Monthly Archives: July 2018

The long-anticipated surge of retiring baby boomers is upon us. The Medicare trustees recently estimated that Medicare Part A (the hospital insurance trust fund) will go bankrupt in 2026, only eight years from now—and three years sooner than they predicted in last year’s report. Consumer decisions and behavior provide important clues about where policymakers can go from here. For decades the debate in Washington has centered on benefit expansion, benefit reduction, or tax increases. In the real world, consumers are offering a fourth way to preserve Medicare: choice and competition.

House Republicans are trying to blunt Democratic attacks over rising Obamacare premiums, an issue that’s poised to play a key role in the November midterm elections. “At least we’re taking some action, and rightfully so, because to do nothing I think is just, one, it’s not the right thing to do,” said Rep. Tom Reed (R-NY), a member of the House Ways and Means Committee, which advanced many of the health care bills last week. “And second, politically to do nothing is not a [good idea].” The bills slated for votes in the House next week include measures expanding HSAs. Sources say other measures include a repeal of Obamacare’s medical device tax and a delay of the health insurance tax, which some members of both parties have criticized for driving up premiums.

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House Republicans want to pass a bill delaying Obamacare’s 40% excise tax on high-cost employer plans—the “Cadillac tax”—by another year, to 2023. GOP hostility to this tax is a mistake. Capping the tax break for job-based insurance is essential for a market-based approach to cost control. The federal government heavily subsidizes every extra dollar spent on job-based insurance, which undermines the incentive for employers and workers to seek out lower-cost options. Some Republicans believe they can kill the Cadillac tax and replace it later with a better alternative. That’s wishful thinking. If Congress keeps delaying the tax and eventually kills it, there will be no appetite to impose a different version of the same policy.

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The Trump administration moved swiftly this week to implement pieces of its plan to bring down drug prices. The Health and Human Services Department on Wednesday submitted a proposal to the White House that would curb kickback exemptions that allow drugmakers to offer insurers and pharmacy-benefit managers rebates widely blamed for keeping drug prices high. On the same day, the Food and Drug Administration released a plan to boost the market for biosimilars, or generic copies of expensive drugs that contain living organisms. On Thursday, FDA Commissioner Scott Gottlieb also said the agency would consider allowing importation of drugs from other countries under certain conditions, including when a generic-drug company that is the sole provider of a medication significantly raises the price of that drug.

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For Kalena Bruce, a fifth-generation cattle farmer in Stockton, Missouri, finding affordable health coverage under Obamacare hasn’t been easy. She’s a young mom and business owner paying $700 a month in premiums alone, not to mention deductibles and copays.

That’s why she’s become an advocate for allowing more small businesses like hers to bring down their health care costs by pooling together. It’s an idea that’s worked for Missouri businesses for more than 15 years and will now be available nationwide thanks to the Trump administration’s new rule expanding access to association health plans, or AHPs.

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Health insurance companies in Colorado have asked to increase premiums by an average of 5.94 percent for 2019 in the Obamacare market, according to rate filings.

No insurers are leaving the exchange, and every county will have at least one health insurer offering coverage. The requested average premium increase for individual gold plans is 6.85 percent, and 12.3 percent for silver plans. For bronze plans, the requested average premium increase is 0.9 percent. Anthem’s filings requested a decrease in premium rates.

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The Trump administration’s drive to wean poor people from government benefits by making them work has been slowed by a federal judge framing a fundamental question: Are poverty programs meant to show tough love or to help the needy?

U.S. District Judge James E. Boasberg in Washington last week halted Kentucky’s first-in-the-nation experiment with Medicaid work requirements, ruling that the Trump administration glossed over potential coverage losses. He sent the state’s plan back to federal authorities for a harder look.

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The federal Centers for Medicare and Medicaid Services has approved Oklahoma’s Medicaid program for a first-in-the-nation drug pricing experiment that supporters say could save taxpayer dollars and provide patients with the most effective medications for their ailments.

Under the “value-based purchasing” program approved in late June, the state and a pharmaceutical company would agree to a set payment if its medication works as advertised, but only a fraction of that if the drug is not as effective as promised.

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A provision of Obamacare that opponents once saw as a potential loophole allowing a Republican president to unravel the law by executive order is now being used by some states to steady their shaky Obamacare markets.

Since the inception of Obamacare, “state innovation waivers,” which ostensibly provide states with some flexibility to experiment with different ways to provide healthcare for their residents, were eyed by those seeking to repeal the law. During the 2012 Republican presidential primaries, Mitt Romney repeatedly vowed that if elected, “On Day One I would issue an executive order paving the way for Obamacare waivers to all 50 states.” Early in the Trump administration, officials saw the waivers as a backup plan to ease Obamacare regulations if congressional repeal efforts were unsuccessful.

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