CBO is anticipating a 21% jump in the cost of federal subsidies this year, driven by a 34% jump in premiums for the “benchmark” plans to which those subsidies are pegged.
But after that, CBO expects a big slowdown. Federal spending on the ACA’s premium subsidies will likely grow by about 5% per year for the rest of the next decade, the budget office said. Those annual increases are mainly a result of rising health care costs.
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A revival movement is sweeping the nation. Millions of souls have already been converted, thanks to a charismatic preacher and his passionate disciples.
I’m talking, of course, about the doctrine of “Medicare for All” and its chief evangelist, Vermont Sen. Bernie Sanders. The socialist senator’s sermons appear to have swayed the masses. In 42 states, a majority of residents now support a Medicare-for-All system, according to new research from Data for Progress, a left-wing think tank. That’s a significant increase from September of last year, when fewer than half of Americans supported single-payer.
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During Fiscal Year (FY) 2017, the Federal Government won or negotiated over $2.4 billion in health care fraud judgments and settlements, and it attained additional administrative impositions in health care fraud cases and proceedings. As a result of these efforts, as well as those of preceding years, in FY 2017 $2.6 billion was returned to the Federal Government or paid to private persons. Of this $2.6 billion, the Medicare Trust Funds received transfers of approximately $1.4 billion during this period, and $406.7 million in Federal Medicaid money was similarly transferred separately to the Treasury as a result of these efforts.
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A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country. Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices.
The Minnesota Legislature offered a solution: a $271 million, publicly funded reinsurance pool that would help health insurance companies pay the most expensive medical claims, thereby lowering overall insurance premiums. The hope was that backstopping the insurers would stabilize the market and halt the rocket-like rise in premiums.
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Congress has been unable to agree on “market stabilization” for the Affordable Care Act (ACA), and it was left out of the recently passed omnibus. Yet, a key discussion has been missing from the conversation, the need to rethink the single risk pool in the ACA.
Throwing money at the status quo will simply slow a market decline, which could leave millions with no access to affordable coverage. Splitting subsidized lives from nonsubsidized into two different risk pools could provide structural relief that allows markets to stabilize longer term.
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The Centers for Medicare & Medicaid Services (CMS) plans to “wind down” support for the federal exchanges by the time open enrollment hits in 2019 and shift funding to states.
For that strategy to work, the agency is relying on Congress to do something it failed to do several times last year: Pass an ACA repeal.
CMS detailed its plan in a fiscal year 2019 budget justification (PDF) released this week that outlines a $403 million cut to its program operations budget next year. With less funding to oversee the federal exchanges for plan year 2020, CMS would dole out grants that allow states to “assume more control of their markets and expand enrollment options.”
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Since the managed care debacle of the 1990s, billions of dollars have been spent in time and resources to improve and measure the quality of patient care. However, measuring the quality of care in the effort to improve it in a cost-efficient manner is showing evidence of being counter-productive, particularly for small physician practices and practices with complex patient populations.
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Congress in 2017 failed to “repeal and replace” the Affordable Care Act. But the health law has been changed in many other ways over the past year and a half. Some changes were made by Congress, some by President Donald Trump and his administration and some by state officials. Here is a timeline of the most consequential events that have shaped the health law:
On his first day in office, Trump issues an executive order to “minimize the unwarranted economic and regulatory burdens” of the health law. It includes instructions to agencies to “exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden.”
The same day, officials at the Department of Health and Human Services begin removing information on how to sign up for coverage from the healthcare.gov website, even though enrollment for 2017 policies lasts until the end of the month.
Maryland lawmakers on Wednesday finalized a bipartisan measure to collect $380 million in taxes from health insurers next year to help curtail surging premiums for 150,000 Marylanders and prevent the state’s Obamacare marketplace from a potential collapse.
The legislation was a quiet, one-year compromise between the Democratic-controlled General Assembly and Republican Gov. Larry Hogan, who is expected to sign the measures.
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After years of being a central political question, health care is on the back burner. Both parties contain experts and activists who want to make major changes to health policy. But for now, both parties’ politicians are wary. Democrats are, as usual, more interested in the subject than Republicans, but they are somewhat divided about what to do next and in any case are not yet in a position to enact anything. Republican politicians, meanwhile, seem to have concluded from their failed efforts to repeal and replace Obamacare that the whole issue is best avoided. It is not surprising, then, that talk of a bipartisan deal to shore up Obamacare’s insurance exchanges has petered out.
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