By Avik Roy
Forbes, Dec. 1, 2018
The blue ribbon for the Dumbest Tax in Obamacare goes to its tax on health insurance premiums, which the Joint Committee on Taxation estimates as raising $161 billion in revenue between 2019 and 2028. The problem is this: Health insurers pass along the cost of the tax in the form of higher premiums for consumers. According to estimates developed by consultants at Oliver Wyman, for every dollar Washington raises in taxes, premiums go up by around $1.27. There is a perfect opportunity for Republicans to repeal a tax that would result in lower premiums for hundreds of millions of Americans and reduced federal spending to boot. State governments would benefit, too, as the premium tax raises their costs for administering Medicaid managed-care plans.
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 James Varney
The Washington Times, Dec. 4, 2018
Louisiana’s legislative auditor wanted to know how the state’s expansion of Medicaid under Obamacare was doing, so he picked 100 people who were deemed eligible under the rules. He found that 82 of them made so much money that they shouldn’t have qualified for the benefits they received. [But, hey, with the federal government initially footing 100% of the costs, who cares?] Auditor Daryl G. Purpera, who issued his findings last month to little fanfare outside of Louisiana, figured if those statistics hold true for the rest of the expanded Medicaid population in his state alone, then the losses to ineligible beneficiaries could be as high as $85 million.
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 Nathaniel Weixel
The Hill, Nov. 29, 2018
Momentum is building among House Democrats for a more moderate alternative to single-payer health care legislation. The legislation, which would allow people aged 50 to 65 to buy in to Medicare, is being championed by Rep. Brian Higgins (D-NY), who supported House Minority Nancy Pelosi (D-CA) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year. Under Higgins’s plan, anyone aged 50 to 64 who buys insurance through the health care exchanges would be eligible to buy in to Medicare.
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 Doug Badger
Galen Institute, Nov. 27, 2018
Replacing our health care financing system with a single-payer system could have profound and unforeseeable consequences on the capacity of doctors, hospitals and other providers to deliver quality care. In this important new paper, Badger argues that substituting government financing for employer-sponsored insurance would:
1. Place fiscal burdens on taxpayers that the private sector now voluntarily bears
2. Require workers with ESI to pay more to finance care for others
3. Eliminate the higher reimbursement rates that private insurers typically pay and which preserve access to medical care for those enrolled in public programs.