Top articles of the week from the Galen Institute’s

ObamacareWatch.org

**** February 2, 2018 ****


* Graham: ‘I will not give up’ on ObamaCare repeal
* How to Increase Health Insurance Coverage by Reducing ACA Crowd-Out
* Mr. Bezos, Welcome to the Health-Care Jungle
* Bureaucrats, Not Doctors, Are Making Health Care So Expensive
* Alex Azar Sworn in as Trump’s New Health Care Chief
* HHS Touts Regulatory Rollbacks Under Trump’s First Year
* More States Jump on Medicaid Work Requirements Bandwagon
* Virginia State Senate Panel Kills Medicaid Expansion Bill
* New Taxes Will Make Health Care More Expensive in Oregon
* Republicans Need a Plan to Broaden Enrollment in More Affordable Insurance


Moving Forward

Graham: ‘I will not give up’ on ObamaCare repeal
By Peter Sullivan
The Hill, Feb. 1, 2018

Sen. Lindsey Graham (R-S.C.) vowed to keep pushing for the repeal of ObamaCare, despite Republican leaders saying they are not interested in diving back into the contentious ObamaCare repeal fight this year. “If reports are accurate that the GOP leadership in Congress is giving up on the Republican promise to repeal and replace Obamacare with a more efficient health care system, then we deserve to lose,” Graham said in a statement. Graham was a main sponsor of a proposal last year to replace ObamaCare with a system of block grants to states. “I am more determined than ever to move forward with this block grant proposal and deliver health care that works for the American people,” Graham said.

How to Increase Health Insurance Coverage by Reducing ACA Crowd-Out –
By Chris Pope
Manhattan Institute, Jan. 23, 2018

Public health care entitlements in the U.S. have traditionally been designed to supplement rather than to supplant privately purchased health insurance. About 40% of the entitlement funds disbursed under Obamacare, however, have gone to individuals who already had private coverage, called “crowd-out.” While the ACA has reduced the share of the American population without health insurance, its spending has been poorly-targeted, and 28 million remain uninsured. The Manhattan Institute assesses the potential for block grants, as in the Graham-Cassidy bill, that would allow states to target assistance at individuals otherwise lacking coverage. Under such a reform, the same level of federal funding could do more to expand access to care and to provide protection from catastrophic medical costs for those who need help the most.

Costs

Mr. Bezos, Welcome to the Health-Care Jungle
By Editorial Board
The Wall Street Journal, Jan. 31, 2018

Amazon announced Tuesday that it will join with J.P. Morgan Chase and Berkshire Hathaway to wade into the jungle of U.S. health care. The press release says the group will form an “independent company that is free from profit-making incentives and constraints.” The problem with U.S. health care is not an incentive for profit, which has driven innovation and cures for diseases like hepatitis C. The fundamental problem is that the cost of a service is disconnected from underlying value. Patients don’t know the price of services and consume health care as if it’s free since government or employers are the third-party payers for most Americans.

Bureaucrats, Not Doctors, Are Making Health Care So Expensive
By Dr. Marion Mass, Dr. Kenneth A. Fisher
Washington Examiner, Jan. 26, 2018

To meaningfully address skyrocketing health care costs, bold reforms are needed. Rather than simplistic assertions that blame doctors, legislators must tackle health care’s stultifying bureaucracy. Consider the reporting requirements that foisted on physicians. Doctors now spend roughly two-thirds of their professional time on paperwork—mostly filling out the never-ending fields that are part of Electronic Medical Records requirements—rather than attending to patients. Because paperwork doesn’t pay, this means patients are essentially spending three times more than they should have to for their doctors’ time. The good news is that reducing physician paperwork, increasing price transparency, and eliminating Soviet-style regulations may even draw bipartisan support and keep health care reform on the 2018 political calendar.

New Leadership

Alex Azar Sworn in as Trump’s New Health Care Chief
CNBC, Jan. 29, 2018

President Trump vowed Monday that his new health care chief Alex Azar, a former top drug-company executive, is “going to get those prescription drug prices way down” as Azar was sworn in for his job. “It’s doing to come rocketing down,” Trump said as Azar was sworn in as Secretary of Health & Human Services. “We have to get the prices of prescription drugs way down, and unravel the tangled web of special interests that are driving prices up for medicine, and are really hurting patients. . . And nobody knows that process better than Alex.”

HHS Touts Regulatory Rollbacks Under Trump’s First Year
By Shannon Muchmore
Healthcare Dive, Jan. 26, 2018

HHS on Friday released a report  touting its 2017 accomplishments, including regulatory rollbacks and cost savings. The 37-page report highlighted some actions that are priorities for the Trump administration, noting that 70 regulatory actions were withdrawn last year and more than $3 billion was recovered through efforts to stop waste, fraud and abuse. It also pointed to a final rule that cuts hospital payments from the 340B Drug Pricing Program, saying it will save $3.2 billion.

States

More States Jump on Medicaid Work Requirements Bandwagon
Roll Call, Feb. 1, 2018

A growing number of mostly Republican-led states are rushing to follow Kentucky’s lead in requiring thousands of people on Medicaid to work. The governors of South Dakota, Alabama, Louisiana, and South Carolina have said in recent weeks that they plan to pursue work requirements for their Medicaid programs, following the Trump administration’s release of guidelines for the concept in January. “Whenever possible, we should always endeavor to help South Carolinians in need find their path to gainful employment and away from temporary assistance of government,” South Carolina GOP Gov. Henry McMaster tweeted Jan. 11, the same day federal officials announced the new guidance.

Virginia State Senate Panel Kills Medicaid Expansion Bill
By Nathaniel Weixel
The Hill, Jan. 25, 2018

Legislation to expand Medicaid in Virginia failed Thursday after a state Senate panel voted on party lines to defeat the measure. The state’s Education and Health Committee voted down the bill 8-7. The bill can be brought up at another time, but if the committee doesn’t take further action, the bill is dead. The bill would have directed the state’s secretary of Health and Human Resources to submit a Medicaid expansion waiver to the federal government. The bill called for the waiver to include work requirements for “able-bodied” adults and income verification, as well as cost-sharing provisions like premiums and copayments—policies favored by conservatives.

New Taxes Will Make Health Care More Expensive in Oregon
By Thomas Aiello
RealClearHealth, Feb. 1, 2018

Oregon voters recently upheld a myriad of new taxes that were passed as part of a major health-care law – last summer. The state government is planning to use the estimated $320 million in revenue to cover hundreds of thousands of residents who have enrolled through Obamacare. The referendum was on sections of House Bill 2391 , which imposes a 0.7% tax on small hospitals as well as a 1.5% on individual and family health care premiums. These revenue raisers are intended to generate more tax dollars for the state. But they also allow Oregon to receive $630 million to $960 million in federal Medicaid matching funds. While proponents of the 1.5% tax on premiums argue that some Oregonians will benefit from expanded Medicaid coverage, the tax is expected to raise the cost of care for more than 1.2 million people enrolled in the health care market.

Republicans Need a Plan to Broaden Enrollment in More Affordable Insurance
By Joe Antos and James Capretta
HealthAffairs Blog, Jan. 26, 2018

The GOP could try again to fully repeal and replace Obamacare in 2018, perhaps with a modified version of the Graham-Cassidy legislation . However, with Republicans now down to a 51-seat majority in the Senate and some House and Senate members facing difficult mid-term elections this November, it will be even more challenging to get a sweeping rollback of the ACA through Congress in 2018 than it was in 2017. Republicans would have a better chance of getting something passed if they lowered their sights and used the possibility of enacting bipartisan market stabilization legislation to achieve more limited objectives. That legislation could serve as the vehicle for Republicans to pursue additional changes in current law to move the overall system in their preferred direction.

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