Donald Trump on Wednesday laid out for the first time how he will reform the U.S. health care system after repeatedly pledging to “repeal and replace Obamacare with something much better.”
Trump published a seven-point health care reform plan that calls for repealing Obamacare, breaking down state barriers that prevent the sale of health insurance across state lines and making individuals’ health insurance premium payments fully tax deductible.
The reforms, which Trump calls “simply a place to start,” are aimed at broadening access to health care, making health care more affordable and improving the quality of care, according to the plan published on Trump’s campaign website.
Congress’ decision to suspend the Affordable Care Act’s tax on health insurers for one year will cost the government $13.9 billion, funding that normally would go to cover subsidies for low-income enrollees and other functions of the law.
The CMS, therefore, expects insurance companies to keep their premiums in check when they file 2017 rates this spring. The hope is the one-year tax reprieve will put a ceiling on premium increases and push savings to consumers instead of into the coffers of health insurers.
“Because the fee is not being collected for the 2017 fee year, administrative costs for plans in all impacted markets are expected to be adjusted appropriately to account for the moratorium,” the CMS said in a document posted Monday.
While many Americans are obsessively following the presidential primary campaign, health policy experts are concerned about little-noticed Republican primary contests for state legislative seats that could determine the fate of Medicaid expansion in Arkansas and other states.
In Arkansas, Tuesday’s elections include several primary contests pitting Republican state lawmakers who voted for Medicaid expansion to low-income adults against GOP primary challengers who promise to end the state’s coverage expansion. Republican Gov. Asa Hutchinson needs votes from 75% of the GOP-controlled Legislature to win approval for his conservative changes in the state’s Medicaid expansion program, or else the expansion will end this year. So he can’t afford to lose any expansion allies.
The vast majority of Americans have not benefited from Obamacare, according to a poll released by National Public Radio, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health Monday.
56 percent of Americans polled said they don’t believe the Affordable Care Act has directly impacted them. Of those surveyed who said it did have a direct impact, more said health care reform has been overall detrimental rather than positive — coming in at 25 percent and 15 percent respectively.
Senator Rubio is proposing to fix a longstanding problem in federal tax law. He wants to make sure that all Americans get a comparable tax break for health insurance, regardless of whether or not they get their insurance through their place of work. For many years, federal law conferred a generous tax break for health insurance only on employer-paid premiums, which are excluded from the taxable compensation of workers for both income- and payroll-tax purposes.
Obamacare’s defenders would say that Obamacare fixed this problem by giving households credits that they can use when they buy insurance through the law’s “exchanges.” But the Obamacare credits are not connected in any way with the value of the tax benefit for employer-provided coverage, they are income-tested and thus phase out for middle-income families, and they can be used only to purchase heavily regulated plans.
Rubio’s proposal would truly level the playing field by first getting rid of Obamacare and then giving Americans who buy insurance on their own, rather than through their place of work, a tax credit of roughly comparable value to the tax break conferred on an employer plan of average cost.
The State Department released the last batch of Hillary Clinton’s emails on Monday, and the exercise has been instructive about her recklessness with classified material. But as a side note, we ought to memorialize what President Obama’s aides were telling Mrs. Clinton about the Affordable Care Act, which was the opposite of what their boss was telling the public.
Despite her duties as top diplomat, Mrs. Clinton found time to follow ObamaCare’s progress in Congress, and she received regular updates from Neera Tanden, then a White House health staffer. Ms. Tanden is now president of the liberal Center for American Progress, Mrs. Clinton’s economic policy shop.
The insurance industry must be kicking itself for backing ObamaCare. Several have since posted big losses and it looks like Blue Cross Blue Shield got the losing end of the stick, too.
Fitch Ratings looked at nearly three dozen BCBS companies and found that 23 saw a decline in earnings that totaled $1.9 billion in the first nine months of last year, while 16 had net losses.
Blue Cross Blue Shield of Michigan lost $622 million from January through September last year. Blue Cross plans in Texas, Oklahoma, New Mexico and Montana lost $442 billion. And those in Pennsylvania, Delaware and West Virginia lost $266 million.
The reason is ObamaCare.
Or as Fitch puts it: “Cost and utilization trends from state insurance exchanges from the Affordable Care Act have been higher than anticipated and are the primary drivers of declining earnings.”
When pressed during last Thursday night’s campaign debate in Houston for details of his proposed plans for replacing Obamacare after it is repealed, presidential candidate Donald Trump (?-NY) once again sputtered out something about eliminating “those lines” that states draw in regulating health insurance. What that exactly means involves some Trump-Land-to- Policy-World translation, and a little primer on what’s usually understand and misunderstood in this area of health policy.
Trump appears to be borrowing some of the language behind a traditional conservative Republican health reform proposal, which involves facilitating competition in health coverage through the sale and purchase of insurance products across states. It’s sometimes referred to as interstate competition or competitive federalism, or even just “consumer choice.”
Cato’s Michael Cannon has doubled down in his latest Forbes column on his outrageous claim that,“Yes, Marco Rubio’s Obamacare Replacement Plan — Tax Credits — Is An Individual Mandate.”
Sen. Rubio’s health policy plan provides an advanceable, refundable tax credit that can be used to purchase insurance. This idea is a centerpiece of free-market health policy. It would create fairness by equalizing the tax treatment of health insurance between those currently receiving employer-based health insurance and those who are shut out of this market. It would allow portability of coverage, make costs more transparent, and turn down the fires on the inflation-generating tax exclusion for job-based health insurance.
Cannon explains the Rubio tax credit this way: “If you purchase a government-approved health plan, you could save, for example, $2,000 on your taxes. If you don’t, you pay that $2,000 to the government. That is exactly how Obamacare’s individual mandate works.”
In a major win for the industry, health insurers will not be forced to have minimum quantitative standards when designing their networks of hospitals and doctors for 2017, nor will they have to offer standardized options for health plans.
The CMS released a sweeping final rule (PDF) Monday afternoon that solidifies the Affordable Care Act’s coverage policies for 2017. The agency proposed tight network adequacy provisions and standardized health plan options in late November, which fueled antipathy from the health insurance industry.
Monday’s rule relaxes those aggressive proposals, a move that likely will raise the ire of consumer groups that have pushed for stronger insurance protections for patients. It does, however, include some victories for transparency advocates. The federal government, for example, will now have to publish all changes to premium rates, not just increases that are subject to review.