Democrats in the House of Representatives have put aside grandiose thoughts of Medicare-for-All and single-payer health insurance – at least for a day or two. Instead, they have introduced a new health plan with a more modest goal: making Obamacare work better.
It has three elements:
- Expand health insurance subsidies to everyone. (Individuals are currently ineligible for help if they earn $48,560 or more.)
- Create a national reinsurance pool to subsidize insurance companies that incur high costs.
- Reverse Trump administration regulations that make it easier to obtain limited-benefit insurance.
So, what’s wrong with that? For starters, it uses taxpayer dollars to give money to rich people and insurance companies.
The Trump administration’s decision to ask a federal appeals court to invalidate the Affordable Care Act has given House Democrats a new opening to pursue what they see as a winning political strategy: moving past talk of impeachment to put kitchen-table issues like health care front and center.
The Democrats’ new bill aims to lower health insurance premiums, strengthen protections for people with pre-existing medical conditions and ban the sale of what Democrats call “junk insurance.”
Is there a health care deal that would meet the needs and solve the political problems of members of both parties in Congress?
It seems almost inconceivable. The only talk on the left at the moment is Medicare for all. On the right there is not much talk about any aspect of health care. But when pressed, Republicans would still like to abolish Obamacare. Neither party is going to get its wish any time soon.
Still, desperate times call for new thinking. As voters get tired of hearing promises that are never met and never will be met, politicians will feel increasing pressure to accomplish something.
There may be several companies selling health insurance in a given market, but we’ve previously found that most people generally enroll with one of a few companies. When that happens, it can mean less competition and higher premiums for that area.
We updated our work with more recent private insurance data. The overall story is similar: The 3 largest companies held 80% or more of the market in at least 37 states.
Available data on the Affordable Care Act insurance exchanges had similar trends. Three or fewer companies held 80% or more of the market in at least:
- 46 of 49 exchanges for individuals
- 42 of 46 exchanges for small employers
Surprise medical billing—cases in which patients are unexpectedly billed at highly inflated prices from providers who do not accept their insurance—has attracted policymakers’ attention. In this report, we outline the economic rationale for why markets have not eliminated this behavior and present policy solutions. We emphasize that much of this phenomenon can be solved via contract reforms that require health care providers to negotiate market prices among themselves. This strategy produces market outcomes and minimizes the risks associated with rate regulation. Targeted rate caps should be considered only in cases in which contractual reforms are not feasible.
If the president is looking for a government to blame for distorted U.S. drug prices, he need look no further than our own. The federal government requires manufacturers to pay rebates, grant discounts, and comply with various price-distorting directives across a range of programs.
States. They’re just as perplexed as the rest of us over the ever-rising cost of health care premiums.
Now some states — including Montana, North Carolina and Oregon — are moving to control costs of state employee health plans. Their strategy: Use Medicare reimbursement rates to recalibrate how they pay hospitals. If the gamble pays off, more private-sector employers could start doing the same thing.
“Government workers will get it first, then everyone else will see the savings and demand it,” says Glenn Melnick, a hospital finance expert and professor at the University of Southern California. “This is the camel’s nose. It will just grow and grow.”
The American people – and just about all our elected officials – frequently and justifiably complain about the high cost of health care. But unless Congress acts, a tax increase on medical devices will take effect Jan. 1 and needlessly raise those costs even higher.
The 2.3 percent tax on medical devices was signed into law by President Obama and took effect in 2013. Fortunately, Congress passed legislation in 2015 and again in 2017 to temporarily suspend the tax. However, without further congressional action the tax will kick back in at the beginning of 2020.
New Jersey Senator Cory Booker claims Medicare for All would “save lives.” Vermont’s own Senator Bernie Sanders promises it would end “the disgrace of tens of thousands of Americans dying every year from preventable deaths.”
But a new study from the National Bureau of Economic Research finds little evidence to support those assertions. The authors examined people who gained government health coverage in recent years and found no “statistically significant pattern of results consistent with . . . mortality changes.”
Recently, I chaired a discussion at CPAC on the importance of choice in health care, and specifically health care coverage. My fellow panelists talked about government rule-making, Medicare waivers and the many problems that approaches like “Medicare for All” create — such as interposing Uncle Sam between physicians and patients. All important aspects of the health care puzzle — but nothing that hasn’t been turned over more than once in a wonky world of $5 words and inside the Beltway policy chatter.