Former Obama administration official Donald Berwick once called the Center for Medicare and Medicaid Innovation (CMMI) “the jewel in the crown of health-care reform.” The metaphor is apt: CMMI, more than any other aspect of Obamacare, is an imperial enterprise.
Congress established CMMI in the Obamacare statute with the goal of finding ways to reduce federal spending on medical care without diminishing its quality. That, of course, is the responsibility of Congress, which created the Medicare program and which alone bears responsibility for making legislative changes to it.
. . .
A group of Republican senators on Wednesday introduced a bill to exempt people from ObamaCare’s individual mandate if they live in a county with one or no options for coverage.
Our constitutional system was carefully designed to prevent any one branch from seizing too much control over the entire government. Only Congress can write legislation; only the President can execute the laws; only the courts can judge whether the laws are constitutional.
This balance of powers, however, does not maintain itself. It is a dynamic equilibrium requiring each branch of government to protect and fully exercise its rightful authorities. When one branch encroaches on another, that balance is endangered — and so are the freedoms the separation of powers were intended to protect.
. . .
An Obamacare provision designed to inject a protective extra layer of competition into fledgling insurance markets fell into near-oblivion — and its failure has made Obamacare’s mounting challenges even more acute.
Under the unwieldy name of the Multi-State Plan Program, the federal government was supposed to contract with two private health plans, at least one a nonprofit. Each is required to offer coverage in all 50 states by next year. But it’s fallen short, reaching fewer states than anticipated, and offering plans that mirror options people already have.
. . .
Conservatives should acknowledge that the coverage expansion is real, it is large (though not as large as we were led to expect), and that while it is not necessarily going to make people much healthier, it is probably going to reduce financial hardship among at least some of the people who have gained coverage. That’s significant, though we can still argue about whether the benefit was worth the cost. (If Obamacare were being voted on today, I would still oppose it).
Liberals, however, should also acknowledge uncomfortable facts. The first is that most of the decrease in the uninsured population came in 2014 and 2015, and is now leveling off. Unless younger and healthier people start buying insurance in much larger numbers, we’re probably not going to see huge improvement. The fact that so few young, healthy people are buying insurance may not only mean that the number of uninsured people stops going down. It could mean that that figure starts going up again.
. . .
The Obama administration proposed this week new rules for its Risk Adjustment program, a critical component of the Affordable Care Act. There are actually some better-late-than-never parts of the proposal. Most notably the new rules will try to compensate for the extra expense insurers incur when people exploit ACA regulatory and enforcement weaknesses to time their insurance purchases to cover only expensive medical emergencies.
. . .
Iowa Insurance Commissioner Nick Gerhart can hardly believe he’s giving some consumers this advice: If you can’t find an affordable, full-fledged health insurance policy, he tells them, maybe you should consider going without one.
The Affordable Care Act started requiring most Americans to have health insurance in 2014. But the law offers an exemption for people who can’t find policies that would cost them less than about 8 percent of their household incomes.
. . .
Six Republican Senators introduced a bill that would exempt consumers living in counties where zero or one insurer is offering plans on the federal exchanges from the Affordable Care Act’s individual mandate.
The legislation comes after several recent analyses have shown the number of U.S. counties with one insurer offering plans on the Affordable Care Act exchange is expected to increase next year. Pinal County in Arizona currently has no insurers planning to offer plans on the marketplace. Under the 2010 health care law, people who are able to afford health insurance are required to purchase insurance or pay a fine to the federal government.
. . .
The Obama administration said Tuesday that it is planning to test out further steps to tighten the rules for ObamaCare sign-up periods that have drawn insurer complaints.
The Centers for Medicare and Medicaid Services (CMS) said that it will launch a pilot program in 2017 to test ways to put in place a “pre-enrollment verification system,” meaning a way to check documentation to make sure enrollees are actually eligible to sign up for ObamaCare through an extra sign-up period.
. . .
No wonder Politifact awarded President Barack Obama its 2013 “Lie of the Year” award for his Obamacare promise, “If you like your health plan, you can keep it.” My wife has been trying to do exactly that for three years, and has failed every time. But at least she was able to keep her doctor—until now.
I have previously discussed my wife’s struggles to find and keep coverage in the age of Obamacare. It was never a problem before Obama and Democrats decided the government needed to improve access to coverage.
. . .