In Britain, both health insurance and the delivery of health care is socialized. But the NHS is no paradise. Open a random edition of a British daily newspaper and you will likely encounter an article about some egregious problem that the NHS has failed to solve. For example: NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as not to “distress, upset or confuse” them; terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support; NHS expert guidelines on the management of high cholesterol were intentionally not revised after becoming out of date, putting patients at serious risk in order to save money.
The latest liberal policy idea would effectively end all private health care for many Americans. The proposal, the Medicare for America Act, first appeared as a 2018 paper by the Center for American Progress. It’s been called “the Democratic establishment’s alternative” to Sen. Bernie Sanders’s single-payer scheme and has been framed as a moderate proposal. But the bill is anything but moderate. When Rep. Rosa DeLauro (D-CT) reintroduced Medicare for America legislation on May 1, she included a new, radical provision. The revised bill prohibits any medical provider “from entering into a private contract with an individual enrolled under Medicare for America for any item or service coverable under Medicare for America.” Essentially, this would bar program enrollees from paying for health care with their own money.
Even when the Supreme Court tells a government labor union that it can’t do something, there’s no guarantee that the union will comply. In its 2014 Harris v. Quinn decision, the Court ruled that an Illinois law forcing home health-care workers—paid with Medicaid funds—to shell out cash to labor unions was unconstitutional. That should have ended unions’ ability to collect fees from these workers—many of whom were not really professionals but were receiving a small subsidy from Medicaid to care for disabled family members at home—unless the workers agreed to join the union. The administration announced it will enforce the ruling.
|Short-Term Limited-Duration Insurance (STLDI), which is exempt from ACA rules, survived as a viable competitive market, offering health coverage priced in proportion to individuals’ risks. But it has been disparaged as “junk insurance” that fails to cover adequate provider networks, offers only catastrophic coverage, makes essential benefits unavailable, helps only young and healthy individuals, undermines protections for those with preexisting conditions, and causes premiums for plans on the ACA’s exchange to soar. This study of the STLDI market finds that each of these claims is false. For equivalent insurance protection, the premiums for STLDI plans are lower than—in some cases, almost half the cost of—premiums on the exchange. The savings to be gained from switching to STLDI are even greater for more comprehensive insurance coverage.|
The Trump administration has been working behind the scenes for months on a strategy to force greater price disclosure across much of the $3.5 trillion health-care industry. The push relies on existing administrative tools, according to people familiar with the discussions. Those include Labor Department powers under the law setting minimum standards for private-industry health plans and current hospital-payment rules under Medicare. The administration is strongly interested in forcing insurers to publicize the negotiated rates they pay for services, the people said. The requirement could affect insurers providing coverage in the private-employer market.
|The U.S. House put to a vote this week a bill that would threaten the health coverage of 1.5 million people. H.R. 987 would overturn a Trump administration regulatory-relief policy while wastefully allocating new taxpayer money to programs proven to fail. Among other changes, the bill would block the Trump administration’s relief efforts that help consumers access “short-term, limited-duration” insurance. While these plans were unnecessarily restricted by the Obama administration, the Trump administration has eased regulations to make incremental progress toward expanded affordable health coverage choices. The House bill would reverse this progress, capping duration of the plans at 90 days, and stripping consumers of the right to renew their coverage.|
Democrats pushed through the House Thursday legislation that they say fortifies the ACA and also curbs prescription drug prices. The bill seems engineered with next year’s elections in mind since it has no chance of surviving in the Senate or getting President Trump’s signature. The measure forced Republicans into the uncomfortable political position of casting a single vote on legislation that contained popular bi-partisan drug pricing restraints they support, but also language they oppose about the Affordable Care Act. [The bill would undo many of the consumer-friendly changes the Trump administration has made through its regulatory authority]. In the end, all but five voting Republicans opposed the overall package; the measure passed by a mostly party-line vote of 234-183.
|Newly released Senate legislation to curb surprise medical bills would allow third parties to settle billing disputes, a provision that could complicate passage because it is opposed by the White House and absent from a House draft. The Senate bill represents nearly a year of work led by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH). The Senate bill would have insurers pay out-of-network doctors and hospitals for the difference between a patient’s in-network cost-sharing requirements and the median in-network rate for their services. If either party wanted to appeal the amount, they could do so using an arbitration process. [AEI’s Jim Capretta explains at RealClearPolicy why arbitration is not a good idea.]|
Bipartisan legislation unveiled this week in the House would limit hospitals and doctors to charging health insurers local market prices for care that is outside a patient’s network, a measure intended to curb surprise medical bills. At a news conference last week, President Trump emphasized bipartisan support for a fix. The House Energy and Commerce Committee unveiled its “No Surprises Act” that would require patients be told which providers are out of their network and whether they could face additional charges. Lawmakers will be collecting feedback in the coming weeks to refine the bill.
|On Wednesday, the Congressional Budget Office released a 30-page report analyzing a single-payer health insurance plan. While the publication explained some policy considerations behind such a massive change to America’s healthcare market, it included precious few specifics about such a change—like what it would cost. Sen. Bernie Sanders (I-VT), perhaps single-payer’s biggest supporter, serves as the ranking member of the Senate Budget Committee. If he asked the budget scorekeepers to analyze his legislation in full to determine what it would cost, and how to go about paying for the spending, CBO would give it high-priority treatment. To the best of our knowledge, that hasn’t happened.|