Expanding Medicaid in the remaining non-expansion states would crowd millions of able-bodied adults out of private insurance coverage and shift them into taxpayer-funded Medicaid. In fact, nearly two-thirds of these adults either have private coverage already or have access to very low-cost coverage through the ObamaCare exchange. Even worse, this expansion could also shift more than one million kids who currently have private insurance into Medicaid.
Ultimately, ObamaCare’s Medicaid expansion means taking resources away from those who truly need Medicaid in order to fund a welfare expansion for those who already have private coverage.
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.
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.
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
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.
Obamacare health plans have been criticized for severely restricting the doctors and hospitals that patients can see. But sometimes even those limited provider lists are riddled with errors, causing additional headaches for patients who had purchased a plan hoping to keep their physician only to later discover that doctor isn’t fully covered by insurance.
Marketplace insurers are fighting lawsuits from consumers in four different states who say they were misled about which health providers were covered under their plan. It wasn’t until after purchasing the plan, these patients allege, that they learned their doctor or hospital was outside its network and therefore covered only partially or not at all.
The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.
Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.
This is a special time of year in health policy nerd world — the arrival of another year of data on National Health Expenditures (NHE) from the Centers for Medicare and Medicaid Services (CMS). The journal Health Affairs published a preview on Wednesday, which the authors summarized thusly: “National health expenditures are projected to grow at an average annual rate of 5.5 percent for 2018–27 and represent 19.4 percent of gross domestic product in 2027.
American consumers and policymakers are increasingly concerned about the high cost of prescription drugs. According to the Kaiser Family Foundation, one in four people taking prescription drugs report difficulty affording their medication. There is bipartisan support for policies that could help lower drug prices and their burden on consumers. Legislation has been introduced and regulatory actions have been advanced to promote competition among drug manufacturers and slow the growth of prices.
Optum Rx, one of America’s largest pharmacy benefit managers (PBMs) sent a letter to drug companies outlining several demands the companies must meet if they seek to lower list prices for their medicines. This would put another obstacles in the path of lowering drug prices.
The letter was sent to several drug manufacturers. In it, Optum demanded a couple of things: 1) at least seven quarters notice before a company reduces its list prices, and 2) equivalent rebates off of lowered prices as compared to existing prices. The message is unclear whether Optum wants rebates to stay the same or the same percentage of a price. But either way, drug companies are unhappy with the letter, since many companies are looking to lower list prices for certain drugs. Additionally the letter was high handed and Optum seems like it is attempting to dictate the terms of various projects.