Sen. Lamar Alexander says he’s more than happy to strike deals with Democrats — even on Obamacare.
“Whoever the president is in January, we’re going to have to take a good, hard look at Obamacare,” the powerful chairman of the Senate HELP committee told POLITICO’s “Pulse Check” podcast. “It can’t continue the way it is.”
Alexander laid out several changes that he’d like to see in health care: Less government “management,” more support of private sector innovation and more flexibility for states on Medicaid. He also credited House Speaker Paul Ryan’s recent white paper that summarized Republican health care proposals as a “helpful” starting point, though he didn’t explicitly endorse the House GOP’s insistence on replacing the whole law.
A new poll of voters in battleground states finds a rare opportunity for bipartisan agreement on healthcare, with Americans strongly favoring action on public policies that support medical discovery into new treatments and cures. The poll was jointly commissioned by the Galen Institute and Center Forward, center-right and center-left think tanks.
Purple Insights interviewed 800 registered voters earlier this month and found that nearly all those surveyed believe it is important for the United States to continue to develop new treatments and cures for diseases and believe these new discoveries are an opportunity to help the United States maintain its competitive edge.
A strong 78% say that fostering policies that support medical innovation should be a top priority for members of Congress and candidates for Congress.
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Ryan’s plan embraces the idea that refundable tax credits can be used to give people universal access to “quality, affordable health care.” It recognizes that we can’t return to the pre-Obamacare status quo, which was too arbitrary, too expensive, and too bureaucratic. It concedes that reforming Medicaid—including Obamacare’s Medicaid expansion—will be a gradual process, requiring a new infusion of federal funds to help cajole states into reforming their own health-care markets (which were hardly free and efficient before Obamacare).
These reforms envision portable, affordable coverage. Routine health expenses would be channeled through Health Savings Accounts. Private exchanges would compete to offer affordable insurance—as they already do for employers. Currently, employers’ spending on health insurance plans is tax-deductible and uncapped—meaning that if organizations want to buy $100,000 health plans and write them off, they can.
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Insurers from Oregon to Pennsylvania, including a failed health-care co-operative and two long-established Blues plans have lost billions of dollars selling Obamacare policies. Now they are suing the federal government to recoup their losses. In a testament to industry desperation, insurers are asking federal judges to simply ignore a congressional ban on the payment of these corporate subsidies.
The regulatory atrocity that is Obamacare inspired this race to the courthouse. Despite billions in subsidies — to both low-income individuals and well-capitalized insurance companies — the industry has incurred big losses in the individual market.
In a paper published June 28 by the Mercatus Center, Brian Blase (Mercatus), Ed Haislmaier (Heritage Foundation), Seth Chandler (University of Houston), and Doug Badger (Galen Institute) used data derived from insurance-company regulatory filings to determine the extent and source of those losses. The study examined the performance of 174 insurers that sold qualified health plans (QHPs) in 2014 to both individuals and small groups (generally companies with 50 or fewer workers).
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The Affordable Care Act (ACA) placed numerous requirements on insurance offered in both the individual and small group markets. This study presents data from the 174 insurers that offered qualified health plans (QHPs)—plans that satisfy the ACA requirements and are certified to be sold on exchanges—in both the individual and small group markets in 2014. QHPs in both markets are essentially the same and are governed by nearly identical regulations, making possible a better-controlled analysis of the performance of insurers participating in the two markets. Average medical claims for individual QHP enrollees were 24 percent higher than average medical claims for group QHP enrollees. Moreover, average medical claims for individual QHP enrollees were 93 percent higher than average medical claims for individual non-QHP enrollees. As a result, insurers made large losses on individual QHPs despite receiving premium income that was 45 percent higher for individual QHP enrollees than for individual non-QHP enrollees. These higher medical claims resulted in loss ratios for individual QHPs nearly 30 percentage points higher than loss ratios in other markets. Given that insurer performance selling individual QHPs worsened in 2015, these findings suggest that the ACA rules and regulations governing QHPs may be incompatible with a well-functioning insurance market even with subsidies to insurers and incentives for individuals to enroll in QHPs.
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Rather than stabilizing in 2016 as many experts predicted, the Affordable Care Act (ACA) is leading to large premium hikes and less choice and competition in the individual insurance market as plans prove unattractive to relatively young, healthy, and middle-class people. In order to achieve a better understanding of the ACA’s impact, a new Mercatus Center working paper compared insurers’ performance selling individual Qualified Health Plans (QHPs) with three other markets: the individual non-QHP market, the small group QHP market, and the small group non-QHP market.
My co-authors, Doug Badger of the Galen Institute, Ed Haislmaier of the Heritage Foundation, Seth Chandler of the University of Houston, and I make two key empirical findings. First, individual market QHP enrollees had average medical claims nearly double the average claims for individual non-QHP market enrollees in 2014. Second, individual market QHP enrollees were about 25% more expensive than enrollees in small group QHPs.
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Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state’s Affordable Care Act insurance exchange next year after losing nearly $300 million in the individual market in 2015.
However, the large Blues insurer is not completely exiting the state-based marketplace. Fully withdrawing has its consequences: Federal law bars insurers from re-entering the marketplaces for five years, assuming they discontinue all types of individual policies.
Instead, Blue Cross and Blue Shield of Minnesota is dropping health plans with the broadest networks sold on and off the exchange and will push people toward its narrower HMO option called Blue Plus, according to the Star Tribune.
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This is a story about how the Obama administration simultaneously stretched the Affordable Care Act possibly beyond its limits and diminished the prospects of that law achieving a sustainable health insurance market. It’s a case of regulators gone wild in a fit of pique. Basically, the Obama administration needlessly eliminated any pressure on individuals, most of whom would be healthy, to obtain decent health insurance policies for free. The pools are less stable as a result and some individuals may needlessly have been cast into medical bankruptcy.
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The billboards went up quickly. The customers came in droves.
Then, in October, Arches collapsed as suddenly as it went up.
Now eight months after it was announced that the state’s only nonprofit insurance co-op would be dissolved, Utah hospitals are still waiting on about $33 million in outstanding claims that the Utah Department of Insurance says it likely cannot pay until 2017.
Officials with the insurance department say they are doing the best they can to create a “soft landing” for Arches after the federal government reneged on what was supposed to be a $11 million payment this summer.
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The results of a recent poll conducted by the University of Southern California (USC) and the LA Times make it clear there is far from a consensus on the quality and affordability of healthcare in the Golden State. Less than half of those surveyed (44%) felt that healthcare in California was good or excellent, while a plurality (48%) felt that healthcare in the state was fair or poor.
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