The Senate proposal wouldn’t cut Medicaid spending in real dollars — spending would continue to grow — but it would slow the rate of spending for the program, phase out extra money the federal government has given to states that expanded Medicaid under the Affordable Care Act (also known as Obamacare) and leave states to…

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Health insurance cannot really be insurance because human health is un-insurable: human beings are not machines or buildings whose function or condition can be ascertained objectively. Yet, an objective assessment of damages and costs is essential for any contractual arrangement to function in a sustainable manner. Consider, for example, that medical care is based on…

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If we want to make headway on improving public policy discourse, a good place to start might be with how we’re debating Medicaid policy, in particular how it might be affected by pending legislation to repeal and replace the Affordable Care Act (ACA), including legislation presented on Thursday by Senate Republicans. Medicaid has long been…

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The Senate bill is the product of a decision not to repeal Obamacare but to improve things where possible—moving incrementally in the direction of a more functional and more market-oriented system—within the framework Obamacare established.

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The House bill contained a fatal flaw. Its flat tax credits would price millions of near-elderly low-income workers out of the insurance market and trap millions more in poverty. Fortunately, buried in the House bill was a way out. Section 202 of the bill contains a transitional schedule of tax credits that was meant to…

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Senate Republicans released their draft bill to repeal and replace ObamaCare on Thursday, and Majority Leader Mitch McConnell is hoping for a vote next week. The binary choice now is between pushing past the media and Democratic flak to pass a historic achievement, or wilting under the pressure and ratifying the ObamaCare status quo. The…

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Senate aides expect that Majority Leader Mitch McConnell (R., Ky.) will bring the health bill as soon as Tuesday, shortly after the Congressional Budget Office has scored the bill. Both chambers have to pass the exact same bill, and there are a few ways for that to happen. The quickest option would be for the…

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The new Senate bill  1) Reduces the number of people eligible for subsidies, reduces the values of the premium subsidies, and lowers the cap on total subsidy expenditure;  2) Eliminates the individual and employer mandates;  3) Restricts coverage for abortion;  3) Ends the cost-sharing reductions — but not before paying insurers back for the money they’ve already laid out;  4) Gives…

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Any legislation that clears Congress under the repeal and replace banner needs to do four things: It needs to rescue millions of people in ACA exchange plans now who are at risk of losing their coverage because of ObamaCare’s multiple failures. It must provide states more flexibility in managing their Medicaid programs so they can…

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Health care legislating ain’t pretty. In many cases, it’s downright coyote ugly. Particularly in the absence of a coherent and consistent majority in favor of substantially revising the status quo. Hence, today’s Senate Republican leadership “discussion draft” bill. To be fair, leaders can’t go where they don’t have enough followers. So a good bit of…

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