Republican lawmakers crafting alternatives to Obamacare face a fundamental decision: whether to focus on expanding coverage or containing costs. Their choice may be driven, at least in part, by budget scorekeepers.
The Congressional Budget Office released a report in December 2008 on key issues in analyzing major health-care proposals. Included was a chart projecting individuals’ willingness to enroll in health insurance at various levels of subsidy (in technical terms, an elasticity curve). That curve suggested that insurance enrollment would remain below 40% until subsidies reached 70% of cost and that even if costs were 100% subsidized, about a fifth of individuals would decline to enroll. (And that level of subsidy is probably much greater than many Republicans would be willing to offer.)
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Will ObamaCare be a top issue in this fall’s presidential and congressional campaigns? Republicans better make it one if they want to prevail.
The continuing unpopularity of President Obama’s signature domestic achievement gives Republicans an enormous opportunity. Only 39.2% of Americans favor ObamaCare in the Real Clear Politics average of recent polls; nearly half, 48.8%, oppose it. There’s also a sharp partisan divide that benefits the GOP: While 78% of Democrats approve of ObamaCare, according to an April survey from the Pew Research Center, 58% of independents and 89% of Republicans disapprove of it.
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UnitedHealthcare will stop offering Affordable Care Act plans in Illinois in 2017, the Tribune confirmed Tuesday.
The departure of the insurance company will reduce the number of coverage options for consumers in 27 counties.
UnitedHealthcare announced in April that it would pull out of nearly all of the ACA exchanges because of heavier-than-expected losses from covering a population that turned out to be sicker than it expected. The ACA plans, which the company offered in 34 states this year, are a small share of UnitedHealthcare’s total business.
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House Republicans and the Obama administration are clashing over subpoenas for ObamaCare documents. Republicans are upping the pressure on the administration, saying officials are withholding documents that Congress has every right to see.
At issue are two separate portions of ObamaCare. One is the Basic Health Program, which states can choose to implement and is aimed at providing choices for low-income people with slightly too much income to qualify for Medicaid. The other is the law’s “cost-sharing reductions” which are payments that help lower out-of pocket-costs for low-income ObamaCare enrollees.
“Your refusal to provide the requested documents and information raises serious concerns about the Department’s willingness to be accountable for the lawful execution of laws passed by Congress,” Energy and Commerce Chairman Fred Upton and House Ways and Means Chairman Kevin Brady wrote to Health and Human Services Secretary Sylvia Mathews Burwell on Tuesday.
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Fresh problems for “Obamacare”: The largest health insurer in Texas wants to raise its rates on individual policies by an average of nearly 60 percent, a new sign that President Barack Obama’s overhaul hasn’t solved the problem of price spikes.
Texas isn’t alone. Citing financial losses under the health care law, many insurers around the country are requesting bigger premium increases for 2017. That’s to account for lower-than-hoped enrollment, sicker-than-expected customers and problems with the government’s financial backstop for insurance markets.
The national picture will take weeks to fill in. With data available for about half the states, premium increases appear to be sharper, but there are also huge differences between states and among insurers. Health insurance is priced locally.
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Yesterday, the New York Times detailed the highly irregular manner preceding the administration’s decision to make the CSR payments once Congress refused to grant the White House’s request for an appropriation. Despite strong disagreements over the legality of these payments among IRS employees, top political appointees with the administration, including then-Attorney General Eric Holder and Treasury Secretary Jack Lew, signed off.
At a congressional deposition, David Fisher, an IRS financial risk officer at the time, testified that the process behind the authorization of the CSR payments was unusual. Moreover, he testified that the “cost-sharing reduction payments are not linked to the Internal Revenue Code, as far as I could tell, directly anywhere. There is no linkage to the permanent appropriation, nor is there any link to any other appropriation that was indicating what account these funds should be paid from.”
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The not-for-profit insurers that are planned to form the backbone of the Obamacare exchanges, including the Blues health plans, reported yesterday that they lost a lot of money in the first quarter of 2016. It was the same day that United Healthcare announced that it was pulling out entirely from the California exchanges–a state that many Obamacare acolytes held up as a model for the law’s successful execution.
In statutory filings that they posted this month, the not-for-profit health plans showed an average negative net margin of -2.5% during the first quarter of 2016. AIS Health Plan Week revealed the data on 41 not-for-profit plans. Credit Suisse reported on those results in a report issued yesterday. The total net losses among the 41 health plans approached a whopping $1.5 billion for the quarter.
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House Republicans say that the Obama administration is ignoring subpoenas for documents related to ObamaCare spending they call illegal.
“Your refusal to provide the requested documents and information raises serious concerns about the Department’s willingness to be accountable for the lawful execution of laws passed by Congress,” Upton and Brady write to HHS Secretary Sylvia Mathews Burwell.
A federal district judge ruled this month, in a lawsuit brought by House Republicans, that the Obama administration lacks the authority to pay cost-sharing subsidies to health insurers if Congress has not appropriated the funds. Some civil servants in the administration may agree.
The House Ways and Means Committee released a deposition Tuesday of David Fisher, former chief risk officer for the Internal Revenue Service. In it, Mr. Fisher recounts a series of events in late 2013 and early 2014 regarding the source and legality of Obamacare cost-sharing subsidies to insurers.
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