Obamacare wasn’t supposed to give free health insurance to everybody. The Affordable Care Act’s authors expected the poor would enroll in Medicaid, while those with higher incomes would buy coverage through the new insurance exchanges, with subsidies that decrease as income rises. It isn’t working that way. A study published this week by the National Bureau of Economic Research shows that ObamaCare has turned out to be a giant welfare program, with millions of working- and middle-class Americans improperly receiving Medicaid—a reflection of the unpopularity of the exchange policies and incompetence of government oversight.
Hospitals would have to disclose the discounted prices they negotiate with insurance companies under a Trump administration rule that could upend the $1 trillion hospital industry by revealing rates long guarded as trade secrets. Hospitals that fail to share the discounted prices in an online form could be fined up to $300 a day, according to the proposal. The price-disclosure requirements would cover all the more than 6,000 hospitals that accept Medicare, as well as some others, and is likely to face fierce industry opposition.
Sen. Kamala Harris raised her hand in the June Democratic presidential debate when the moderators asked who would eliminate private health insurance. Then she backtracked. Harris says she’ll provide a “commonsense path” for folding everything from Medicaid to employer insurance into the federal system. Her website says employers could offer either private Medicare Advantage plans or dump workers into Medicare for All. She wants her plan to appear less disruptive than the Sanders bill, yet the obvious conclusion is that it would still blow up traditional employer-sponsored insurance and eventually put everyone on a single federal health program.
| A public option is not a moderate, compromise proposal. Its inevitable consequence is the death of affordable private insurance. Government insurance options mainly erode, or “crowd out,” private insurance rather than provide coverage to the uninsured. Jonathan Gruber, the Massachusetts Institute of Technology economist credited with designing ObamaCare, showed in 2007 that when government insurance expands, six people go off private insurance for every 10 people who go on public insurance. And the public option would cause premiums for private insurance to skyrocket because of underpayment by government insurance compared with costs for services. |
Joe Biden’s new health-care plan is supposed to show his moderation, but there was strong pushback from Sen. Bernie Sanders who wants a full single payer system. If you cut through the spin, the only debate Democrats are having is whether to eliminate private health insurance in one blow or on the installment plan. Biden supports a new government insurance plan that would “compete” with private insurance. We use quotation marks since a government insurer with zero cost of capital and political backing starts with an unbeatable advantage. The public option would undercut competitors on price, stiff providers with low reimbursement rates, and crowd out private insurance over time. Voila, single payer!
Millions of Americans in high-deductible health plans associated with HSAs may find it easier to access insulin, inhalers and other treatments for chronic health problems under guidance released last week by the Trump administration. Currently, people in high-deductible plans with pretax health-savings accounts have to pay down their deductible before their insurance covers treatment for chronic diseases such as diabetes or high blood pressure. The rule change will allow insurers to begin providing coverage for those treatments, such as glucose or blood-pressure monitors, before the deductible is paid.
Congress has twice delayed the Cadillac Tax—originally set to take effect in 2018—and weakened it by allowing employers to deduct the levy itself from their profits. But repealing the Cadillac tax is a bad idea. Instead, Congress should modify it to encourage the use of health savings accounts. It would be better to shift the tax advantage toward HSAs and away from third-party payment—especially high-cost employer-sponsored insurance—to encourage consumers to shop around and assess what’s worth the cost. This would give employees greater control over their health spending and reduce the incentive to overconsume care in the mistaken belief that someone else is paying for it.
President Trump said Friday he was preparing an executive order that would lower drug prices so that the federal government would pay no more than the costs paid by other countries.
He said the action would focus on a “favored-nations clause,” which is generally a contract under which a seller gives buyers the same best terms it offers to others.
By the left’s account you’d think the Trump Administration’s only ambition on health care is to rip insurance from the poor and sick. So note that a Health and Human Services rule finalized last month represents a dramatic expansion in health-care choices for those who may have limited insurance options.
The Trump Administration finished regulations expanding health reimbursement arrangements, often known as HRAs. The arrangements will allow an employer to give a worker tax-exempt dollars to buy a health-insurance plan in the individual market. Such arrangements have existed in some form since the early 2000s, but the Obama Administration used the Affordable Care Act to limit them.
Scott Kohan woke up in an Austin, Texas, emergency room after an attack that broke his jaw. The hospital was within his insurance network. But the oral surgeon who set his jaw wasn’t. Mr. Kohan’s insurer refused to pay the surgeon’s $8,000 bill.
He’s not alone. An estimated 51% of ambulance rides, 22% of emergency-department trips, and 9% of elective cases, in which patients have time for due diligence, lead to surprise bills. These typically come from providers who refuse to join insurance networks so they can charge astronomical fees.