Mr. Summers offers various caveats along with his prediction of a mass-casualty legislative event. But he largely accepts the Congressional Budget Office’s guess that 13 million more people will choose not to enroll in government health plans if insurance is no longer required (Summers rounds the guess down to 10 million), and he basically credits his former colleague Kate Baicker’s research suggesting people are more likely to die if they are not enrolled in a health insurance plan.
Mr. Summers is not alone among ObamaCare defenders in wanting to persuade people that the number of people covered by government insurance is the true measure of health. But the vast expansion of such coverage engineered by his old boss doesn’t seem to have made Americans healthier.
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The House and Senate recently passed tax reform bills because they successfully made the case that reform is a “once-in-a-generation” opportunity that is long overdue. It’s a compelling argument. When the last tax reform bill passed in 1986 the Internet was in its infancy and cell phones were the size of a briefcase. The world has changed, the argument goes, but our tax code has not.
What’s curious, however, is that the largest deduction in the tax code – the exclusion from income tax of employer-sponsored insurance, which dates back to the 1940s – is untouched by the reform bills. This omission is an enormous missed opportunity for American consumers and both political parties.
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Congressional repeal of Obamacare’s individual insurance mandate penalty is not tantamount to pressing the button on the doomsday machine.
Critics of the Senate tax bill say repeal of the mandate penalty to buy Obamacare coverage will result in a spike in premiums, an increase in the numbers of the uninsured, and a “collapse” of the health insurance markets. In other words, the individual mandate is the “glue” that holds Obamacare together.
The assumption: Millions of Americans will buy Obamacare coverage—regardless of whether they want it or like it—because the government forces them to do it, and penalizes them if they do not.
Do we have compelling evidence that this is, in fact, the case? No.
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At the 2017 Forbes Healthcare Summit, I interviewed Seema Verma, Administrator of the U.S. Centers for Medicare and Medicaid Services, about her policy agenda. CMS is one of the most important agencies in the federal government, administering programs spending over a trillion dollars a year, including Obamacare.
Our discussion was wide-ranging. Verma spoke about fellow Indianan Alex Azar, President Trump’s nominee for the post of Secretary of the Department of Health and Human Services. She discussed her view of what CMS can do on drug pricing. She talked about the opioid crisis, and how to modernize the Medicare and Medicaid programs and empower patients to take charge of their own health care.
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House Ways and Means Committee Chairman Kevin Brady (R-Texas) told reporters Tuesday that he expects most House Republicans will support repealing ObamaCare’s individual mandate in tax legislation, as GOP senators did.
“We’ll be asking our members where do they want us to be on that position. I suspect there will be strong support,” he said.
The House-passed tax bill did not include repeal of the individual mandate, while the Senate bill did. The two chambers now must reconcile their versions of tax-reform legislation in a bicameral conference.
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Maine made history earlier this month by becoming the first state to adopt Obamacare’s Medicaid expansion via ballot initiative. The vote could inspire progressive activists in other states to push for similar referenda.
Expanding Medicaid to cover childless, able-bodied adults would blow a hole in state budgets while yielding few, if any, public health gains. That’s because Medicaid provides such low-quality care that its beneficiaries often experience worse health outcomes than people with no health insurance.
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Since 2011, the U.S. Census Bureau has reported on a new, more comprehensive Supplemental Poverty Measure (SPM) that accounts for various safety net programs. The new measure takes into account the hundreds of billions of dollars provided to the needy—including food stamps and cash assistance programs—and makes adjustments for major expenses such as out-of-pocket medical spending, income, and taxes. According to the new measure, out-of-pocket health spending alone added 10.5 million people to the ranks of the poor in 2016 .
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A top House Republican said Democrats need to make concessions that make them “wince” in order to get a vote on two Obamacare stabilization bills.
The comments from Rep. Tom Cole, R-Okla., Monday comes less than a week after the two bills looked headed for passage in the Senate after a deal to get Sen. Susan Collins, R-Maine, to support tax reform. But while President Trump and Senate GOP leadership gave support for the bills, such a commitment in the House has been lacking.
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Congress may have moved on from health care. The public has not.
With taxes and spending, debt and defense piled up on Congress’ extremely full plate this month, a new poll by POLITICO and the Harvard T.H. Chan School of Public Health shows that Americans remain sharply focused on health care — but Republicans and Democrats aren’t looking at the same things.
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The policy proposition of the Affordable Care Act was to increase the number of people with health insurance by expanding government programs and subsidizing private insurance premiums. It did so by expanding eligibility for government insurance programs and regulatory authority over U.S. health care via new mandates, regulations, and taxes. The two major elements of the law—a significant Medicaid expansion for non-disabled adults and subsidies for exchange-based private insurance—will each be funded with almost $1 trillion of taxpayer money over a decade, according to a January 2017 CBO analysis.
The harmful effects of this ill-conceived approach are now well documented: Insurance premiums have skyrocketed; many insurers have withdrawn from the state marketplaces; and for those with coverage, doctor and hospital choices have narrowed dramatically. The ACA will also undoubtedly accelerate the development of the kind of two-tiered health care system characteristic of other nationalized systems, where people with money or power are able to circumvent the substandard government systems that the lower classes must endure. The result will be an end to the superior access, broad freedom of choice, and exceptional quality of care that distinguishes American health care from the centralized systems that are failing the world over.
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