By Rea Hederman and Andrew Kidd
The Hill, Dec. 3, 2018
When Medicaid expansion under the Affordable Care Act (ACA) added healthy, able-bodied adults without dependent children to the list of beneficiaries, policymakers overlooked the substantial price paid by these recipients who, as the Congressional Budget Office once forecasted, forego hourly wages and earnings in order to maintain their Medicaid eligibility.In a new paper, Healthy and Working: Benefits of Work Requirements for Medicaid Recipients, the authors explain that healthy and single Medicaid recipients working less than 20 hours a week, afraid to work more at the risk of losing their benefits, may actually sacrifice hundreds of thousands of dollars in earnings over their lifetime—more than $212,000 for women and $323,000 for men. Medicaid’s non-work incentive has some not-so-healthy consequences.
By Anna Gorman
The Washington Post, Dec. 3, 2018
Newly-available short-term insurance plans are an enticing, low-cost alternative for healthy people, with federal rules allowing plans that last up to three years. Colorado resident Gene Ferry, 66, recently bought a short-term health plan for his wife, Stephanie, who will become eligible for Medicare when she turns 65 in August. The difference in the monthly premium price for her new, cheaper plan through LifeShield National Insurance and the policy he had through the ACA is $650.
By U.S. Department of Health and Human Services, Dec. 3, 2018
As health care spending continues to rise, Americans are not receiving the commensurate benefit of living longer, healthier lives. Invoices for medical care are too complex, choices are too restrained, and insurance premiums and out-of-pocket costs are climbing faster than wages and tax revenue. In this new report, HHS suggests a range of opportunities for action to revise federal and state regulations, including repealing certificate of need laws, expanding health savings accounts, developing alternative payment models with a free-market approach, changing state licensing and scope of practice laws, greater use of telemedicine, and others in nearly 50 options for change.
By Lanhee Chen
HealthAffairs, Nov. 16, 2018
In 2020, the Republican presidential nominee will likely signal broad opposition to the ACA and a desire to replace it with a state innovation–based approach to reform, based on the Graham-Cassidy-Heller-Johnson legislation considered by the Senate in the fall of 2017. This article takes that legislation as a starting point, contextualizes it within the broader health reform discussion, and suggests ways to improve upon it to enhance the affordability of and access to coverage and to ensure that states have adequate flexibility to implement their policy goals.
By Doug Badger
The Daily Signal, Nov. 20, 2018
A federal judge is expected to rule soon on whether Obamacare’s individual mandate is constitutional without a tax penalty to enforce it, and if it is not, whether the rest of Obamacare’s provisions (including its insurance regulations) are no longer operative. Even if the high court were to strike down the federal rules, states would retain the authority to regulate health insurance. Policymakers should not panic with hasty legislation. States would be free to explore other ideas to protect people who have pre-existing conditions without pricing health insurance out of the reach of those who don’t and could pursue innovative regulatory approaches to improve their insurance markets.
By Stephanie Armour
The Wall Street Journal, Nov. 29, 2018
The Trump administration on Thursday released four model waiver ideas states can use under its new-and-improved Section 1332 guidance to give them more flexibility to lower premiums and increase choices in their health insurance markets. The templates suggest ways states could use waivers to restructure ACA premium subsidies that now go to almost nine million people. As examples, states can develop a new premium subsidy structure and decide how those premium subsidies should be targeted; they can set the rules for what type of health plan is eligible for state premium subsidies to give people access to more health plan options; and states can implement risk stabilization strategies to address the costs of high risk individuals to reduce premiums in the market for everyone.
By Scott Atlas
The Wall Street Journal, Nov. 12, 2018
Nationwide “Medicare for all” would cost more than $32 trillion over its first decade. Doubling federal income and corporate taxes wouldn’t be enough to pay for it. No doubt, that cost would be used to justify further restrictions on health care access. But the problems with single-payer go well beyond cost. In the past half-century, nationalized programs have consistently failed to provide timely, high-quality medical care compared with the U.S. system. That failure has countless consequences for citizens: pain, suffering and death, permanent disability, and forgone wages.
By Rea Hederman
The Hill, Nov. 2, 2018
President Trump’s Department of Health and Human Services recently announced welcome new guidance to states looking to improve their health care and health insurance systems through “state innovation waivers” under Section 1332 of the ACA. The new guidance gives states significantly more flexibility to devise creative solutions to meet the health care and insurance needs of their constituents, and it builds upon new community engagement waivers that made Medicaid more flexible for states earlier this year. Section 1332 allows states to experiment and creatively tailor their health care coverage programs under certain conditions.
By Ryan Ellis
Washington Examiner, October 26, 2018
The Trump administration has been hard at work doing what it can to give families more and better healthcare choices than what Obamacare saddled them with. In so doing, the administration has created several welcome escape hatches from Obamacare. From giving employees more flexibility in how they obtain health coverage, to Association Health Plans, less-expensive short-term plans for bridge coverage, and giving states the flexibility to tailor ACA spending more to their citizens’ needs, the Trump administration’s “Obamacare Optional” agenda of more choices and more affordable healthcare is a very robust one.
By Jonathan Ingram
Foundation for Government Accountability, Oct. 30, 2018
In August 2018, the Trump administration finalized a rule to strengthen short-term plans by allowing individuals to keep them for a period of up to 364 days (and renew them for up to three years). The new rule is one of several strategies the Trump administration has pursued to offer more affordable options to millions of Americans who were priced out of the insurance market by skyrocketing premiums. New research from the Foundation for Government Accountability finds that for the average monthly premium for a 40-year-old non-smoking female, short-term plans would be 59% less expensive than individual market plans. For the same patient, there would be eight times as many short-term plans available.