of the U.S. Bishops’ Committee on Domestic Justice and Human Development, issued a statement in June about a discussion draft of health reform legislation that was then before the Senate, the Better Care Reconciliation Act.  He praised its life protections: “The Bishops value language in the legislation recognizing that abortion is not health care by attempting to prohibit the use of taxpayer funds to pay for abortion or plans that cover it. While questions remain about the provisions and whether they will remain in the final bill, if retained and effective this would correct a flaw in the Affordable Care Act by fully applying the longstanding and widely-supported Hyde amendment protections. Full Hyde protections are essential and must be included in the final bill.”

The leadership in the Senate, the House, and the White House know that any future health reform legislation must contain these strong life protections.

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Voters in Maine approved a ballot measure on Tuesday to allow many more low-income residents to qualify for Medicaid coverage under the Affordable Care Act, The Associated Press said. The vote was a rebuke of Gov. Paul LePage, a Republican who has repeatedly vetoed legislation to expand Medicaid.

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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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Federal health officials are proposing changes to rules for coverage sold through the ACA’s insurance marketplaces that, starting in 2019, would let states alter the benefits that health plans must provide and limit enrollment help for consumers. In envisioning a larger role for states in setting benefits, the draft rule would still require ACA plans to cover 10 categories of medical services. But for the first time, any state could adopt benefits standards already in use by another state—or rewrite its own standards.

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As California health care officials brace themselves for changes to the Affordable Care Act by President Donald Trump and the Republican-controlled Congress, state lawmakers today and Tuesday will hold a hearing examining the gaps in coverage and financing of California’s current system.

Among the topics expected to be front and center is single-payer health care and Senate Bill 562, introduced earlier this year by Senators Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego. That controversial proposal would replace California’s private health insurance market with a single, government-run plan with no premiums or deductibles for nearly 40 million Californians.
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Iowa is abandoning its quest to shed major elements of the Affordable Care Act, after federal health officials failed to approve the plan in time for the insurance-buying season that begins in just over a week. The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal.

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The West Virginia Insurance Commission approved rate increases for Highmark West Virginia and CareSource Insurance’s services sold in the “Obamacare” exchange.

MetroNews learned Tuesday premiums for Highmark West Virginia will increase by 25.6 percent, while CareSource Insurance will have a 19.6-percent increase in its rate.

Eight-five percent of the around 25,000 residents who received health care through the exchange last year received a government subsidy, but those who did not saw a 32-percent increase in monthly premiums.

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The plan Iowa has developed to salvage its insurance market — the Iowa Stopgap Measure — suffers three major flaws.

  1. Although the Iowa Stopgap Measure helps upper middle class Iowans afford health insurance, it illegally deprives poorer Iowans of the ability to make use of health insurance.
  2. The Iowa Stopgap Measure creates effective marginal tax rates of more than 100% on many individuals, particularly those over 50, and excessive effective marginal tax on many others.
  3. Unless there’s more to its fuzzy math than it has heretofore presented, the Iowa plan costs the federal government a good deal of money.

Don’t add rejection of the Iowa waiver to the list of acts of sabotage of the ACA by the Trump administration. This is an instance where the President has faithfully executed the law. And if that law is not working or if the waiver criteria are too strict, it is to Congress that complaint should be made.

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