Category Archives: Health Reform

Coverage Losses by State for the Senate Health Care Repeal Bill

Source: Emily Gee, Center for American Progress, June 27, 2017

….The Center for American Progress has estimated how many Americans would lose coverage by state and congressional district based on the CBO’s projections. By 2026, on average, about 50,500 fewer people will have coverage in each congressional district. Table 1 provides estimates by state, and a spreadsheet of estimates by state and district can be downloaded at the end of this column…..
H.R. 1628, Better Care Reconciliation Act of 2017
Source: Congressional Budget Office, Cost Estimate, no. 52849, June 26, 2017

From the summary:
CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law.

Not just for the poor: The crucial role of Medicaid in America’s health care system

Source: Simon Haeder, The Conversation, June 7, 2017

Despite many assertions to the contrary, Senate leaders are now saying they want to vote on the replacement bill for Obamacare before the month is out. Front and center is the planned transformation of America’s Medicaid program, which covers 20 percent of Americans and provides the backbone of America’s health care system. …. To understand how the ACHA’s proposed changes to Medicaid would affect people and our health care system, let’s look more closely at the program….

A Health Care Bargain

Source: Matt Bruenig, Jacobin, June 2, 2017

Don’t believe the critics: a new report shows California’s single-payer plan is eminently affordable.

Economic Analysis of the Healthy California Single-Payer Health Care Proposal (SB-562)
Source: Robert Pollin, James Heintz, Andrew Glyn, Peter Arno, Jeannette Wicks-Lim, University of Massachusetts-Amherst, Political Economy Research Institute (PERI), May 2017

SB 562 (Lara) – The Healthy California Act (pdf)
Source: State of California, Senate Comittee on Appropiations, Senate 2017-2018 Regular Session, Version: April 17, 2017

2017’s Cities Most Affected by Trumpcare

Source: Richie Bernardo, WalletHub, March 20, 2017

…According to estimates by the nonpartisan Congressional Budget Office, the recently proposed American Health Care Act — unofficially going by the names “Trumpcare” and “Ryancare” — would raise the average health-insurance premium for an individual policyholder by 15 to 20 percent just one or two years from now and lower federal subsidies. In contrast, the CBO projected, average Obamacare premiums would decrease 10 percent by 2026.

In order to gauge the AHCA’s impact on people who buy their own insurance, WalletHub’s analysts compared the differences in premium subsidies that the average households in 457 U.S. cities would receive under Obamacare and Trumpcare. Read on for our findings, commentary from a panel of experts and a full description of our methodology….

Source: WalletHub

Pre-ACA Market Practices Provide Lessons for ACA Replacement Approaches

Source: Gary Claxton, Larry Levitt, and Karen Pollitz, Kaiser Family Foundation, Issue Brief, February 2017

From the overview:
Significant changes to the Affordable Care Act (ACA) are being considered by lawmakers who have been critical of its general approach to providing coverage and to some of its key provisions. An important area where changes will be considered has to do with how people with health problems would be able to gain and keep access to coverage and how much they may have to pay for it. People’s health is dynamic. At any given time, an estimated 27% of non-elderly adults have health conditions that would make them ineligible for coverage under traditional non-group underwriting standards that existed prior to the ACA. Over their lifetimes, everyone is at risk of having these periods, some short and some that last for the rest of their lives.

One of the biggest changes that the ACA made to the non-group insurance market was to eliminate consideration by insurers of a person’s health or health history in enrollment and rating decisions. This assured that people who had or who developed health problems would have the same plan choices and pay the same premiums as others, essentially pooling their expected costs together to determine the premiums that all would pay.

Proposals for replacing the ACA such as Rep. Tom Price’s Empowering Patients First Act and Speaker Paul Ryan’s “A Better Way” policy paper would repeal these insurance market rules, moving back towards pre-ACA standards where insurers generally had more leeway to use individual health in enrollment and rating for non-group coverage.1 Under these proposals, people without pre-existing conditions would generally be able to purchase coverage anytime from private insurers. For people with health problems, several approaches have been proposed: (1) requiring insurers to accept people transitioning from previous coverage without a gap (“continuously covered”); (2) allowing insurers to charge higher premiums (within limits) to people with pre-existing conditions who have had a gap in coverage; and (3) establishing high-risk pools, which are public programs that provide coverage to people declined by private insurers…..
Compare Key Elements of ACA Repeal and Replace Proposals with New Interactive Tool

Affordable Care Act Executive Order: Legal Considerations

Source: Congressional Research Service, CRS Reports & Analysis Legal Sidebar, January 24, 2016

On January 20, 2017, President Donald J. Trump issued an executive order (EO) declaring his intention to “seek the prompt repeal of the Patient Protection and Affordable Care Act [ACA]” while minimizing “economic and regulatory burdens of the Act,” ensuring that the ACA is “efficiently implemented,” and preparing to allow states “more flexibility and control.” Broadly, the EO issues the following three directives to executive branch agencies:

– First, it directs agencies with authorities or responsibilities under the ACA to “waive, defer, grant exemptions from, or delay the implementation of” any ACA provision that would impose a fiscal or regulatory burden on states or a host of private entities (including individuals, health care providers, health insurers, and medical device manufacturers).
– Second, the EO directs those same agencies to provide greater flexibility and cooperation to states in implementing healthcare programs.
– Third, the EO directs all agencies with responsibilities relating to healthcare or health insurance to encourage the development of a free and open interstate market for health services and health insurance…

Repeal & Replace Watch

Source: Kaiser Health News, 2017

President-elect Donald Trump has promised to “repeal and replace” the Affordable Care Act, but has offered few details about what comes next. That’s why Kaiser Health News is launching Repeal & Replace Watch to track the new administration’s plans to revamp America’s health care system.

With a steady stream of analysis, explanation, investigation and data, Repeal & Replace Watch will follow how the new politics of health care are playing out here in D.C. We’ll also report on how the changes in Washington affect patients, hospitals, doctors and insurers across the country.