Author Archives: Kara Jones

A decade after the nation’s top hospitals used all their advertising and lobbying clout to keep their tax-exempt status, pointing to their vast givebacks to their communities, they have seen their revenue soar while cutting back on the very givebacks they were touting, according to a POLITICO analysis.

Hospitals’ behavior in the years since the Affordable Care Act provided them with more than 20 million more paying customers offers a window into the debate over winners and losers surrounding this year’s efforts to replace the ACA. It also puts a sharper focus on the role played by the nation’s teaching hospitals – storied international institutions that have grown and flowered under the ACA, while sometimes neglecting the needy neighborhoods that surround them.
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The United States is facing another crisis in organizing its health care system. It is clear that the private exchanges concocted under the Obama administration are failing at a record rate for the simple reason that they violate all known sound principles of insurance. The planners who put these programs together unwisely thought that universal coverage would overcome the standard insurance problems of adverse selection and moral hazard.

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Rolling back ObamaCare’s Medicaid expansion has become the focal point of the health-care debate, and rightly so. Without fundamental change, Medicaid—expanded or not—will push state budgets to the brink even as it fails to help the most financially vulnerable Americans.

Consider Oklahoma, our home state. Despite intense lobbying by hospital corporations, the state Legislature stood strong and refused the Medicaid expansion. But the Medicaid rolls increased anyway, and at a dramatic cost to priorities like education, public safety and transportation.

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After all this time, it increasingly appears impossible to get 50 Republican senators to agree on legislation to replace Obamacare. Last night brought genuinely shocking news as two GOP senators, who up until now hadn’t appeared to be likely “no” votes, announced their opposition: Jerry Moran of Kansas and Mike Lee of Utah.

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Two more Senate Republicans have declared their opposition to the latest plan to overhaul the nation’s health-care system, potentially ending a months-long effort to make good on a GOP promise that has defined the party for nearly a decade and been a top priority for President Trump. Sens. Mike Lee (Utah) and Jerry Moran (Kan.) issued statements declaring that they would not vote for the revamped measure.

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Senate Majority Leader Mitch McConnell (R-Ky.) announced Saturday night that Senate consideration of legislation repealing and replacing ObamaCare will be delayed while Sen. John McCain (R-Ariz.) recovers from surgery.

McCain had announced earlier on Saturday that he would not be in the Senate next week, depriving Republicans of a key vote.

Without McCain, Senate Republicans likely would not have had the 50 votes necessary to advance the legislation.

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Congressional Republicans should stop calling their health-care bills a repeal of Obamacare. The House bill is not one — it keeps Obamacare’s regulatory heart — and the Senate bill is even less of one now that it has been amended to keep some of Obamacare’s most economically destructive tax increases. And because the bill is not a real repeal, people will face some combination of higher premiums, co-payments, and deductibles than they otherwise would. Moderate Republicans, who said for years that they wanted to repeal Obamacare but apparently never thought through what repeal would entail, are mostly to blame for these disappointing facts. Republicans have failed to make good on their promises.

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In the coming days, the Congressional Budget Office will release an updated analysis of the Senate bill to repeal and replace Obamacare. The CBO will likely predict lower health insurance coverage rates if the bill becomes law. The American people and Congress should give this prediction little weight in assessing the bill’s merit.

The reason: The CBO’s methodology, which favors mandates over choice and competition, is fundamentally flawed. As a result, its past predictions regarding health-care legislation have not borne much resemblance to reality. Its prediction about the Senate bill is unlikely to fare much better.

When Obamacare passed in 2010, the CBO projected a healthy individual market with 23 million people enrolled in exchange plans by this year. The CBO predicted that by 2017, exchange plans would be profitable and annual premium increases low.

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Politics is a team sport, and Republicans are playing it poorly. They have one more chance in the Senate to repeal and replace ObamaCare—possibly their last hope for a victory.

Democrats are performing like a well-coached team. Minority Leader Chuck Schumer has all 48 members of his caucus on board with saving ObamaCare at all cost. It’s been a successful strategy.

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