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 waiting for approval. President Trump decided to delay the executive order after Sen. Tom Cotton, R-Ark., pushed for the inclusion of the individual mandate repeal in the tax bill, and has been supportive of its inclusion in statements he has made on Twitter.
. . .
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 plan,” Ryan told “Fox News Sunday” in an interview taped Friday. “We expect our friends in the Senate to be about a week behind us.”
Ryan said doing away with the controversial individual mandate measure in the Affordable Care Act was still on the negotiation table among House Republicans.
. . .
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 measures of health spending in the United States are not helpful to most people. Their intent is to create a measure using readily accessible data that is intuitive and easy for the average person to understand. Such an index, if widely adopted, might help galvanize public support for efforts to bring more cost discipline to the provision of medical care.
. . .
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 single-payer plan.
. . .
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 unique Medicare patients per year would be exempted under the rule finalized Tuesday.
. . .
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 the state insurance marketplace has rapidly vanished; and for those with ACA coverage, doctor and hospital choices have narrowed dramatically. Meanwhile, consolidation across the health care sector has accelerated at a record pace, portending further harm to consumers, including higher costs in medical care.
. . .
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 the Senate’s incumbent protection racket, where deliberation on legislation is avoided to spare Senators—of both parties—tough votes; 3) Conservatives must learn how to sell their ideas.
. . .
The premiums for 2018 Marketplace plans were recently released to give consumers a chance to look at their plan options before open enrollment begins on November 1. Premiums are rising significantly in many counties across the country, in part due to the decision of the Trump Administration to cease payments to insurers for cost-sharing reductions. Insurer participation also declined in many areas, leaving more counties with only one insurer, which likely contributed to the high rate of premium growth.
. . .
For some lower-income people in Obamacare, the rising premiums President Donald Trump has talked so much about will barely be felt at all. Others, particularly those with higher incomes, will feel the sharp increases when insurance sign-ups begin Wednesday.
Richard Taylor is one of the people on the wrong end. The 61-year-old, self-employed Oklahoman has meticulously tracked his medical costs since 1994. In 2013, he signed up for an Affordable Care Act plan for the law’s first year offering coverage to millions of Americans.
. . .
Democrats are accusing the Trump Administration of “sabotaging” Obama Care by discontinuing illegal subsidies to insurers, but last week even an Obama-appointed judge in California said otherwise. The ruling deserves more public attention.
Federal Judge Vince Chhabria rejected and ridiculed a petition by 18 states to enjoin the White House from stopping cost-sharing reduction payments (CSRs) that subsidize lower copays and deductibles for consumers on the exchanges who earn less than 250% of the poverty line. “It appears initially that the Trump Administration has the stronger legal argument,” the judge noted, adding that “the emergency relief sought by the states would be counterproductive.”
. . .