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…

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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),…

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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…

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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…

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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…

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In this issue of JAMA, Emanuel and colleagues propose an Affordability Index to measure the ability of the average US household to pay for its medical expenses. As the authors point out, standard economic measures used to track health spending do not adequately represent the effect of rising costs on families. Emanuel and colleagues correctly observe that aggregated…

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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…

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The CMS has finalized a proposed rule to exempt more small providers from complying with MACRA. It also reversed course on plans to give providers a pass on gauging whether they are cutting costs under the Merit-based Incentive Payment System, or MIPS. Physician practices with less than $90,000 in Medicare revenue or fewer than 200…

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The Affordable Care Act is failing. Focused on shrinking the uninsured population, the law expanded government insurance programs and imposed considerable federal authority over U.S. health care via new mandates, regulations, and taxes. The harmful impacts of this ill-conceived approach should now be clear: Insurance premiums have skyrocketed even as deductibles rose; consumer choice on…

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The upside of the failure of the Senate to pass any semblance of repealing and reforming the ACA is that it highlights three structural impediments to achieving not only health care insurance reform, but most of the Trump agenda as well: 1) Congress must realign its interests with voters’ interests; 2) The Senate must eliminate…

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