Sen. Bernie Sanders (I-VT) on Wednesday unveiled his revamped Medicare for all bill with the support of four Senate Democrats also running for president. Sanders, who is again seeking the Democratic nomination for president in 2020, rolled out the bill that would largely eliminate private insurance and institute a single-payer system managed by the government. Sens. Elizabeth Warren (MA), Kirsten Gillibrand (NY), Cory Booker (NJ) and Kamala Harris (CA)—all 2020 Democratic presidential candidates—again signed on to the bill after also supporting it in 2017. The updated version will also include coverage for long-term care, such as nursing homes, which is currently not covered by the Medicare program. No cost estimate was provided.
Seeking to show Republicans’ commitment to protecting those with pre-existing conditions, a group of GOP senators led by Sen. Thom Tillis of North Carolina is reviving and expanding a bill that would retain at least some of the protections built into Obamacare. The move is an attempt to address concerns that the popular and ironclad provisions secured by the ACA may disappear amid President Trump’s renewed drive to overturn the landmark health reform law. It comes as Democrats offer up an array of new proposals for universal, government-backed health coverage. The bill’s introduction comes less than two weeks after the Trump administration said in a federal appeals filing that the entire ACA should be struck down. |
The Trump Administration may be slowing down its push to replace the ACA, but several conservative groups are still pushing the Health Care Choices proposal. “We keep hearing that Republicans don’t have any ideas and it makes us a little crazy, because [we] worked for a year and a half to come up with a new generation of health reform,” said Grace-Marie Turner, president of the Galen Institute. “One thing we have learned is that the federal government is out of its element overseeing and regulating something as regional and personal as health care,” said Turner. “States have a much better understanding of their markets and their constituencies. . . . and can really influence how their state moves forward. Also, people are smarter and understand more than they did before that more regulations mean higher costs.”
We don’t know what will emerge as President Trump’s plan to replace Obamacare, which he has promised to unveil immediately after the 2020 elections. But he has recently endorsed several proposals, and they could provide clues. A group of conservative health policy experts has developed a health care proposal that would hand states blocks of money and a few rules, and encourage them to develop their own health care systems. The plan would require that government-subsidized systems offer every American a choice of a private health plan, a requirement that would probably foreclose a liberal state from enacting a single-payer program and that might require restructuring of some state-run Medicaid programs.
Acting White House chief of staff Mick Mulvaney said Sunday that the White House plans to release an Obamacare replacement plan before the 2020 election, after hosting top administration officials at Camp David over the weekend for a meeting on health care. “I do think you’ll see a plan here fairly shortly,” Mulvaney said. White House aides and administration officials—including HHS Secretary Alex Azar and Seema Verma, CMS administrator—huddled at the historic Maryland property on Saturday to discuss the general path forward for President Trump’s health care policy, White House aides said. The talks ranged from messaging strategies to lowering drug prices to individual health insurance marketplaces.
Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health-care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude health-care providers based on quality or cost.
Nearly a quarter of a million British patients have been waiting more than six months to receive planned medical treatment from the National Health Service, according to a recent report from the Royal College of Surgeons. More than 36,000 have been in treatment queuesfor nine months or more.
Long waits for care are endemic to government-run, single-payer systems like the NHS. Yet some U.S. lawmakers want to import that model from across the pond. That would be a massive blunder.
President Trump has tasked three Republican senators with coming up with a replacement for Obamacare if courts strike it down. It’s a prudent contingency plan. Republicans should, for that matter, advance their own health-care plan even if the lawsuit fails. They cannot prevent Democrats from attacking them over health care by abandoning the issue.Obamacare’s key innovation was not the subsidization of Americans’ health-insurance purchases, an enterprise in which the federal government had been engaged for decades, albeit on a somewhat smaller scale. It was the centralization of health-insurance regulation in Washington, D.C. It is that centralization, and accompanying curtailment of choice and raising of costs, that Republicans tasked with replacing Obamacare should now work to undo.
On Tuesday, Americans for Tax Reform held a Capitol Hill briefing on the Department of Health and Human Services (HHS) proposal to subject Medicare Part B drugs to an “International Pricing Index” (IPI).
As ATR has written extensively, the IPI payment model will effectively import foreign price controls into the United States, lowering quality and access to lifesaving medicine. In November, ATR led a coalition of 56 conservative groups in opposition to the IPI.
ATR President Grover Norquist opened the panel by highlighting the effects of the proposal on trade, saying: “Under this rule, every time we win on trade, the administration would have to raise drug prices on Americans. This is a truly bad idea.”
The Trump administration has decided to challenge the constitutionality of Obamacare in court. Some Republicans in Congress and even some in the administration resisted this decision. Critics assume that if there is no Obamacare, we would revert to the pre-Obamacare health system. If so, how bad would that be? Let’s take a look.