We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999–2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Using estimates from the medical literature of the impact of pharmaceuticals on acute disease, we found that roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors. Despite this substantial cost-saving improvement in cardiovascular health, additional opportunities remain to lower spending through disease prevention and control.
Litigation continues in Texas v. Azar, a lawsuit over the constitutionality of the individual mandate and, with it, the entire Affordable Care Act (ACA). This post provides a brief update on the status of the case in the district court and the Fifth Circuit Court of Appeals, as well as some new positions taken by states in the lawsuit following the midterm elections. For now, the Texas litigation is on hold pending the end of the partial government shutdown, after which the case will proceed in the Fifth Circuit.
Writer and editor Robert Verbruggen presents in this National Review Magazine piece perhaps the best overview of the Obamacare battles and experience that we have seen. And he sees a silver lining in the current legislative stalemate: Though two simple changes—Congress ending the individual mandate and President Trump expanding other options through regulatory changes—both individuals and states now have more freedom without denying Obamacare to anyone who wants it. There will be some downsides, for sure, and conservatives shouldn’t be happy that so much of the law remains in place. But maybe, just maybe, the GOP might have bungled its way into something that works.
Gov. Jay Inslee and Democratic lawmakers Tuesday announced proposed legislation for a new “public option” health care plan under Washington’s health insurance exchange. “We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care in the state of Washington,” said the governor, who is considering a run for president in 2020.
New York City Mayor Bill de Blasio (D) on Tuesday issued a bold guarantee of affordable health care for every resident, thrusting the nation’s largest city to the forefront of debates over universal health coverage and immigrant rights.
The promise is aimed at 600,000 New Yorkers who lack insurance because they can’t afford it, believe they don’t need it, or can’t get it because they are in the country illegally.
The announcement makes New York the second U.S. city to attempt to provide health care to everyone living there, coming about a dozen years after San Francisco pioneered the idea with a more limited promise.
After dismissing for years the idea that Democrats’ health care plans would lead to a government takeover, new House Budget Committee Chairman John Yarmuth on Tuesday asked Congress’ top economist to sketch out the options for a government takeover. The Kentucky Democrat also implicitly sketched out the political game plan: enact socialized medicine before patients and taxpayers understand what they’ll be losing.
Even here in the United States, government-run health care programs such as those of the Veterans Administration and the Indian Health Services have appalling records of patients dying while waiting for care.
For anxious mothers like me who don’t want to wait three days for results from a lab culture while my child suffers, government-run health care doesn’t promise speedy service.
House Democrats used their new majority on Thursday to squeeze Republicans on health care, taking the first step to intervene in a court case in which a Texas judge has ruled the Affordable Care Act unconstitutional.
That move will be followed by a vote next week designed to force GOP lawmakers into a political corner: agree to defend a law many members have spent years reviling or appear to oppose popular ACA protections for millions of Americans with preexisting medical conditions that many have pledged to uphold.
Thursday’s authorization was part of a collection of rules the House adopted to guide its operation in the new Congress. It gives Pelosi permission to intervene in the Texas court case and allows the chamber’s counsel to work on the litigation.
What will Nancy Pelosi do now once she is back in the Speaker’s chair? In light of Judge Reed O’Connor’s recent ruling that Obamacare is unconstitutional and that the entire law must be scrapped, there is likely to be strong pressure to pass some sort of legislation to improve protections for people with pre-existing conditions. Of course, Rep. Pelosi also will face pressure from those who want to resurrect the idea of a public option—an idea she supported during the fierce debates of 2009-2010, but which foundered for lack of votes in the race to the finish line. And with various progressives jockeying for position in the 2020 race, there likewise will be a vocal minority urging a push for Medicare for All. To her credit, Rep. Pelosi has wisely desisted from endorsing that singularly bad idea. But it would be a shame if Nancy Pelosi squandered this opportunity by merely re-arranging deck chairs on the Titanic. By now it is manifestly clear that Obamacare—like so many ambitious government programs before it–has massively overpromised and underdelivered.
When a federal judge recently ruled that the Affordable Care Act is unconstitutional, many in the media were caught off guard. Little attention had been paid to the case, which was brought by the attorneys general of 20 states and by the Texas Public Policy Foundation (representing individual clients who have been harmed by Obamacare).
But when U.S. District Judge Reed O’Connor handed down his ruling, he suddenly had everyone’s attention. What has followed has been an exercise in opinion-forming and prediction-making—based on too little information and even less understanding of how we got here.