In 2017 an obscure Obamacare provision takes effect that could enable a Republican president to dismantle Obamacare, without a single vote from Congress.
The provision allows the executive branch to waive large sections of the law for a state that chooses a different approach to expanding health coverage. It was designed to allow progressive states to go further than Obamacare. Vermont, for instance, wanted to create a single-payer plan.
But if Republicans gain control of the White House, the tool could be used by a Republican president, working with Republican governors, to toss the much-reviled individual and employer mandates, health insurance exchanges, subsidies that certain people receive to afford their health plans, and mandates for what benefits are covered.
Read more at Politico:
Hillary Clinton will roll out her fixes to the Affordable Care Act this week, an aide said Sunday, and will do so by hitting Republicans for outright opposing the law.
Attaching herself to one of President Barack Obama’s most consequential legislative achievements, Clinton will use events in Louisiana, Arkansas and Iowa to tout the controversial law’s successes, offering a contrast to Republican presidential hopefuls who oppose the plan.
A new report in The Washington Post (online, by Lena H. Sun, 9/14) “hospitals treating the most vulnerable patients are being deprived of needed resources.”
This information comes from a study as published in the Journal of the American Medical Association (JAMA). The reason? According to Sun’s Washington Post story, “For the last four years, Medicare has wielded a big stick: It has fined hospitals, if too many of their patients returned to any hospital within weeks of being released.”
Additionally, according to The Washington Post, “Researchers at Harvard Medical School found that hospitals are being penalized to a large extent based on the patients they serve. The researchers found that nearly two dozen variables, such as patients’ education, income and ability to bathe, dress and feed themselves, explain nearly half of the difference in readmission rates between the best-and worst-performing hospitals.”
Sun’s Washington Post story features the plight of Franklin Medical Center, in Winnsboro, La. A 39 bed “rural hospital,” they stand to lose, as in pay penalties of $91,000 . . . “for the coming fiscal year,” according to Sun’s article.
Hadley Heath, a senior policy analyst at the Independent Women’s Forum, which in part focuses on healthcare issues, offers latest take on the current state of the Affordable Care Act. It’s featured in The Blaze.com (online, 9/8). She says, “But at its core, our current healthcare payment system is very similar to the system before Obamacare.” She adds, “The law did nothing to alleviate the tax disadvantage that individual-market customers face. In fact, Obamacare’s employer mandate supports the employer-centric nature of our system.”
Ms. Heath also finds fault with what she sees as a “doubling down” scenario, at least when it comes to federal Obamacare mandates, which she says is, “another bad idea, the law creates federal-level benefit mandates . . . on top of what states require. Our new Obamacare system is much like the old health care system: It’s not competitive. It’s not a market. It’s not patient-centered. It’s not transparent. It’s not affordable. It’s rife with third-party payers and cost-shifting. It’s difficult for people to navigate, especially those on the margins of society.”
The Blaze article goes on to suggest some Obamacare improvement, including: Moving away “from an employer-centric health system to one centered on individual choice.”
Heath’s Blaze piece additionally points out, “Obamacare failed to significantly fix the problems in health care because it assumed the wrong premise: that there was too little government intervention in the health sector. In fact, the opposite was true . . . And that’s why there was (and is!) little price transparency, consumer choice, and competition among insurance plans and health providers.”
A survey cited in a recent article in The Hill.com (online 9/9, by Heather Richardson Higgins and Hadley Heath Manning) my shed some light on just how Republicans on Capitol Hill should pursue their individual, if not collective strategies, to revamp or scrap, the Affordable Care Act.
Higgins and Manning elaborate that the “national survey of 1,000 likely voters conducted by McLaughlin and Associates and commissioned by Independent Women’s Voice . . . can point them in the right direction.” For as Higgins and Manning add,” The survey reveals that large pluralities of the American electorate would prefer Congress use reconciliation to target harmful provisions of the ACA, rather than try to repeal the law in full.”
“Perhaps as importantly, an analysis of the survey cross tabs indicates that action against specific provisions of the ACA is even more strongly preferred by key battleground voter groups, such as Independent women and those who are undecided on the generic ballot test question.”
Meanwhile, there is new survey and polling data for Republicans on Capitol Hill to consider. “The data makes clear that even among Republicans, more voters prioritize Congress sending to Obama’s desk targeted relief efforts – – against say, taxes that make the healthcare more expensive, regulations that make insurance overly comprehensive, the individual mandate, and the Independent Payment Advisory Board.”
First it was those without insurance, or possessing substandard health coverage, increasingly using the emergency room as doctor’s office, following the passage of Obamacare. That trend continues, but another is now emergent: an increase in the diagnosis of “chronic diseases,” inclusive of conditions like Diabetes.
A recent report in The (Philadelphia) Inquirer’s Philly.com Web page (un-bylined, 9/9 – citing Health Day) quotes a new study’s senior author, Joshua Salomon, who is professor of global health at Harvard, as saying, “Our study suggests that insurance expansion is likely to have a large and meaningful effect on diagnosis and management of some of the most important chronic illnesses affecting the U.S. population.”
The study also said, as the Philly.com report summarizes, “Insured people were much more likely than uninsured people to receive a diagnosis for a chronic disease, including diabetes, high blood pressure and high cholesterol.”
The research inquiry also forecasts, according to Philly.com, “If the number of Americans without health insurance is cut in half under the ACA, commonly called Obamacare, that likely means up to 1.5 million newly insured people will be diagnosed with one or more chronic illnesses.”
A new report in The Heritage Foundation’s The Daily Signal (online 9/11, by Edmund Haislmaier) asks, “If workers in companies with 50 to 100 employees should not be subjected to Obamacare’s benefit mandates because doing so would result in ‘higher premiums, less flexibility, and new barriers to coverage,’ then on what grounds is it acceptable for Congress to continue subjecting people with individual and small group plans to the same adverse effects?”
Haislmaier’s article also suggests, “the fairer solution would be for Congress to ditch Obamacare’s costly benefit mandates entirely.”
One of Congress’ main issues it must wrestle with upon returning from its August recess, “is a provision in Obamacare that changes the definition of ‘small employer’ from ’50 or fewer employees’ to ‘100 or fewer employees.’” This redefinition takes place, beginning on Jan. 1, 2016. Haislmaier’s Daily Signal article also points out, “While there are instances when Congress has exempted small employers from a requirement imposed on larger businesses, in this instance the opposite is the case,” adding, “That’s because the Affordable Care Act actually imposes more costly benefit mandates on individual and small group health insurance policies than it does on large employer plans.”
Currently, Obamacare’s mandated coverage of ‘Essential Health Benefits’ is applicable to individual consumer policies “and small business group policies sold by insurers, but not to large group policies or to self-insured employer plans (of any size),” according to Haislmaier’s Daily Signal story. The article adds, “Consequently, the impending change in the definition of small employer from 50 to 100 workers means that Obamacare’s costly benefit mandates will soon be extended to the health plans of several million more Americans.”
The ThinkProgress.org site features an article (online, 9/10, by Ian Millhiser). He says a recent development in federal court is a victory for Republicans, at least for now. It’s a milestone for especially those currently serving in the U.S. House. For as Millhiser writes, “The team of lawyers who successfully defended the Affordable Care Act against two attempts to kill it in the Supreme Court hung their collective heads . . . in an acknowledgement that they will need to devote yet another year of their lives to the same cause.” The reason? The case of U.S. House vs. Burwell has been revived by Federal Judge Rosemary Colyer’s most recent ruling, that the case can proceed. Unlike the two predecessor cases targeting president Barack Obama’s “signature” healthcare legislation, this case does not threaten to obliterate the ACA, rather it targets it. It “challenges the subsidies paid to health insurers in order to compensate them for out-of-pocket expenses for relatively low-income beneficiaries – the Republican-controlled house claims that these subsidies were never appropriated by Congress.”