Kansas’ new law allowing the sale of health plans that can turn away people with pre-existing medical conditions has heightened concerns that more states may move to allow leaner, cheaper plans that don’t comply with ACA rules. So far, three states have passed laws allowing their Farm Bureaus to bypass ACA rules and sell health plans that are free from any state insurance regulation. Kansas became the latest last week. The state’s Democratic governor let the bill become law without her signature in the hope of winning GOP support for a bill to expand Medicaid to low-income adults, though that remains uncertain.
Federal health officials on Monday unveiled a new primary care experiment that seeks to pay doctors for providing stepped-up services that keep patients healthy and out of the hospital, an effort they say will transform basic medical services for tens of millions of American patients. The initiative, called CMS Primary Cares, includes five new payment options for small and large providers, allowing them to take varying levels of financial responsibility for improving care and lowering costs. It broadly seeks to change how primary care is delivered in the U.S. by rewarding doctors for improving management of patients with chronic illnesses such as diabetes and high blood pressure and averting expensive trips to the hospital.
The CMS is inviting state Medicaid agencies to pursue new ways of integrating care for patients eligible for both Medicare and Medicaid—a population that has complex health needs and accounts for a big portion of spending in both public health programs. In a letter to state Medicaid directors, CMS Administrator Seema Verma described three new ways states can test approaches to integrating care for dual-eligible patients with the goal of improving the quality of their care and reducing costs for federal and state governments. “Less than 10% of dually eligible individuals are enrolled in any form of care that integrates Medicare and Medicaid services, and instead have to navigate disconnected delivery and payment systems,” Verma said. “This lack of coordination can lead to fragmented care for individuals, misaligned incentives for payers and providers, and administrative inefficiencies and programmatic burdens for all.”
The number of uninsured climbed by 1.4 million from 2016 to 2018, according to a report out last week from the Congressional Budget Office. Naturally, this led those on the left to blame the Trump administration for its Obamacare “sabotage.” But the data in that report—which was released on the same day the Mueller report came out and largely ignored—tell an entirely different story. All of the increase in the uninsured over the past two years—all of it—is the result of the massive rate increases that Obamacare’s mandates and regulations caused. According to the Health and Human Services Dept., premiums in the individual insurance market doubled from 2013 to 2017. They shot up again in 2018.
As I listened to the Town Hall where Democratic Presidential candidate Bernie Sanders proclaimed his dream of Medicare for All, I realized that he was speaking in vague generalities that were void of realism. Medical care would be “free at the point of service with no co-pays.” Would there be any brakes on the over-utilization of services? He had no answer. He thus needs to understand that the demand for medical services is limitless when other people are paying the bill. The suggestion that “Medicare for all” would save money is surely an example of a pipe dream.
Last week, Sen. Bernie Sanders reintroduced a bill that would end health care as we know it, and Americans should thank him for letting us see where the Democrats want to take the country. Its central premise appears to be that Washington bureaucrats know better than patients and doctors. But as if taking health care choices from patients isn’t bad enough, this bill also hurts seniors, eliminates private health insurance for nearly 180 million Americans, wipes out Medicare Advantage for over 22 million, and harms our economy for generations to come. It doesn’t stop there: For good measure, the bill removes critical support for children and service members’ families while providing free care to illegal immigrants.
Many of the left’s policy proposals come with the same design flaw: While sounding great on paper, they have little chance of working in practice. Monday brought one such type of reality check to Sen. Bernie Sanders (I-VT) and supporters of single-payer health care, in the form of the annual Medicare trustees report. The report once again demonstrates Medicare’s shaky financial standing, as the retirement of 10,000 Baby Boomers every day continues to tax the program’s limited resources. So why would Sanders and Democrats raid this precariously funded program to finance their government takeover of health care?
For years, Sen. Bernie Sanders (I-VT) has campaigned for what he calls “Medicare for All”—a proposal that would abolish private insurers and replace them with a “federally administered single-payer health care program” that would cover all forms of health care with “no more copays, no more deductibles,” and no premiums aside from substantially higher taxes. The irony of the proposal is that it looks nothing like the actual Medicare program that seniors use today. Indeed, the part of Medicare that is working best is Medicare Advantage, which deploys private insurers to provide high-quality, low-cost coverage to seniors. The best way to reform Medicare is to enact reforms that will further improve the quality and affordability of Medicare Advantage plans, and to learn from Medicare Advantage to improve the coverage that younger Americans can obtain.
Reports suggest President Trump is planning to release a health care reform plan soon. That’s good news. Republicans may have failed to pass reforms in 2017, but health care nonetheless remains a major concern for Americans. Since the failed reform effort in 2017, conservative health policy experts spent a lot of time working with colleagues across the country to develop a consensus proposal that could succeed where the previous effort fell short. It’s required some hard thinking about the lessons of previous efforts, as well as the failures of implementing Obamacare. This piece highlights seven lessons that will serve policymakers well in crafting the new plan.