News Update for February 27, 2017
President Trump to Talk Healthcare in Public Address to Congress
President Trump will be making a nationally televised address to a joint session of Congress this Tuesday night. He will be discussing healthcare and the repeal and reformation of the Affordable Care Act, as well as many other topics.
Tensions Flare over Obamacare and Medicaid Reform at National Governors’ Association Meeting
At the National Governors’ Association Meeting this weekend, a heated debate arose between Democratic and Republican governors. After hearing a report that a Medicaid overhaul “would result in tens of thousands of people losing their insurance coverage in an average-size state,” Democrats, such as Washington Governor Jay Inslee, called the report “disturbing” and accused Republicans of wanting “to spend less money on people’s healthcare so they can do tax cuts for the rich.”
Some Republicans, including Governor Matt Bevin of Kentucky, believe these results are necessary to fix what they see as a broken Medicaid system. Governor Bevin stated, “The piper has to get paid at some point.” Other Republicans, such as Governor Doug Ducey of Arizona said that none of the governors “want to see any citizen have the rug pulled out from underneath them” and that the governors would work hard to improve healthcare and reform the Medicaid system.
House Republicans Might Present Obamacare Plan Later This Week
A leaked draft of a House Republican bill to repeal the Affordable Care Act was obtained by Politico last week. The draft is most likely undergoing some changes at the moment, possibly because many experts said that the proposal would result in a large increase in the country’s rate of uninsured people. House Speaker Paul Ryan has said that he wants to present a repeal bill later this week.
Execs from Major Insurance Companies to Meet with President Today
Cigna Corp, Humana Inc, and the Blue Cross Blue Shield Association announced that some of their executives would be meeting with President Donald Trump on Monday. Representatives of other insurance companies are also expected to attend. Last week, the Trump administration proposed rules to attempt to alleviate concerns that many of these companies had about the individual insurance marketplace. However, many insurance companies felt that the proposals were inadequate and they are looking for assurances “that the government will continue to provide cost-sharing subsidies” for the individual marketplace.
Vermont, a Blue State, Redesigns Its Healthcare Plan to One Similar to Republican-Approved Plan
Vermont is attempting a statewide experiment to change how its healthcare is delivered and paid for. The new experiment “aims to test new payment systems, prevent unnecessary treatments, constrain overall growth in the cost of services and drugs, and address public health problems such as opioid abuse.”
The Affordable Care Act has a provision that permits state governments to launch experimental healthcare reforms so long as certain coverage expansions and consumer protections remain. Vermont’s experiment, which was approved by the Obama administration in October, is notable because it is being enacted in a blue state, despite the experimental plan’s many similarities to Republican proposals.
News Update for February 24, 2017
Draft of Obamacare Replacement Bill Leaked
Politico has obtained a draft of a House Republican repeal bill. The bill would take apart the Obamacare individual mandate, end subsidies based on income for the individual insurance marketplace, roll back Medicaid expansion funding, and give state governments money to help them create high-risk pools for people with pre-existing conditions.
The replacement would fund itself “by limiting tax breaks on generous health plans people get at work.” Read more.
House Republicans Are Trying to Work With Republican Governors on Obamacare Repeal Compromise Bill
The National Governors Association is meeting in Washington for the next couple of days. President Donald Trump will meet with many Republican leaders over the issue of Medicaid funding. Ohio governor John Kasich, a Republican and key supporter of the Medicaid expansion under Obamacare, is a major critic of defunding Medicaid. He will meet with Trump privately over the next few days. House Republicans have reached out to Kasich and Nevada governor Brian Sandoval, another Republican supportive of Medicaid expansion. Many Republican officials throughout the country are in the same boat as Kasich and Sandoval: having to choose between the party line, or whether or not to defund a program that hundreds of thousands rely on in their own states.
Republicans in the House are hoping that Sandoval and Kasich can work out a compromise with other Republican governors who rejected Medicaid expansion. The GOP is hoping that if the governors can resolve concerns amongst themselves, then the party can use the public support of the president and the governors to help get an Obamacare repeal bill passed.
A current plan from House Republicans would temporarily continue using federal funds to cover people who are already insured through Obamacare’s Medicaid expansion. This would, for a time, alleviate concerns for Republican governors who support Medicaid expansion. This plan would also give funding to the 19 Republican-led states that rejected Medicaid expansion.
Former Speaker of the House Says Obamacare Probably Won’t Be Repealed
Former House Speaker John Boehner, at a healthcare conference in Orlando on Thursday, stated that a complete repeal and replace of the Affordable Care Act is “not what’s going to happen.” Boehner, who left politics in 2015 after being pressured out by conservatives in his own party, said that he “started laughing” when Republicans said that they were going to quickly repeal and replace the law. Boehner believes that the Republicans will probably “fix the flaws and put a more conservative box around it,” but the essential framework of the law would probably stay intact. He added, “In the 25 years that I served in the United States Congress, Republicans never, ever, one time agreed on what a healthcare proposal should look like. Not once.”
Can the GOP Ensure Coverage for Pre-Existing Conditions?
Many experts and veteran healthcare industry officials have gone on record to say they believe House Speaker Paul Ryan’s plan to set up high-risk pools for people with pre-existing conditions won’t work. High-risk pools are devoid of healthier (and less expensive) consumers who would otherwise offset the costs of covering people with pre-existing conditions.
The pools under Speaker Ryan’s plan would be run by state governments and be partially financed by the federal government. Ryan’s “A Better Way” plan would give out $2.5 billion a year for the next decade in order to help fund high-risk pools. High-risk pools operated in 35 states before the Affordable Care Act, but their effectiveness was inconsistent. Before the ACA’s reforms took effect, $5 billion was set aside by the federal government to set up a “temporary national high-risk pool program.” According to Kathleen Sebelius, a former Secretary of Health and Human Services under President Obama, the pools “ran out of money because the costs were far more expensive than anyone could have, would have predicted just given the fact that there’s some really sick folks out there.” Many conservative health policy experts also agree that the plan and its financing are unworkable. “The needed amount is more like $16 billion [a year],” says Dean Clancy, a health policy consultant who worked in the George W. Bush administration.
News Update for February 23, 2017
Polls Indicate Approval for Obamacare Continues to Rise
New polls conducted by Morning Consult/Politico show that the Affordable Care Act has again increased in popularity compared to polls conducted earlier this year, since President Trump first took office. “Fifty-one percent of registered voters said Obamacare should be completely or partially repealed,” which is “down 8 percentage points from the beginning of the year. … Seventy-eight percent of GOP voters want the ACA to be at least partially repealed,” which is down 5 percentage points. Support for whether the law should be completely or partially repealed declined by 9 percent for independent voters and 6 percent for Democrats.
Congressional Republicans Not Expecting Trump to Offer His Own Plans for Obamacare Repeal
In January, President Donald Trump said that he and his allies in Congress would be “filing a plan” for Obamacare’s repeal and replacement as soon as Tom Price was confirmed as Secretary of Health and Human Services. Now, indications from the executive branch and the House suggest that Trump will go for a hands-off approach. Congressional Republicans are expecting Trump to not involve himself in the crafting of the legislation. They are, however, expecting him to provide his public endorsement of later proposed bills in order to get them passed.
GOP Looking to Cut Out Parts of Obamacare’s 10 Essential Benefits
Hoping to cut costs, some Republicans are suggesting a roundabout solution to cutting or weakening Obamacare’s 10 essential health benefits. Because the benefits are explicitly laid out in the Affordable Care Act, the law would have to be changed outright in order to get rid of them. This is unlikely to happen immediately as it would be highly improbable for Republicans to obtain the 60 Senate votes needed to enact this scenario. Instead, Republicans could change regulations that federal officials wrote to enact the law. This would, in effect, weaken or eliminate the enforcement of the 10 essential health benefits. Read this NPR article to learn more.
Small Businesses Are Worried Congress Will Continue Ignoring Their Insurance Complaints in Obamacare Repeal
Many small business owners believe Democrats focused too much on reforming the individual insurance marketplace when they created and passed Obamacare. Small businesses (defined as businesses with fewer than 50 workers) feel that this focus was done at the expense of their own concerns.
Employer-based health insurance is the largest source of coverage in America, and “more than 56 million Americans work for small businesses,” which make up to 90 percent of the country’s employers. The percentage of employers who offer employer-based health benefits has been falling over the last 20 years, led mostly by small businesses who struggle to afford the coverage.
Barbara Otto, the director of Health and Disability Advocates in Chicago, an organization that advocates for increased access to healthcare, said “Small business must have a seat at the table. They were not central to the first round of healthcare reform.” She believes that if the new administration can center small employers as a cornerstone for any new healthcare reform laws, the administration will be able to provide an environment for financial growth and more efficient health insurance coverage.
News Update for February 22, 2017
Protests and Contentious Town Halls Continue for Republican Lawmakers Seeking to Repeal Obamacare
Multiple sources have been reporting over the past week or so a marked increase in rallies, protests, and town hall meetings swarmed by Obamacare supporters. These passionate displays of support stem from constituents’ fear over losing their healthcare coverage. Many of them feel that a rushed repeal process could threaten their lives or livelihoods. This Business Insider article collects footage and recollections of constituents’ grievances from around the country.
Group Tied to Senate Majority Leader to Release Pro-Repeal AND Replace Campaign in Response to Obamacare Hardliners
A group affiliated with Senate Majority Leader Mitch McConnell, One Nation, is announcing a series of TV ads in 9 states to both highlight the failings of the Affordable Care Act as well as to promise that the GOP will repeal AND replace the law. The campaign is expected to cost over $3 million. The campaign will also use polling data to show the Freedom Caucus that its hardline stance is out of touch with public opinion.
The poll’s findings include:
- Only 17 percent of Americans polled (1,201 likely voters in 12 Senate battleground states) believe the ACA should be repealed immediately. 34 percent believe it should be repealed only when a replacement is available.
- Only 33 percent of Republicans believe the law should be repealed immediately. 56 percent believe in repeal and replace.
- If repeal passes, 69 percent of respondents believe that the replacement should be enacted immediately. 10 percent believe repeal should be enacted within 6 months. Another 10 percent believe it should take place within a year.
- 66 percent of all voters say they would oppose Democrats who would oppose all replacement plans.
Republican Senators Offer Two Proposals for ACA Risk Corridors Program
The Affordable Care Act’s risk corridors program was designed to attract more comprehensive insurance plans onto the ACA exchanges. As these new plans would be covering more benefits, the ACA established the risk corridors program to help keep these plans affordable to consumers while at the same time economically sustainable for the insurance companies. The risk corridors program used cash from exchange plan companies that did well between 2014 to 2016 to help those that did not do as well in the same years. Many Republicans oppose the risk corridors program. They believe that it is a bailout for health insurance companies. The program, according to the Department of Health and Human Services, owes insurance companies about $8 billion for 2014 and 2015. “Risk corridors program managers have collected enough cash to pay only 15 percent of the 2014 program obligations. Managers have not made any payments for 2015.”
- Senator Marco Rubio (R-FL) has proposed a bill that would prevent the HHS from making any payments to these plans.
- Senator Bill Cassidy (R-LA) has proposed a bill that “would create an optional grant program for states, using the cash that otherwise would be spent on each state’s Affordable Care Act coverage expansion programs.” This bill would allow state governments more autonomy over their approaches to risk corridors programs.
California Senate Introduces Single-Payer Healthcare Bill
State Senator Ricardo Lara (D-Bell Gardens) has introduced a single-payer healthcare bill in the California State Senate. The bill is a preliminary step and, if passed, would officially designate that it would be the “intent of the [State] Legislature” to create a “comprehensive, single-payer health care program.” Experts agree that, while the plan might appeal to many Californians worried about the status of the Affordable Care Act, the disruption that a single-payer system might cause could prove to be its downfall. No specifics were included in the legislation as Lara has, self-admittedly, “not yet figured out the financing” because it is “still early in the legislative process.” Lara was an instrumental figure in last May’s passage of state legislation, which resulted in coverage for 170,000 undocumented immigrant children.