ObamaCare Watch Newsletter 4/20/18

  • Here’s the Path Forward for Health Reform in 2018 –
  • Trump Official: Alternative to ObamaCare Plans Likely This Summer –
  • Effects of the Affordable Care Act on Health Behaviors after Three Years –
  • 3 Red States Could Put Medicaid Expansion on the Ballot This Year –
  • Arizona Proposes $40 Million Cut to Medicaid Reimbursement –
  • Dem Senators Unveil Expanded Public Option for Health Insurance –
  • Exposing the Myth of Widespread Medical Bankruptcies

Expanding Patient Freedom

 

Here’s the Path Forward for Health Reform in 2018
By Marie Fishpaw and Grace-Marie Turner and 30 conservative leaders
The Daily Signal, April 18, 2018

Americans need genuine relief that doesn’t just paper over Obamacare’s serious flaws but instead opens a new path for real reform. The conservative community is working to chart this new path based on the reform plan offered last year by Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Ron Johnson (R-WS), and Dean Heller (R-NV). The plan targets the two main problems under Obamacare: Costs went up, and choices went down. To fix these problems, we lay out three big goals to: 1) lower costs and improve patient choices, 2) give states flexibility and resources to achieve these goals, and 3) set federal guardrails so people can choose private coverage if they don’t like the options their state provides.  More than 30 conservative leaders joined in signing the open letter urging action on reform.

Trump Official: Alternative to ObamaCare Plans Likely This Summer
By Peter Sullivan
The Hill, April 16, 2018

The Trump administration hopes to move forward with a rule expanding alternatives to ObamaCare plans by this summer, Secretary of Labor Alex Acosta said Monday. The rule allows small businesses and self-employed individuals to band together to buy insurance as a group in what are known as association health plans. “We hope to have that by this summer,” Acosta said Monday during a tax reform event alongside President Trump in Florida.


Impact

 

Effects of the Affordable Care Act on Health Behaviors after Three Years
By Courtemanche, Marton, et al.
National Bureau of Economic Research, April 2018

Economists analyzed the impacts of the ACA—which, they write, “increased insurance coverage through regulations, mandates, subsidies, and Medicaid expansions”—on behaviors related to future health risks after three years. They found that the ACA increased use of preventive care, but also increased risky drinking. These results are driven by the private portions of the law, as opposed to the Medicaid expansion.  The authors used data from the Behavioral Risk Factor Surveillance System and an identification strategy that leveraged variation in pre-ACA uninsured rates and state Medicaid expansion decisions.


Medicaid

 

3 Red States Could Put Medicaid Expansion on the Ballot This Year
By Dylan Scott
Vox, April 16, 2018

Medicaid expansion is back on the ballot. Organizers in Utah submitted signatures on Monday to put an initiative expanding Medicaid on the state’s ballot in November.Last year, Maine became the first state to approve Medicaid expansion by ballot initiative. Organizers are also hoping to put initiatives on the ballot in Idaho and Nebraska.

Arizona Proposes $40 Million Cut to Medicaid Reimbursement
By Virgil Dickson
Modern Healthcare, April 16, 2018

Arizona has asked CMS to allow it to end retroactive coverage for Medicaid beneficiaries. If granted, the waiver request now under review at the CMS, would nix providers’ ability to bill for services provided in the three months before a beneficiary applies for Medicaid coverage, assuming the patient was eligible during that time. Providers in the state had urged the state not to submit the waiver to the CMS because it could put hospitals in a difficult financial situation and limit access to care.


Democrats Look to Build on Obamacare

 

Dem Senators Unveil Expanded Public Option for Health Insurance
By Peter Sullivan
The Hill, April 18, 2018

A group of Democratic senators on Wednesday introduced an expanded public option for health insurance as the party debates the next steps to build on ObamaCare. The new proposal, called the Choose Medicare Act, was introduced by Sens. Chris Murphy (D-CT) and Jeff Merkley (D-OR). The measure has no real chance of becoming law anytime soon but is part of a growing debate among Democrats about what the best next steps beyond ObamaCare are, which could come to fruition when Democrats next win back the White House.


Health Care Affordability

 

Exposing the Myth of Widespread Medical Bankruptcies
By Aparna Mathur
Forbes, April 9, 2018

In 2005 and 2009, Elizabeth Warren and her co-authors released two papers claiming that more than half of all bankruptcy filings in the U.S. were caused by medical debts. Now an academic study published in the New England Journal of Medicine challenges these results. The study tracks a stratified sample of adults between the ages of 25 and 64 who were admitted to the hospital for non-birth-related reasons between 2003 and 2007. It finds that fewer than 4% of hospitalizations resulted in bankruptcies, far lower than the 2009 study’s claimed 62%.

The study shows the sample in the original studies was skewed:  By limiting the sample to those who had already filed for bankruptcy, the study overstated the incidence of medical debt. Further, the Warren results show that only 29% of those surveyed believed their bankruptcy was actually causedby medical bills.  However, Warren chose to add people who lost any weeks of work due to their own or a spouse’s illness, the percent of people with more than $5,000 in medical bills, and the percent of people reporting any medical problems. This is clearly an overstatement of the problem.