Last month, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a ruling declaring Obamacare unconstitutional. The case was brought by 20 Republican state attorneys general. Seventeen Democratic state attorneys general responded January 3 by appealing to the U.S. Court of Appeals for the 5th Circuit.

Judge O’Connor appears to be on a bit of an island — the conventional wisdom on both the right and left is that his decision will be overturned by a higher court.

The number of uninsured Americans is rising. Last year, 27.4 million Americans went without health insurance, an increase of 700,000 from 2016, according to a just-published analysis from the Kaiser Family Foundation. Government mandates deserve much of the blame. Regulations and red tape have driven premiums through the roof, pricing many Americans out of the insurance market. Nearly half of uninsured people cite high premiums and prohibitive deductibles as the reasons they aren’t covered. Free-market reforms would enable millions more people to afford insurance that fits their needs and those of their family.

Numbers released this week by the government show just a slight dip in the number of people enrolled in Affordable Care Act coverage next year through HealthCare.gov. That’s the case even though the Republican-led Congress repealed fines for being uninsured effective Jan. 1. The drop — from 8.8 million to 8.5 million — was far less than experts forecast.

“The five hearings we held reminded us of something else we should agree on: one major reason for the unnecessarily high cost of health care is that the health care system does not operate with the discipline and cost saving benefits of a real market. Too many barriers to innovation drive up costs. And most Americans have no idea of the true price of the health care services they buy—which also drives up costs.”

—Sen. Lamar Alexander 

Please submit comments to LowerHealthCareCosts@help.senate.gov by March 1, 2019.

Rather than opting for the cheap, politically expedient trick of “blaming Big Pharma,” our national leadership should insist that all members of the health-care ecosystem create expert-vetted, user-friendly education programs so that patients know the real costs of what they’re buying, where the profits are going and, most importantly, how they can use this knowledge to become savvier consumers.

The U.S. labor market is as healthy as it has been in a long time, especially for those with limited education and skills. Yet enrollment for the nation’s two largest means-tested safety-net programs, Medicaid and the Supplemental Nutrition Assistance Program, remains near historic highs.

In previous periods of rising employment and income, takeup rates in assistance programs dropped. This hasn’t been the case in the years following the Great Recession, even after accounting for ObamaCare’s expansion of Medicaid. What gives?

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2017 National Health Expenditure (NHE) data. Links below.

For 2017, drug spending grew by a mere 0.4%—significantly below the growth of spending on hospitals, physician services, and overall national healthcare costs. These latest CMS data confirm the drug spending slowdown that I have highlighted in previous Drug Channels articles.

The nation’s health care tab hit $3.5 trillion last year, or $10,739 per person, the government reported Thursday. But behind those staggering figures was some fairly good news: The rate of growth slowed for the second year in a row, according to economic experts at the federal Health and Human Services department. Health care spending increased by 3.9 percent in 2017, following a 4.8 percent increase in 2016.

According to a new NPR-IBM Watson Health Poll, about one in five people said they have delayed or canceled some kind of health care service, such as a doctor’s appointment or medical procedure, because of cost in the preceding three months. The proportion of people who said cost had deterred them from getting care varied by age, with a third of people under 35 saying it had been a problem compared with only 8% of people 65 and older. The cost of prescriptions also appeared to be a bigger concern for younger people, with 38% of those under 35 saying they had difficulty paying for their medicine. Only 9% of people 65 and older said they had the same problem.

When the Medicaid expansion under the Affordable Care Act (ACA) added healthy, able-bodied adults without dependent children to the list of beneficiaries, policymakers overlooked the substantial price paid by these recipients who, as the Congressional Budget Office once forecasted, forego hourly wages and earnings in order to maintain their Medicaid eligibility. Without a work requirement for able-bodied adults to receive Medicaid, studies have shown that the program tacitly encourages such recipients to stay home and not go to work. And, as it turns out, Medicaid’s non-work incentive has some not-so-healthy consequences.