The Trump administration formally declared its opposition to the entire ACA on Wednesday, arguing in a federal appeals court filing that the signature Obama-era legislation was unconstitutional and should be struck down. The filing was made in a case challenging the law brought by Ken Paxton, the attorney general of Texas, and 17 other Republican-led states. In December, a federal judge from the Northern District of Texas, Reed O’Connor, ruled that the law was unconstitutional.
The Trump administration is making it a top priority to protect doctors, hospitals or other medical providers who object on a moral or religious basis to providing services like abortion, sterilization or assisted suicide. In a 440-page rule issued Thursday, the HHS Office of Civil Rights said it will use a broader array of tools to enforce more than two dozen “conscience protection” laws, some that have been on the books since the 1970s.
House Democrats on Wednesday unveiled a more moderate proposal for expanding health care coverage than M4All legislation supported by a number of the party’s 2020 presidential candidates. The Medicare for America Act, sponsored by Reps. Rosa DeLauro (D-CT) and Jan Schakowsky (D-IL), would not move the entire country into a single government-sponsored health plan. It would preserve employer-based coverage but allow Americans to enroll in an expanded Medicare plan, with caps on what people would have to pay in premiums.
The core appeal of the 2020 Democratic presidential candidate’s Medicare for All proposals, whether it’s optional buy-ins floated by moderate Democrats or Sen. Bernie Sanders’s comprehensive single-payer reforms, is the notion that enormous savings could be generated by dispensing with private insurance. Advocates claim that that insurer profits, as well as costs associated with managing risk and advertising plans, could be dispensed with, and that hospital fees could be greatly reduced by imposing Medicare rates, which are 40% lower under the M4All plans.Yet, it is notable that no such savings ever have materialized—even under the most propitious of circumstances.
Creating a single-payer health–care system in the U.S. would be a “major undertaking that would involve substantial changes” to medical coverage, according to a report issued by the Congressional Budget Office. The nonpartisan agency that evaluates the potential budgetary, economic and other effects of legislative proposals didn’t assess any specific bill or estimate costs. “The transition toward a single-payer system could be complicated, challenging and potentially disruptive,” the CBO said on Wednesday.
More than 100 House Democrats have endorsed Rep. Jayapal’s Medicare for All Act of 2019. Fourteen Democratic senators have co-sponsored a similar bill from Sen. Bernie Sanders (I-VT). The title is deeply misleading. It implies that the current Medicare system would be extended to all Americans. In fact, Medicare for All differs from Medicare in fundamental ways. While America needs a debate about health care, it should be based on an accurate description of the alternatives.
Americans are frustrated with the current health care system. Care costs far too much. Millions are priced out of the insurance market, and even those with insurance say premiums and deductibles are so high they might as well be uninsured. But when government officials make decisions about what services will be covered, how much providers will be paid, and how much citizens must pay in mandatory federal taxes, consumers will have even fewer choices and less control than they do today. M4All will reduce access to new technologies, stifle innovation, and result in a near-doubling of the tax burden. The Left is undaunted with its promises of free virtually unlimited health care for everyone and has an answer for everything. The House Rules Committee hearing on Tuesday, where Chuck Blahous and I testified, showed what we are up against.
“Medicare for All” sounds good until you see its high price tag and consider the implications it would have on the quality and access to health care. The House Rules Committee held its first ever hearing Tuesday on the Democrats’ Medicare for All bill introduced by Rep. Pramila Jayapal (D-WA). The bill would implement a government takeover of health care coverage, where all medically necessary services would be paid for by the federal government and all private insurance that duplicates government coverage would be prohibited. Grace-Marie Turner, president of the Galen Institute and a witness testifying against the bill, argued that it’s hard to see how patients would be more empowered when dealing with a single government payer for health care: “In a country that values diversity, will one program with one list of benefits and set of rules work for everyone?”
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.