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. |
To pay for Medicare for All, Democratic presidential candidates have focused on taxing the rich. But many of the plans they’ve put on the table would require across-the-board tax increases that would hit middle-earners as well as the wealthy, public policy analysts say. None more than Medicare For All. Raising the more than $30 trillion needed to fund Sanders’s health plan over a decade would require doubling all personal and corporate income taxes or tripling payroll taxes, which are split between employees and employers, said Marc Goldwein, a senior vice president at the non-partisan Committee for a Responsible Federal Budget.
Democrats asked CBO to lay out some parameters of how to set up single-payer, hoping to elude analysis of any one bill in Congress. The latter would carry political accountability—and a price tag. Instead CBO walks through “key design components and considerations” in a report that aims to bore and deploys the word “could” 209 times. Yet even this limited analysis is instructive about the “major undertaking” of single payer, as CBO puts it in hilarious understatement. CBO acknowledges, for example, that a transition that includes moving 160 million people from employer-sponsored coverage to single payer would be “complicated, challenging, and potentially disruptive” to health care and the economy. You don’t say.
| People who switched from traditional Medicare to private Medicare Advantage plans in 2016 spent $1,253 less in 2015, on average, than beneficiaries who remained in traditional Medicare, after adjusting for health risk. Even among traditional Medicare beneficiaries with specific health conditions, those who shifted to Medicare Advantage in 2016 had lower average spending in 2015, including people with diabetes ($1,072), asthma ($1,410), and breast or prostate cancer ($1,517). |
Tennessee is charging ahead to become the first state in the nation to ask the Trump administration for Medicaid funding in a lump sum—a radical overhaul of the entitlement program that critics warn could force major cutbacks in healthcoverage for low-income people. State Republican lawmakers last week, emboldened by the Trump administration’s promise to provide states with more flexibility to run their Medicaid programs, approved legislation requiring Tennessee to submit a Medicaid block grant plan to the federal government within six months. The legislation now goes to Republican Gov. Bill Lee, who will sign the bill, a spokesperson said.