No single bill will fix all the challenges Medicaid faces, but Congress and the president have a historic opportunity to adopt permanent reforms. Working together with governors and state Medicaid reformers, we can empower states with new statutory flexibilities. We can modernize the waiver process so states can focus on managing their programs based on the needs of their patients, not managing paperwork for the Centers for Medicare and Medicaid Services. We can create better tools and incentives for states to reduce costs, boost quality and improve health outcomes.
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Although letting U.S. patients buy drugs from other countries sounds free-market, doing so would actually import price controls dictated by foreign governments.
President Donald Trump pledged on the campaign trail to allow drugs from foreign countries to be sold in the United States. Although this may sound laissez-faire, the fact is other countries undermine free and fair trade by imposing price controls that would be imported to the U.S. This would further undermine the profit, and thus increase the cost, of developing safe drugs in the U.S., for which manufacturers currently pay $2.6 billion on average per new drug, argues Grace-Marie Turner, president and founder of the Galen Institute, in this Health Care News Podcast Episode, hosted by HCN Managing Michael Hamilton.
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As Congress and the Trump administration move forward with plans to repeal and replace the Affordable Care Act (ACA), they are looking for proven state-led reforms that maintain access for those with pre-existing conditions in the current exchange market while also lowering premiums for everyone buying insurance in the individual market.
Maine faced similar challenges in 2011 as it sought to unwind failed experiments that pushed its market into a long-term death spiral. But by creating an invisible high-risk pool and relaxing its premium rating bands, Maine policymakers were able to cut premiums in half while still guaranteeing those with pre-existing conditions access to plans.
As a result of these changes, individuals in their early 20s were able to see premium savings of nearly $5,000 per year, while individuals in their 60s saw savings of more than $7,000.
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President Donald Trump’s core principles for health care include ensuring that Americans with pre-existing conditions have access to coverage, and that Americans should be able to purchase the health insurance plan they want, not one forced on them by the government. Each of these goals is laudable and achievable, taken separately. But President Trump and others are about to confront what others have learned the hard way: Achieving both goals simultaneously is extremely challenging.
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Given the focus on the disastrous launch of the Obamacare insurance Exchanges in 2013, many people don’t know that most of Obamacare’s coverage gains have come not through those Exchanges, but through a new expansion of Medicaid to able-bodied, working-age adults.
Medicaid was originally intended to provide important safety net coverage to vulnerable populations such as individuals with disabilities, low-income children and the elderly, among others. But Obamacare’s massive expansion of this entitlement to able-bodied adults has placed added strain on an already stressed program in many states.
Even prior to Obamacare, Medicaid stood in desperate need of reform. In many states, low physician reimbursement rates resulted in poor access for beneficiaries. One supporter of the program called a Medicaid card a “hunting license”—the chance for beneficiaries to try to find a doctor who will treat them.
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We will have, over the next few weeks, a once-in-a-generation opportunity to get our health sector back on track, moving control over health care and coverage decisions to doctors, patients, and families.
Congress has an extremely difficult task, with innumerable hurdles in repealing and replacing ObamaCare, but the train is nearly ready for boarding and the month-long journey is about to begin.
This is the chance for Congress to show the American people members hear them and that they can govern.
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House Republicans have rolled out their highly anticipated bill to repeal and replace Obamacare this week, but a more obscure measure introduced by Rand Paul (R-KY) is gaining attention and should not escape notice.
Paul, who has positioned himself as a leading conservative critic of the forthcoming GOP proposal, has sponsored a measure that would leave untouched both Obamacare’s $1 trillion in taxes and its Medicaid expansion.
Stranger still, though Paul has characterized Republican plans for an age-related refundable tax credit as “Obamacare Lite,” his bill does the unthinkable: It retains the Obamacare income-related refundable tax credits.
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House Republicans on Monday unveiled their long-awaited legislation to repeal and replace ObamaCare.
The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, its expansion of Medicaid, its taxes and its mandates for people to have insurance. (READ THE BILLS HERE AND HERE.)
In its place, Republicans would put in place a new system centered on a tax credit to help people buy insurance.
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How should the GOP move forward on Obamacare? First, they must honor their promise to repeal the law. Second, Republicans can’t make it worse; instead, they need to fix the problem. They can do this by: 1.) Beginning with the 2015 reconciliation bill repeal language, 2.) Also repealing the insurance regulations, and 3.) Focusing on areas of consensus among Republicans. Don’t try to replace one 2,000-page monstrosity with another. Instead, adopt common-sense specific reforms that will increase competition, drive down costs, expand choices and put patients back in charge of their health care.
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President Donald Trump, heading into a critical stretch of Republicans’ push to rewrite the Affordable Care Act, acknowledged Monday the effort would be complex and politically risky, but said he is determined to forge ahead because the ACA is a “disaster.”
“Nobody knew that health care could be so complicated,” Mr. Trump told a group of Republican governors after meeting with them and insurers—two groups whose cooperation could make or break the attempt to overturn the law some call Obamacare.
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