ObamaCareWATCH – Weekly Newsletter – February 9, 2018

Top articles of the week from the Galen Institute’s

— ObamacareWatch.org —

**** February 9, 2018 ****


* The GOP’s Coming Obamacare Capitulation
* Lindsey Graham: Abandoning Obamacare Repeal ‘Biggest Mistake We Could Make in 2018’
* Trump’s Domestic Policy Chief: We Have an Ambitious Health Care Agenda For 2018
* From Clinics to Child Insurance, Budget Deal Affects Health Care
* Pharma furious after being “blindsided” in budget deal
* House Passes Bill to Ease Menu Labeling Rules Under Obamacare
* JAMA Forum: Don’t Let Budget Cuts Wreck Medicare Reform
* Making Medicaid a Pathway Out of Poverty
* Gov. Holcomb Announces Federal Approval to Continue the Healthy Indiana Plan
* Let States Emulate Romneycare: It Covered More at Less Cost Than Obamacare
* Why Desperate Families Are Getting Religion on Health Coverage


Congress Must Act on Reform

The GOP’s Coming Obamacare Capitulation
By Doug Badger, Marie Fishpaw, and Michael Needham
National Review, Feb. 5, 2018

Congressional Republicans were elected to repeal Obamacare. They may run this year as the politicians who saved it. Since late last year, GOP leaders have been planning to pump tens of billions of dollars’ worth of new federal spending into the veins of insurance companies that are hemorrhaging red ink on the Obamacare exchanges. The transfusion is expected to appropriate cost-sharing-reduction payments to insurers and give insurers an additional $10 billion (and perhaps more) in federal cash. Both bills are a distraction and fail to address the real reasons Obamacare is driving up premium costs and reducing Americans’ insurance options. If Republicans don’t coalesce behind something soon, they will find themselves bystanders as their GOP colleagues link arms with Democrats to preserve and enlarge Obamacare, not to repeal and replace it.

Lindsey Graham: Abandoning Obamacare Repeal ‘Biggest Mistake We Could Make in 2018’ –
By Sean Moran
Breitbart News, Feb. 6, 2018

Sen. Lindsey Graham (R-SC) said this week that giving up Obamacare repeal “could be the biggest mistake we could make in 2018,” which will “hurt us at the ballot box.” Sen. Graham continued, “If the reports are true that the Republican leadership is abandoning the promise to repeal Obamacare, it’s a huge mistake not only in the short term, but also the long run. There’s only unpardonable sin in politics, and that’s to stop trying to fulfill a promise.”

Trump’s Domestic Policy Chief: We Have an Ambitious Health Care Agenda For 2018
By Avik Roy
Forbes, Feb. 4, 2018

President Trump’s State of the Union address left some declaring that he has “thrown in the towel” on repealing Obamacare. But conversations with people in the Trump White House make clear that health care, including Obamacare, remains front-and-center for this administration. The view of Andrew Bremberg, Director of the President’s Domestic Policy Council—and his boss’s view—is that the Trump administration has done more than people appreciate on Obamacare, and on health care more broadly. On health care, Trump’s “policy direction is more robust and substantive than some people understand,” Bremberg said.

The Budget Deal

From Clinics to Child Insurance, Budget Deal Affects Health Care
By Robert Pear
The New York Times, Feb. 8, 2018

The budget deal that was passed last night in Congress includes health care provisions including an additional four-year extension of funds for the Children’s Health Insurance Program, funding for community health centers, and the Independent Payment Advisory Board, a powerful 15-member panel created by the ACA to control the rising costs of Medicare. The board was to recommend specific savings if Medicare spending per beneficiary was projected to grow faster than certain benchmarks, but these recommendations did not need congressional approval to take effect (and were not subject to judicial review). The power of the board gave pause to politicians in both parties.

Pharma furious after being “blindsided” in budget deal
By Caitlin Owens and Bob Herman
Axios, Feb. 9, 2018

The pharmaceutical industry is livid about a surprise change to Medicare drug policy that was slipped into the Senate budget deal. The bill would close the Medicare Part D “donut hole” in 2019, a year earlier than required under the ACA, and force drug companies to shoulder most of the cost. “Rather than prioritizing lowering seniors’ out-of-pocket costs, this proposal provides a massive bailout for insurance companies and undermines their incentive to reduce Part D costs, an incentive that has worked well for more than a decade,” said Steve Ubl, the CEO of the Pharmaceutical Research and Manufacturers of America, the industry’s leading trade group.

House Passes Bill to Ease Menu Labeling Rules Under Obamacare
By Lydia Wheeler
The Hill, Feb. 6, 2018

The House passed legislation Tuesday to ease the ObamaCare rule that requires restaurants, convenience stores and supermarkets to list the calorie count of each menu item before it’s set to take effect in May. The Common Sense Nutrition Disclosure Act, introduced by Rep. Cathy McMorris Rodgers (R-WA) and Tony Cárdenas (D-CA), passed, 266-157, with the support of 32 Democrats. The legislation keeps business owners from having to provide calorie counts for every possible variation of a sandwich, salad or slice of pizza. Instead, sandwich shops and pizza chains could give a calorie range, base the calorie count on how the item is commonly ordered or list the number of calories per serving.

Reforming Government-Sponsored Health Care Programs

JAMA Forum: Don’t Let Budget Cuts Wreck Medicare Reform
By Stuart Butler
JAMA Forum, Feb. 2, 2018

Although entitlement reform is certainly needed, Republicans should be focusing on reforming Medicare rather than Medicaid, as Medicare is the bigger fiscal problem. Moreover, while the ACA’s budget controls need to be maintained and refined, two other key reforms are required—and each could be crafted in ways that could win bipartisan appeal. One is an expansion of Medicare Advantage with premium support. The other is to learn from Medicaid by introducing new waiver authority in Medicare to invest in nonmedical services that can improve health, such as social services and safer housing.

Making Medicaid a Pathway Out of Poverty
By CMS Administrator Seema Verma
The Washington Post, Feb. 4, 2018

Our nation should always give our utmost attention and care for Americans most in need. As such, we must allow states, who know the unique needs of their citizens, to design programs that don’t merely provide a Medicaid card but provide care that allows people to rise out of poverty and no longer need public assistance. The aim is to restore a strong state-federal relationship while also modernizing the program to deliver better outcomes for all the populations served. The first step is to recognize that Washington does not know what is best for states. To the contrary, we should empower states to work with their communities, providers and citizens to design innovative programs that meet their diverse needs, while holding them accountable for achieving positive outcomes.

States

Gov. Holcomb Announces Federal Approval to Continue the Healthy Indiana Plan
Fox 59, Feb. 2, 2018

Indiana Gov. Holcomb joined HHS Secretary Alex Azar in Indianapolis on Friday to announce that the state gained federal approval to continue its Healthy Indiana Plan.  The plan, which the state calls a successful alternative to traditional Medicaid, has been approved through Dec. 2020. This will allow the state to continue health coverage for more than 400,000 low-income adult Hoosiers. The Healthy Indiana Plan was created in 2007 under Gov. Mitch Daniels and expanded in 2015 by then Gov. Mike Pence with a federal waiver to implement HIP as an alternative to traditional Medicaid expansion.

Let States Emulate Romneycare: It Covered More at Less Cost Than Obamacare
By Chris Pope
Manhattan Institute, Feb. 6, 2018

Chris Pope, a health policy expert at the Manhattan Institute, argues that the GOP should allow states to structure ACA funds as block grants, allowing them to increase the number of insured by filling gaps in private insurance. This follows the model designed by former Massachusetts Gov. Mitt Romney that covered more people than under the ACA, despite spending less in public funds. As opposed to Obamacare, Romneycare was better at targeting assistance to fill gaps in coverage and was more careful to ensure that increased public spending supplemented private spending rather than supplanting it.

Insurance Alternatives

Why Desperate Families Are Getting Religion on Health Coverage
By Paul Demko and Renuka Rayasam
Politico, Feb. 4, 2018

Health care sharing ministries have become a more entrenched part of the health care system than anyone could have possibly imagined eight years ago when they were quietly exempted from Obamacare’s individual mandate penalty. The plans were an afterthought at the time, with only about 150,000 individuals enrolled in the faith-based plans. In the ensuing eight years, however, enrollment in health sharing ministries has skyrocketed, particularly in states in which the individual insurance market has been beset by spiraling premiums and dwindling competition. As more people look for cheaper alternatives to health insurance, they are stumbling on ministry plans to escape Obamacare’s requirements and state oversight but still satisfy the law’s individual mandate which, despite its repeal in the recent tax overhaul, remains in effect until 2019.

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