ObamaCare Watch Newsletter 6/08/18

  • Justice Dept. Says Crucial Provisions of Obamacare Are Unconstitutional
  • Texas Plaintiffs Personalize Uphill Legal Challenge to Overturn Obamacare
  • The ObamaCare Fix for Mom and Pop
  • Obamacare’s Cost Sharing Is Too High, Even for HSAs
  • Eight Reasons to Still Hate Obamacare
  • Obamacare Plans Ask for 19% Increase in Washington State
  • HHS To Allow Insurers’ Workaround On 2019 Prices
  • Medicaid Work Requirement Bill Sent to Michigan Governor
  • Virginia Governor Signs Medicaid Expansion into Law
  • The Social Security Trust Fund Goes Bust
  • Pelosi: ‘Medicare for All’ Should Be ‘Evaluated’ If Dems Win House

Legal Challenges

Justice Dept. Says Crucial Provisions of Obamacare Are Unconstitutional
By Robert Pear
The New York Times, June 7, 2018

In a court case filed by Texas and 19 other states, the Justice Department said in a brief on Thursday that the requirement for people to have insurance—the individual mandate—was unconstitutional. If that argument is accepted by the federal court, it could eviscerate major parts of the Affordable Care Act that remain in place. A definitive court ruling could be months away and appeals of any decision could take many more months.

Background from Sam Baker at Axios:

  • The ACA’s individual mandate requires most people to buy insurance or pay a tax penalty. The Supreme Court upheld that in 2012 as a valid use of Congress’ taxing power.
  • When Congress claimed it repealed the individual mandate last year, what it actually did was drop the tax penalty to $0.
  • So the coverage requirement itself is still technically on the books.
  • A group of Republican attorneys general, representing states led by Texas, say it’s now unconstitutional — because the specific penalty the Supreme Court upheld is no longer in effect.
  • That’s the argument the Trump administration’s Justice Department signed onto last night.

Texas Plaintiffs Personalize Uphill Legal Challenge to Overturn Obamacare
By Renuka Rayasam
Politico, June 4, 2018

Two self-employed Texans, John Nantz and Neill Hurley, have leading roles in the latest legal effort to kill Obamacare. The men are the named plaintiffs in a lawsuit by 20 states that argues Congress fatally undercut the law when it repealed the individual mandate penalty in tax cut legislation. Nantz and Hurley say the mandate compels them to buy costly insurance that doesn’t fit their needs—even though the financial penalty for not complying is disappearing next year. The case—which conservatives hope will be the fifth Obamacare challenge considered by the Supreme Court—hinges on whether the rest of the law can legally survive without the mandate.


Regulatory Changes

The ObamaCare Fix for Mom and Pop
By Tom Price
The Wall Street Journal, June 4, 2018

A rule the Labor Department is expected to unveil shortly would greatly expand association health plans (AHPs). AHPs allow small businesses and their employees to buy health insurance through large purchasing groups, creating the same efficiencies that allow big corporations to negotiate lower rates. Through AHPs, small businesses can spread risk and share costs. They could also shop across state lines, creating a truly national market.


Obamacare Impact

Obamacare’s Cost Sharing Is Too High, Even for HSAs
By Edmund Haislmaier
The Heritage Foundation, June 1, 2018

Escalating premiums, higher plan deductibles, higher out-of-pocket maximums, and narrowing provider networks are all manifestations of the basic flaws in Obamacare’s public policy architecture. One effect is that Obamacare’s maximum out-of-pocket limits are higher than those for HSA-compatible plans. As a result, more than half of all plan designs offered on Healthcare.gov in 2018 have out-of-pocket maximums that are too high for the plan to qualify as HSA-compatible. Congress needs to get back to work on repairing the damage done to the individual insurance market by Obamacare.

Eight Reasons to Still Hate Obamacare
By Stephen Moore
Washington Examiner, June 3, 2018

The clear-eyed reality is that things aren’t going well with Obamacare:  1) Health insurance is more expensive than ever;  2) Entitlement spending has exploded;  3) Obamacare has not stopped the stampede of rising health care costs;  4) Americans are paying more money for less health coverage;  5) Fewer insurance choices;  6) Medicaid enrollment is exploding;  7) Nearly 30 million Americans still uninsured; and  8) Obamacare continues to ignore obvious cost-saving alternatives.


Premium Increases 

Obamacare Plans Ask for 19% Increase in Washington State
By Kimberly Leonard
Washington Examiner, June 4, 2018

Health insurers are asking Washington state regulators to allow them to raise the price of Obamacare premiums in 2019 by an average of 19%. Under the latest proposals made public Monday, no county in the state will be left without an Obamacare insurer, but 14 counties would have only one insurer to choose from, which will limit their options and the doctors and hospitals that will be in their network.

HHS To Allow Insurers’ Workaround On 2019 Prices
by Julie Rovner
Kaiser Health News, June 7, 2018

Federal officials will not block insurance companies from again using a workaround to cushion a steep rise in health premiums caused by President Donald Trump’s cancellation of a program established under the Affordable Care Act, Health and Human Services Secretary Alex Azar announced Wednesday. The technique—called “silver loading” because it pushed price increases onto the silver-level plans in the ACA marketplaces—was used by many states for 2018 policies. But federal officials had hinted they might bar the practice next year.


Medicaid 

Medicaid Work Requirement Bill Sent to Michigan Governor
By David Eggert
Associated Press, June 7, 2018

The Republican-led Michigan legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state’s Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature. Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month—through work, school, job or vocational training, an internship, substance abuse treatment, or community service.

Virginia Governor Signs Medicaid Expansion into Law
By Kimberly Leonard
Washington Examiner, June 7, 2018

Gov. Ralph Northam (D-VA) signed a bill into law Thursday that will allow more people to sign up for health care coverage paid for by the Medicaid program. This is projected to move 400,000 low-income residents onto the program. Lawmakers arrived at a compromise on Medicaid and on other parts of spending in part by setting a tax on hospitals. Under Obamacare, the federal government paid for all of the cost of Medicaid expansion in states beginning in 2014, but this support will fall to 90% of costs by 2020. That will mean billions of dollars in additional spending.


National Debt and Single-Payer

The Social Security Trust Fund Goes Bust
By Charles Blahous
The Wall Street Journal, June 7, 2018

The downward spirals have begun. The combined Social Security trust funds—one for disability, one for retirement—as well as Medicare’s hospital-insurance trust fund, will begin eating into their reserves this year, according to reports released this week by the programs’ trustees. The trust funds for these safety-net programs are now projected to diminish until they are depleted. The Medicare hospital-insurance fund is projected to run dry in 2026. The bipartisan trustees have for several years been warning that Social Security and Medicare finances need fundamental repairs or people are going to get hurt.

Pelosi: ‘Medicare for All’ Should Be ‘Evaluated’ If Dems Win House
By Peter Sullivan
The Hill, June 7, 2018

House Democratic Leader Nancy Pelosi (CA) said Thursday that “Medicare for All” proposals should be “evaluated” if Democrats win back the House this year, adding “it’s all on the table.” Pelosi has long backed a public option for health insurance but has not supported going further—as many Democrats want—and setting up government-run, universal health insurance. The Democratic leader did not explicitly endorse the idea of Medicare for All during a press conference Wednesday, but she also did not rule out the proposal.