Trump administration officials have a lot of work ahead of them, but also a tremendous opportunity to make history. Returning the executive branch to its proper role under the Constitution will also spur Congress to enact reforms that make health care better, more affordable, and more secure.
Michael F. Cannon, Director of Health Policy at the Cato Institute, outlines 14 ways Trump-administration officials can restore the Constitution’s limits on executive power, provide relief to Americans suffering under Obamacare, and hasten repeal.
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Conservative Republicans, worried about growing voices within the party advising or accepting a slower pace for repealing the Affordable Care Act, are redoubling their push to speed the GOP’s long-desired goal.
President Donald Trump on Sunday became the latest top Republican to sound cautious notes about the party’s ability to rapidly repeal large swaths of the 2010 health law and enact its own vision. He told Fox News’s Bill O’Reilly that “maybe it’ll take until sometime into next year,” saying repeal and replacement was “statutorily” difficult to accomplish quickly.
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In his first post, Conover argued that drawing inferences from observational studies about whether covering the uninsured will save lives is a fool’s errand . Quasi-experimental studies hypothetically provide a better tool for figuring out whether insurance coverage reduces mortality risks. Unfortunately, the two studies we have available are very unreliable instruments for figuring this out.
That said, based on the two studies reviewed, Conover cannot rule out the possibility of “excess deaths” in the event some people lost coverage as a result of repeal-and-replace efforts. Ironically, because the lion’s share of coverage gains under Obamacare has been through Medicaid, the New York study arguably is the most appropriate one to use to determine the effects of repeal. However, it is less credible than the Massachusetts study in terms of how much confidence anyone should have in its results.
In short, beware of anyone who claims we will lose 1 life for every 435 newly uninsured. 1 life for every 830 people is more believable, but even that is exaggerated and is far more likely to apply to those gaining private coverage than those enrolling in Medicaid. Unfortunately, the current state of science does not provide a very solid basis for guessing how much this estimate is inflated.
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Obamacare proponents have been increasingly shameless in trotting out scare statistics to convince people that the GOP wants to “make America sick again:”
Two Harvard professors–who, not uncoincidently, are diehard single payer advocates–are lamenting that “repealing the Affordable Care Act will kill more than 43,000 people annually”
False claims about the adverse effects of repealing Obamacare on mortality that are grounded in observational studies result from:
- Grossly exaggerating the number of people who would actually lose coverage. This exaggeration of lost coverage occurs even in the worst-case scenario that Obamacare is not replaced.
- “Excess” mortality estimates related to lack of coverage that are both upward-biased and unreliable by nature due to the inability of researchers to account for unmeasured influences.
- Inappropriate extrapolation of results to populations (e.g., Medicaid) not included in the original study.
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As Republicans consider paring back the Affordable Care Act’s federal mandates, they face a difficult question: What does health insurance need to cover?
The 2010 health law created a new set of federal requirements for plans sold to individuals and small businesses, including a list of 10 benefits, among them prescription drugs, mental-health services and laboratory tests. It also mandated that plans cover preventive services such as vaccinations at no cost to enrollees.
The rules, along with other minimum standards set by the law, were meant to ensure that consumers had strong protections and weren’t surprised by unexpected gaps or limits in their coverage. But that also contributed to making individual insurance more expensive in many cases.
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