Sen. Bernie Sanders has proposed paying for his policies that transform large sectors of the government and the economy mainly through increased taxes on wealthy Americans. A pair of new studies published Monday suggests Sanders would not come up with enough money using this approach, and that the poor and the middle class would have to pay more than Sanders has projected in order to fund his ideas.
The studies, published jointly by the nonpartisan Tax Policy Center and the Urban Institute in Washington, concludes that Sanders’s plans are short a total of more than $18 trillion over a decade. His programs would cost the federal government about $33 trillion over that period, almost all of which would go toward Sanders’s proposed system of national health insurance. Yet the Democratic presidential candidate has put forward just $15 trillion in new taxes, the authors concluded.
The Obama administration on Friday announced changes to ObamaCare sign-up rules that are intended to cut down on people gaming the system and address a complaint from insurance companies that they say is causing them to lose money.
The Centers for Medicare and Medicaid Services announced that it is tightening the rules for enrolling in one of ObamaCare’s extra sign-up periods.
The CMS unveiled an interim final rule late Friday that could help the Affordable Care Act’s struggling co-op plans. The rule also responds to insurers’ complaints that people are abusing special enrollments in the exchanges.
The CMS tightened the use of special enrollments, specifically making the rules around moving to a new home more restrictive to avoid any gaming of the system. Co-ops also can seek outside funding from investors to build up their capital, something that was outlawed previously.
Using a combination of subsidized premiums for Marketplace coverage, an individual mandate, and expanded Medicaid eligibility, ObamaCare has increased insurance coverage rates. The authors of this study assess the relative contributions to insurance changes of these different provisions in the law’s first full year.
Their four key findings include:
- Insurance coverage was only moderately responsive to price subsidies, but the subsidies were still large enough to raise coverage by almost one percent of the population; the coverage gains were larger in states that operated their own health insurance exchanges (as opposed to using the federal exchange).
- The exemptions and tax penalty structure of the individual mandate had little impact on coverage decisions.
- The law increased Medicaid coverage both among newly eligible populations and those who were previously eligible for Medicaid (the “woodwork” effect), with the latter driven predominantly by states that expanded their programs prior to 2014.
- There was no “crowdout” effect of expanded Medicaid on private insurance. Overall, we conclude that exchange premium subsidies produced roughly 40% of the ACA’s 2014 coverage gains, and Medicaid the other 60%, of which 2/3 occurred among previously-eligible individuals.
Insurers — who might not be allowed the huge rate increases they need to stay solvent — are looking to save money by eliminating so-called Bronze-level plans.
Fierce Health Player reports on an Inside Health Policy (subscription only) warning from earlier this week:
One problem, according to the article, is risk adjustment–as CMS data indicate bronze is the only metal level for which insurers of all sizes in the individual and group markets had to pay into the program. Federal officials are considering some changes to the risk adjustment program, which some say unfairly penalizes smaller insurers.Already, filings show a CareFirst BlueCross BlueShield subsidiary in Virginia will transform its bronze plans into silver-level plans for 2017, according to Inside Health Policy, and experts tell the publication this could set a troubling precedent for the industry.
Iowa’s insurance commissioner filed a lawsuit against the federal government on Tuesday, saying it is withholding $20 million in connection with the liquidation of not-for-profit insurer CoOportunity Health — which failed in December 2014.
“Through the wind down of CoOportunity, we’ve worked collaboratively with the Centers for Medicare and Medicaid Services and the federal government on many issues,” said Insurance Commissioner Nick Gerhart in a news release. “In this instance, we tried diligently to settle our differences with the federal government in extensive discussions over several months, but were informed by the Department of Justice that further negotiations would be futile.”
Gerhart said U.S. Department of Health and Human Services and CMS have “tried to jump to the head of the creditor line,” and are not following Iowa or federal law.
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More Democrats seem to be having doubts about the federal health care law, a contentious issue for most of President Barack Obama’s tenure and one of the defining elements of his legacy.
With the administration counting down its final year, Sen. Bernie Sanders’ call for “Medicare for all” appears to have rekindled aspirations for more ambitious changes beyond “Obamacare.”
That poses a challenge for Hillary Clinton, who has argued that the health care law is working and the nation should build on it, not start over.
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Six years after the introduction of Obamacare, Americans are still divided over the controversial health reform law even though most tend to support many parts of the measure, a new HealthDay/Harris Poll found.
However, none of the current crop of presidential candidates appears to inspire much hope that they’ll properly handle health care policy if elected, the poll results show.
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Nearly 25% of Americans surveyed last September who had coverage through employer plans, the Affordable Care Act exchanges, or individual plans outside the exchanges reported problems paying family medical bills in the previous 12 months, according to the Urban Institute’s Health Reform Monitoring Survey, released last month. That compared with 16% of people on Medicaid and 27.8% of uninsured individuals who said they had problems with medical bills.
The Kaiser Family Foundation reached similar findings through focus group interviews with 91 low-income Medicaid and exchange-plan enrollees in six cities during January and February 2016.
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Insurers are in the process of filing proposed premiums for ACA-compliant nongroup plans that will be available inside and outside of Marketplaces in 2017.
Recent reports by insurers about their experiences during the first two years under the ACA suggest that some assumed that enrollees would be healthier than they turned out to be and set their premiums too low, leading in some cases to significant financial losses for ACA-compliant plans and an expectation that premiums could rise faster in 2017. Some insurers took relatively large premium increases for 2016 to better match premium levels with the costs of their enrollees — which would help to offset the need for 2017 premium increases — but it is too soon to know if these efforts were generally successful or whether losses have continued into 2016.
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