The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Obamacare is entering a new stage. The recent announcement by United Health Care that it will stop selling insurance to individuals and families through most health insurance exchanges marks the transition. In the next stage, federal and state policy makers must decide how to use broad regulatory powers they have under the Affordable Care Act to stabilize, expand, and diversify risk pools, improve local market competition, encourage insurers to compete on product quality rather than premium alone, and promote effective risk management. In addition, insurance companies must master rate setting, plan design, and network management and effectively manage the health risk of their enrollees in order to stay profitable, and consumers must learn how to choose and use the best plan for their circumstances.

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The uninsurance rate for nonelderly adults increased in the decade before the passage of the Affordable Care Act (ACA), driven by declining rates of employer-based coverage, especially during the recession at the end of the decade. The ACA was intended to decrease the percentage of the population without health insurance and to provide “quality, affordable health care for all.” The purpose of this brief is to consider how uninsurance rates are changing under the ACA.

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Two GOP lawmakers have introduced a bill that deviates from years of Republican health care orthodoxy by not attempting to repeal the Affordable Care Act.

Sen. Bill Cassidy (R-La.) and Rep. Pete Sessions (R-Texas) on Monday formally announced a bill that they say would cover more people than the Affordable Care Act does now. While the bill does not repeal the 2010 health care law, it would repeal both the individual and employer mandates and limits the “non-essential” products that plans would have to cover.

They aren’t being shy about how great they think their proposal is. They are calling it the “World’s Greatest Healthcare Plan.”

Although she promises to tinker with the Affordable Care Act (see below) Clinton is not proposing to fix any of its largest problems.

So what does Hillary Clinton propose to do about Obamacare? Spend more money. She proposes (1) to limit out of pocket costs to 5% of family income by offering a tax credit of up to $5,000 for spending above that amount, (2) to limit premium expenses to 8.5% of income, (3) to fix the family glitch, whereby dependents who are offered unaffordable coverage at work are barred from the exchange and (4) to spend more money to enroll people in Medicaid.

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Earlier this week, as was widely reported, Judge Rosemary Collyer of the District of Columbia District Court prohibited the Obama administration from continuing to divert money Congress had appropriated for federal tax refunds to instead pay insurance companies billions of dollars in “cost sharing reductions,” part of the Affordable Care Act.

The decision affects more than just the cost sharing reduction program. Just as a teaser, if upheld on appeal – and expect this case to get to the United States Supreme Court – the decision means that some high level Obama administration officials run a serious risk of criminal charges being brought against them should a subsequent President and Attorney General be motivated to pursue them.

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Let’s face it: When it comes to products most of us buy, health insurance is one of the least popular. And new survey results from the Kaiser Family Foundation out Friday morning find that sentiment reaching new lows.

Kaiser’s Larry Levitt said it makes perfect sense why consumers are feeling cranky about their coverage. “People are paying more, and in many cases getting less,” he said. The most obvious reason people aren’t psyched, Levitt said, is due to the explosion in health plans with high deductibles.

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Kaiser’s latest poll shows that people with ACA plans are generally satisfied with their coverage.  Two-thirds say their coverage is excellent or good, but a growing number say it is only fair or poor. The poll reveals warning signs for the future:  A diminishing number of participants feel their health insurance is a good value, those with high-deductible plans are most dissatisfied, and families feel it is increasingly difficult to pay off debt and save for the future.

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To see how vacuous the 2016 presidential campaign has become, consider just one issue: health reform. Exhibit 1: A new study from the liberal Urban Institute estimates that Bernie Sanders’s pet proposal for a single-payer health-care program would cost $32 trillion over the next decade. That’s right: $32 trillion! Exhibit 2: Continuing her strategy for bankrupting America just a little more slowly than Senator Sanders, Hillary Clinton is now calling for a Medicare “buy-in.” Exhibit 3: And Donald Trump’s plan for health-care reform is — well, who the heck knows? It would be helpful if, just for a little bit, we all paid attention to actual issues. Then again, given these three candidates and their proposals, maybe it’s bad news no matter what.

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Health plans are seeking double digit rate increases for their 2017 Obamacare plans—17.3% in New York, 25% in Michigan, 20% in Oregon, as examples.  From special enrollment periods to countless exemptions, the Obama administration traded short term political gain for the long-term stability of the program and its risk pools. The big premium spikes for 2017 are an economic reckoning of this shortsightedness. The policy mistakes have compounded Obamacare’s woes. Fixing them will require more than regulatory tweaking.

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As senior House Republicans work on a promised replacement for the Affordable Care Act, a pair of GOP lawmakers plan to introduce an alternative Thursday that would dramatically reshape the nation’s healthcare system.

The sweeping legislation – co-sponsored by Rep. Pete Sessions (R-Texas) and Sen. Bill Cassidy (R-La.) – stands little chance of becoming law as long as a Democrat is in the White House.

But just as Sen. Bernie Sanders of Vermont shook up the Democratic presidential primary by pushing the liberal dream of a “single-payer” government-run health system, Sessions and Cassidy are resurrecting a long-held conservative goal of overhauling of the healthcare system by rewriting an important part of the tax code.

In the process, the two lawmakers are also highlighting the difficult trade-offs that would be necessary in any replacement for the health law President Obama signed in 2010, commonly called Obamacare.

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