The Trump Administration has been looking for lifeboats for Americans trapped in ObamaCare exchanges, and one project is to expand “association health plans,” or AHPs, that let employers team up to offer coverage. But the fine print in the proposed Labor Department rule is causing concern and needs to be cleaned up.
The issue is whether the Trump rule will let association health plans set prices based on risk, which is how insurance is supposed to work. The point of the rule is to let businesses enjoy the flexibility that large employers have under a law known as Erisa. Under the Affordable Care Act bigger businesses have fared much better than those stuck in the small group market, which is heavily regulated.
. . .
After 94-year-old Enid Stevens was treated for a spinal fracture at a hospital in Northern England last month, she was wheeled out from the overcrowded ward to a hallway, where she lay on a gurney, unable to easily alert nurses, for six days.
“The health service is failing,” said Wayne Stevens, Mrs. Stevens’s 40-year-old grandson. “It’s not just my grandmother—there are thousands, if not hundreds of thousands, of grandmothers going through the same indignities.”
. . .
As goes Iowa, so goes the nation — or at least that’s the conventional wisdom during presidential elections. Let’s hope the same rule applies to healthcare reform.
Earlier this month, Iowa Gov. Kim Reynolds signed a law that takes advantage of a major loophole in Obamacare. The legislation, based on a similar effort in Tennessee, enables any Iowan to enroll in a “health benefit plan” sponsored by the Iowa Farm Bureau. Due to a legal technicality, the plans aren’t subject to Obamacare’s premium-inflating regulations.
The reform is a laudable attempt to give consumers an affordable alternative to the plans for sale on Obamacare’s exchanges. Until Congress makes good on its promise to repeal and replace the law, other states can liberate their residents from the law’s financial burdens by following Iowa’s lead.
. . .
Arizona has asked the CMS to allow it to end retroactive coverage for Medicaid beneficiaries.
If granted, the waiver request now under review at the CMS, would nix providers’ ability to bill for services provided in the three months before a beneficiary applies for Medicaid coverage, assuming the patient was eligible during that time.
Providers in the state had urged the state not to submit the waiver to the CMS because it could put hospitals in a difficult financial situation and limit access to care.
. . .
A group of Democratic senators on Wednesday introduced an expanded public option for health insurance as the party debates the next steps to build on ObamaCare.
The new proposal, called the Choose Medicare Act, was introduced by Sens. Chris Murphy (D-Conn.) and Jeff Merkley (D-Ore.), both seen as potential presidential contenders, though Murphy has said he is not running in 2020.
The measure has no real chance of becoming law anytime soon, but is part of a growing debate among Democrats about what the best next steps beyond ObamaCare are, which could come to fruition when Democrats next win back the White House.
. . .
Congressional leaders were poised last month to spend tens of billions of dollars in the omnibus bill to temporarily shore up Obamacare’s failing health insurance system.
That money, however, never would have given Americans the long-term relief they so desperately need.
After this idea was struck from the spending bill, Sen. Lamar Alexander, R-Tenn., who had worked closely with Sen. Susan Collins, R-Maine, to shape a bipartisan deal, said that “the only choice we have is to go back to repeal and replace the Affordable Care Act.”
We agree. Obamacare is broken and cannot be fixed, and there is a better way forward.
. . .
The Trump administration hopes to move forward with a rule expanding alternatives to ObamaCare plans by this summer, Secretary of Labor Alex Acosta said Monday.
The rule allows for small businesses and self-employed individuals to band together to buy insurance as a group in what are known as association health plans.
“We hope to have that by this summer,” Acosta said Monday during a tax reform event alongside President Trump in Florida.
. . .
Medicaid expansion is back on the ballot.
Organizers in Utah submitted signatures on Monday to put an initiative expanding Medicaid on the state’s ballot in November. They got 165,000 signatures, or about 50,000 more than they needed.
State legislators are actually pushing a limited form of Medicaid expansion, but, as we covered before, the Trump administration seems unlikely to greenlight that proposal. The ballot initiative being submitted today would be a clean version of expansion
. . .
This paper examines the impacts of the Affordable Care Act (ACA) – which substantially increased insurance coverage through regulations, mandates, subsidies, and Medicaid expansions – on behaviors related to future health risks after three years. Using data from the Behavioral Risk Factor Surveillance System and an identification strategy that leverages variation in pre-ACA uninsured rates and state Medicaid expansion decisions, we show that the ACA increased preventive care utilization along several dimensions, but also increased risky drinking. These results are driven by the private portions of the law, as opposed to the Medicaid expansion. We also conduct subsample analyses by income and age.
. . .
In 2005 and 2009, Elizabeth Warren and her co-authors released two papers claiming that more than 50 percent of all bankruptcy filings in the U.S. were caused by medical debts. I wrote about the problems with these studies when they first came out, and even testified in Congress against reading too much into the findings of these studies because they suffered from several biases. Now an academic study published in the New England Journal of Medicine is skeptical of these results as well. The study tracks a stratified sample of adults between the ages of 25 and 64 who were admitted to the hospital for non-birth-related reasons between 2003 and 2007. It finds that fewer than 4 percent of hospitalizations resulted in bankruptcies, far lower than the 2009 study’s claimed 62 percent.
. . .