Democratic and Republican states are moving in opposite directions on health policy, leaving Americans with starkly divergent options for care depending on where they live.
The Trump administration and congressional Republicans, by easing many of the Affordable Care Act’s nationwide requirements after failing last year to repeal the entire law, are effectively turning major components of health policy over to the states.
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The latest lawsuit against Obamacare poses little immediate danger to the health care law — but it could look a lot more potent if the balance of the Supreme Court changes in the next two years.
The case may look like a long shot, given that the courts have upheld the health law more than once. But proponents of Obamacare have notoriously underestimated the stream of legal challenges against the Affordable Care Act, and the staying power of the conservatives intent on scrapping the 2010 law.
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Twenty states have filed a lawsuit against the Trump administration over Obamacare’s individual mandate — again.
Wisconsin, Texas and several other red states claim in the lawsuit filed today that since Congress repealed the individual mandate’s tax penalty for not having coverage, that means the mandate itself — and the whole health care law — is invalid.
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Over a 6-month period, the OIG found in California:
For our sample of 150 beneficiaries, California made Medicaid payments on behalf of 112 eligible beneficiaries. However, for the remaining 38 beneficiaries, California made payments on behalf of ineligible beneficiaries (e.g., a woman who did not meet eligibility requirements for the newly eligible group because she was pregnant) and potentially ineligible beneficiaries (e.g., a beneficiary who may not have met the residency requirement). On the basis of our sample results, we estimated that California made Medicaid payments of $738.2 million ($628.8 million Federal share) on behalf of 366,078 ineligible beneficiaries and $416.5 million ($402.4 million Federal share) on behalf of 79,055 potentially ineligible beneficiaries. (These estimates represent Medicaid payments for fee-for service, managed-care, the drug treatment program, and mental health services.) These deficiencies occurred because California’s eligibility determination systems lacked the necessary system functionality and eligibility caseworkers made errors. We also identified a weakness in California’s procedures related to determining eligibility of individuals who may not have intended to apply for Medicaid.
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Through its regime of subsidies, penalties, and federal regulations, the Affordable Care Act (ACA) made health insurance affordable to millions of people who were uninsured because they earned too little or had preexisting conditions. But it also made insurance more expensive for millions who used to be able to afford it. Between December 2013 and January 2017, average premiums more than doubled, and individual markets were in turmoil.
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I come to bury IPAB, not to praise it.
Like Brutus and his co-conspirators wielding the knife against Julius Caesar, the budget deal Congress passed in the early morning hours of February 9 put to death an idea whose time apparently never came and, now never will. The Independent Payment Advisory Board (IPAB), created in the Affordable Care Act (ACA), is history.
It is a rare moment when Republicans and Democrats agree on something they don’t like about the ACA. Behind IPAB’s demise is a belief that Congress shouldn’t delegate its powers to determine Medicare’s rules and a massive political force that reinforced that belief.
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The most significant federal entitlement reform in our lifetime was a little noticed provision that Democrats included in the Affordable Care Act (Obamacare). The provision garnered almost no attention from the mainstream media or even from most conservative commentators. Yet according to the Medicare Trustees report that followed, this one provision eliminated $52 trillion of unfunded federal government liability – an amount that was more than three times the size of the US economy.
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Here’s what the Department of Health and Human Services could do:
- Relax rules so companies of all sizes can take advantage of HRAs. Medium-sized and large employers want the same option of setting up HRAs for workers to buy ACA coverage, said Chris Condeluci, who worked on the ACA as a Senate GOP staff attorney.
- Now that the individual mandate has been repealed, the administration could open the door for companies “to provide funds to buy noncompliant coverage,” said Gary Claxton, a vice president at the Kaiser Family Foundation.
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Earlier this week, the Trump administration restored Obama-era rules that allow individuals to buy affordable insurance plans that aren’t bound by Obamacare’s costly regulations. Here’s the low-down on how those plans could affect your insurance choices.
Overcharging the healthy to undercharge the sick
Obamacare’s most significant change to the U.S. health care system was that it introduced an entirely new layer of federal regulations for individuals and families who buy their own health insurance directly, instead of getting it from their employer or from a government program like Medicare or Medicaid. Prior to 2014, these “individual market” or “nongroup” plans were regulated solely at the state level.
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A bipartisan group of governors working to strike compromise on hot-button policy issues will take on the health care question at an event Friday.
Republican Gov. John Kasich, of Ohio, Democratic Gov. John Hickenlooper, of Colorado, and Alaska Gov. Bill Walker, an independent, are among governors scheduled to headline a briefing at the National Press Club in Washington to discuss their latest ideas for improving the nation’s health care system.
Their blueprint, a copy of which was provided to The Associated Press, lays out a host of ideas for improving affordability, restoring stability, promoting flexibility so that states can innovate and eliminating duplicative and burdensome insurance regulations.
The governors urge the federal government to restore insurer subsidies that were stopped by Republican President Donald Trump, triggering sharp increases in premiums this year.
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