Category: State Actions

Throughout much of last year, critics of the White House darkly predicted that Congress’ repeal of the tax penalty on the uninsured, coupled with an administration rule lifting federal restrictions on short-term policies, would lead to double-digit premium increases in 2019.

The good news is that none of that has happened. To the contrary, average premiums for “benchmark” plans—policies whose premiums are used in calculating premium subsidies—declined by about 1% in 2019, for the first time in the program’s history.

The decline was driven by seven states (Alaska, Maine, Maryland, Minnesota, New Jersey, Oregon and Wisconsin) that obtained waivers from the Trump administration to deviate from certain Obamacare mandates.

Premiums in those states fell by a median of more than 7%, while median premiums in the other 44 states and the District of Columbia rose by more than 3%.

Badger has updated an important paper from last year showing that some states are succeeding in lowering premiums and increasing enrollment in health insurance by doing a better job of targeting existing resources. Obamacare established a regime of subsidies, mandates, regulations, and tax penalties that resulted in substantial increases in premiums for individual insurance coverage. But seven states obtained waivers to target subsidies for high-cost patients, and they saw premiums fall by nearly 7.5%, while premiums in the other states rose by more than 3%. He examines estimated premiums in five additional states that have applied for risk-mitigation waivers for 2020. Premiums for benchmark plans rose in all five states in 2019, but actuarial analyses forecast that premiums will decline in all five states if the federal government approves their waiver applications.

“Medicare for All” proposals may vary greatly, but a common feature is their call for the regulation of prices for hospital care. This element has widespread support among establishment Democrats, and it lacks the enormous cost and controversy associated with other aspects of single-payer health care.

Comprehensive hospital-payment regulation is not a new idea: it’s been widely tried at the state level for half a century, including in Maryland—the only state where it remains. Maryland therefore provides a useful case study.

The Maine Senate unanimously advanced a package of bills on Tuesday aimed at reducing prescription drug prices, including a Canadian drug importation program modeled on a first-in-the-nation Vermont law that would need federal approval.

The legislative push is led by Senate President Troy Jackson, D-Allagash, and endorsed by AARP Maine. It looks to lower drug prices in the nation’s oldest state by median age, where people have often made bus trips to neighboring Canada for access to price-controlled prescription drugs that have been the subject of action in Maine over the past decade.

Citing the need to reduce rising health care costs, Gov. Ron DeSantis signed a bill Tuesday that would allow Florida to pursue importing prescription drugs from abroad — though components of the bill will still require federal approval to take effect.

HB 19 will open up three pathways for bringing medication in from different countries, including Canada, through a 2003 federal law that tasks federal officials with authorizing state plans to import prescription drugs. No state has received such approval in the 16 years since the bill was passed, but DeSantis, surrounded by a half-dozen lawmakers in the Villages, said he is confident Florida will clear those hurdles when the state asks for the approval likely next year.

California will become the first state to pay for some adults living in the country illegally to have full health benefits as the solidly liberal bastion continues to distance itself from President Donald Trump’s administration.

Democrats in the state Legislature reached an agreement Sunday afternoon as part of a broader plan to spend $213 billion of state and federal tax money over the next year. The legislature is expected to approve the deal this week. The agreement means low-income adults between the ages of 19 and 25 living in California illegally would be eligible for California’s Medicaid program, the joint state and federal health insurance program for the poor and disabled.

If any state can serve as the poster child for the problems associated with ObamaCare’s Medicaid expansion, it’s Louisiana, which joined the expansion in 2016, after Democrat John Bel Edwards became governor. An audit released last year exposed ineligible Medicaid beneficiaries, including at least 1,672 people who made more than $100,000. But Louisiana’s Medicaid expansion has revealed another waste of taxpayer funds, both in the Pelican State and nationwide: the money spent providing coverage to people who already had health insurance.

The Georgia Public Policy Foundation has long advocated for market-oriented solutions to Georgia’s health care challenges. The Foundation has released a report analyzing the cost and potential impact of two Section 1332 State Innovation Waivers the governor could consider:

• A reinsurance program that would apply to all large insurers in the state and “reimburse accumulated claim costs that exceed a set threshold within a given year.”

• A Georgia primary care access option, which would require large insurers to offer at least one plan that includes a direct primary care model.