With Congress seemingly on the brink of repealing the Affordable Care Act’s centerpiece requirement that most people get insurance or pay a penalty, Democrats are warning such a move would be disastrous, and Republicans are anticipating a sweeping symbolic victory.
Senate Republicans included a measure to repeal the mandate in their recently passed tax overhaul; the House didn’t, leaving GOP leaders to hammer out a final agreement for the compromise bill they hope to pass by year’s end. President Donald Trump on Friday night threw his weight behind the push to strike the mandate, promising a crowd in Pensacola, Fla., that it would soon be gone.
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Shopping to update your coverage on the health insurance marketplace may be annoying — didn’t you just do this last year? But letting the exchange automatically renew your coverage instead could be a big mistake. If you don’t like the plan you’re auto-enrolled in this year you may be stuck with it in 2018, unlike previous years when people could generally switch.
It’s all in the timing. This year, the open enrollment period, which started Nov. 1, will end a week from today, on Dec. 15 in most states. On Dec. 16, if you haven’t picked a new plan, the marketplace will generally re-enroll you in the one you’re in this year or another one with similar coverage.
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How many individuals would knowingly want to enroll in a form of health coverage with “persistently inferior” outcomes? A new study published in the Journal of the American Medical Association Oncology suggests that Medicaid provides those persistently inferior outcomes in the nation’s largest state of California, raising more questions about the program that represents the bulk of the coverage expansion under Obamacare. Overall, the study found “substantial and persistent disparities in survival for patients with either no or other public insurance compared with private insurance for all five cancer sites examined.”
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Growth in U.S. health spending slowed considerably in 2016, rising by 4.3 percent, after two years of higher spending growth spurred by Obamacare and prescription drugs.
The slowdown in health spending growth was seen broadly across all major forms of private and public insurance, and in medical services, prescription drugs and other goods, according to an official analysis released Wednesday.
But because health spending grew faster, as it has for years, than overall gross domestic product, health spending’s share of the economy increased to 17.9 percent in 2016, up from 17.7 percent of the economy the year before.
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Health insurance a la carte?
As the Affordable Care Act open-enrollment season moves into its final weeks, some consumers looking for lower-cost alternatives are considering a patchwork approach to health insurance. The products may secure some basic protection but leave patients on the hook for high medical bills.
The idea involves mixing and matching several types of insurance products originally designed to cover the deductibles and other gaps in traditional coverage.
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As small business owners learn what their 2018 health insurance costs will be, some are considering providing different types of coverage for their employees.
Companies are receiving notices of premium and coverage changes for 2018. The changes vary, depending on factors including the state where a company is located, how many employees it has and how comprehensive its insurance is. But many owners are seeing rate increases of double-digit percentages, finding dramatically reduced coverage, or both. Health insurance consultants expect more owners to rethink their strategies beyond 2018 and choose alternatives like paying for claims themselves or adding health services that can lower costs.
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Cyndee Weston can barely remember the last time she didn’t have to switch health plans during an Affordable Care Act sign-up season. By her count, she has been on five plans in five years.
Every fall, after she has spent months figuring out her insurance plan’s deductibles, doctor networks, list of covered drugs and other fine print, she receives notice that the policy will be canceled as of Dec. 31. Because her job doesn’t come with insurance, “it’s agonizing going through all the plans and trying to compare,” said Weston, 55, who has diabetes and a history of melanoma. “Every year it’s the same scenario: ‘We’re not going to renew your policy.’”
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Republicans have famously failed to pass health-care legislation this year. But future attempts at reforming Obamacare will have an advantage over previous ones. The most politically powerful argument against Republican health-care legislation has been that it would “take insurance away” from many millions of people. That argument was based on the CBO’s findings, and most of it was based on the end of the individual mandate.
If Republicans end the mandate in the tax bill, any estimates of the effects of future legislation on coverage will be about 13 million lower. The tax bill doesn’t just advance a major conservative objective on health policy. It prepares the ground for replacing other parts of Obamacare as well.
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Mr. Summers offers various caveats along with his prediction of a mass-casualty legislative event. But he largely accepts the Congressional Budget Office’s guess that 13 million more people will choose not to enroll in government health plans if insurance is no longer required (Summers rounds the guess down to 10 million), and he basically credits his former colleague Kate Baicker’s research suggesting people are more likely to die if they are not enrolled in a health insurance plan.
Mr. Summers is not alone among ObamaCare defenders in wanting to persuade people that the number of people covered by government insurance is the true measure of health. But the vast expansion of such coverage engineered by his old boss doesn’t seem to have made Americans healthier.
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The House and Senate recently passed tax reform bills because they successfully made the case that reform is a “once-in-a-generation” opportunity that is long overdue. It’s a compelling argument. When the last tax reform bill passed in 1986 the Internet was in its infancy and cell phones were the size of a briefcase. The world has changed, the argument goes, but our tax code has not.
What’s curious, however, is that the largest deduction in the tax code – the exclusion from income tax of employer-sponsored insurance, which dates back to the 1940s – is untouched by the reform bills. This omission is an enormous missed opportunity for American consumers and both political parties.
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