Category Archives: Uncategorized

ACA repeal makes hospitals more vulnerable to closure

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http://www.fiercehealthcare.com/healthcare/hospital-closures-aca-repeal-makes-organizations-more-vulnerable?utm_medium=nl&utm_source=internal&mkt_tok=eyJpIjoiTldOaE1tUXlaRFUxTlRrMyIsInQiOiJVUFpNQ0tIKzF1c1pzU0gzbVpuaTNMdE8wbHUxY09LWW1mN1hoaHJ4QnVtVzdOWUExOXNqUXhPZkxTaUUwcFpHWW9ib21QdkRxanU1TzhRMXltUUNZN2dFdVdhSnpJWWpKbTVhMGkzSmlWT3R5UDVhMTJQUXhwSlF3eXNKT1VsRyJ9

hospital hallway

Millions of insured Americans could lose health insurance coverage if Congress and the new White House administration make good on their threat to repeal the Affordable Care Act. But they aren’t the only victims.

Many hospitals could also close as a result of the legislative action and the loss of government funds and increase in uninsured Americans who need care.

And these potential closures only add to the growing problem of vanishing hospital beds, according to a Bloomberg report. Indeed, more hospitals have shifted their focus from inpatient to outpatient care for financial reasons, acquiring or opening stand-alone facilities, physician practices and retail clinics.

“It’s been a very tough environment for hospitals,” Jason McGorman, a Bloomberg Intelligence analyst, said in the piece. “They have to get into other areas and businesses to free up cash and generate better margins than inpatient care, which has become a slow-growth business.

Who pays for war on Planned Parenthood?

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http://www.fresnobee.com/opinion/editorials/article124977729.html?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=40612592&_hsenc=p2ANqtz-9LselH-wiu-loS_ePlL-q1z4YWLvVwoqV-OpQTh47u3NfJb5vHpDsS_ASUb-Rf_gelQDO3_8OTQCcoHHVaptBrra60kw&_hsmi=40612592

Planned Parenthood supporters in Los Angeles rally in 2015 for women’s access to reproductive health care on National Pink Out Day. Republicans in Congress this week announced plans to strip the group of federal funding.

The 15-month, $1.6 million congressional “investigation” into Planned Parenthood is finally over, with the chilling announcement that Republicans in charge plan now to eviscerate the nonprofit most associated with reproductive rights.

Tennessee’s Rep. Marsha Blackburn and the fellow Republicans on her “Select Panel on Infant Lives” – launched last year in the wake of the bogus “fetal parts” video smear led by California anti-abortion activist David Daleiden – issued their “recommendations” on Wednesday, with no Democratic input and zero proof of wrongdoing. Baseless as the proposals were, House Speaker Paul Ryan swiftly announced that at least one – senselessly stripping Planned Parenthood of hundreds of millions of dollars in federal funds – will be among the first orders of business.

Blackburn also called for bans on abortion at 20 weeks and federal funding for research using fetal tissue. Never mind that the former is unconstitutional and the latter saves lives.

This crusade against Planned Parenthood in particular – and reproductive rights in general – is misogynistic, archaic and counterproductive. Good people can disagree on the morality of abortion, but women have had the right to choose for more than 40 years and polls show the vast majority of Americans want to keep it that way.

In the name of placating evangelicals in their base and attacking one of Democrats’ favored organizations, congressional Republicans have singled out a health care provider that annually serves 2.5 million sometimes desperate humans. About nine in 10 Planned Parenthood clients come for services that have nothing to do with pregnancy termination. Eight in 10 are on Medicaid; many of the rest have no insurance.

Obamacare architect’s 5 points about health care reform

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Obamacare architect’s 5 points about health care reform

Dr. Ezekiel Emanuel, M.D., Ph.D., former Chief Health Policy advisor to the Obama Administration; Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. Photo credit: Courtesy of The Commonwealth Club

In a wide-ranging conversation Wednesday night at the Commonwealth Club in San Francisco, Dr. Ezekiel Emanuel, Obamacare’s main architect, talked about health care reform and the debate over President-elect Donald Trump’s pledge to repeal and replace the Affordable Care Act, which has helped insure at least 20 million more  Americans, including five million Californians.

Emanuel is still a strongly advocate of the law, saying it has contributed to keeping U.S. health care costs more under control than at any time in the last 50 years. But like many other health care experts, he acknowledges room for improvement — and hopes it can now be done a bipartisan fashion. Here are five key points he made:

1) If you abolish the mandate that everyone must have health insurance, there are few options to induce people to get covered and create a stable insurance market. You need compulsion, but Americans don’t like compulsion.

2) A possible bipartisan alternative? One possibility is for the government to automatically enroll everyone in a catastrophic coverage plan — and if someone wants more coverage, that person would pay a higher premium.

3) The two biggest mistakes made by the Obama administration and supporters of the Affordable Care Act: flawed communication and rollout. The administration should have relied more on doctors and nurses and less on politicians to explain the reform to the public because the “white coats” are trusted sources of health care information. The botched launch of HealthCare.gov, the website for the federal exchange, didn’t help.

4) The subsidies for Obamacare aren’t high enough to drive down prices for many people.

5) A bipartisan-backed health care law isn’t a dream.  The U.S. almost got nearly universal health care in the early 1970s with a plan proposed by Republican President Richard Nixon and supported by two powerful Democrats: veteran Arkansas Congressman Wilbur Mills, chairman of the House Ways and Means Committee, and Massachusetts Sen. Ted Kennedy. But scandals led to its derailment after Mills was caught with stripper Fanne Fox — and Nixon was implicated in Watergate. Democrats had hoped to regain traction on the issue after the 1974 mid-term elections, but the proposal lost momentum.

 

What Could President Trump Do Through Executive Order to Dismantle the ACA?

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http://www.commonwealthfund.org/publications/blog/2017/jan/what-could-president-trump-do-through-executive-order

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The Republican House and Senate have begun the process of repealing the Affordable Care Act (ACA) through the budget reconciliation process. Enacting a budget reconciliation bill is likely to take weeks, however, and at this point it seems likely that such a bill will delay repeal of some of the most important provisions of the ACA for much longer.

In a meeting with Republican lawmakers on January 4, 2017, Vice-President-elect Mike Pence stated that the Trump administration may move much more quickly against the ACA through executive action. He told reporters that the Trump administration would begin on the first day of the administration an orderly transition process to unwind the ACA: “We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for Obamacare.”

The President and the executive departments and agencies clearly do have a great deal of power. They can exercise their authority through issuing executive orders, rules, and guidance. The executive branch of government operates programs, decides whether and how to defend or settle litigation, and exercises discretion in enforcing the law. But within our constitutional system the president and executive departments and agencies must comply with the laws and operate according to the processes laid down by law.

What can the executive do to “unwind” a law without congressional action and within the law?

States That Leaned In on the Affordable Care Act Have Much to Lose

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http://www.commonwealthfund.org/publications/blog/2017/jan/states-that-leaned-in

The Affordable Care Act (ACA) created health insurance marketplaces to make it easier for consumers to shop for and compare plan options in one place. As of December 24, 2016, over 11.5 million people had signed up for coverage through the marketplaces, and the U.S. Department of Health and Human Services projects that 13.8 million consumers will have selected a plan for 2017 by the close of this open enrollment period.

However, our new president and Congress are committed to the repeal of the ACA. Repeal could cause as many as 30 million to lose coverage, 9.3 million of whom receive federal premium assistance through the marketplaces. Nearly one-third of these enrollees reside in the 17 states that embraced the chance to set up and manage their own ACA marketplace.1  All but one of these states also expanded their Medicaid program and most incorporated the ACA’s consumer protections into their own state insurance laws, effectively adopting them as their own. These states not only embraced the ACA’s vision of improving access to affordable, quality health coverage, but also took full advantage of the flexibility for states provided under the law to design an insurance market to meet local needs.2

Within days of the ACA’s enactment, legislators, agency staff, and health care stakeholders from these states began working to develop the policy and operational infrastructure needed to build and maintain a sustainable health insurance marketplace. Doing so not only gave these states greater autonomy and flexibility to manage their insurance markets, but also allowed them to tailor public education and outreach efforts to their local population.

 

 

Medicaid’s Future: What Might ACA Repeal Mean?

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http://www.commonwealthfund.org/publications/issue-briefs/2017/jan/medicaids-future-aca-repeal?omnicid=EALERT1152581&mid=henrykotula@yahoo.com

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Abstract

Issue: Republicans in Congress are expected to repeal portions of the Affordable Care Act (ACA) using a fast-track process known as budget reconciliation.

Goals: This issue brief examines how repeal legislation could affect Medicaid, the nations’s health care safety net, which insured 70 million people in 2016.

Findings and Conclusions:Partial-repeal legislation that passed Congress but was vetoed by President Obama in 2016 offers some insight but new legislation could go further. It could repeal the ACA’s Medicaid eligibility expansions for adults and children but also roll back other provisions, such as simplified enrollment and improvements in long-term services and supports for beneficiaries with disabilities. Additionally, the Trump Administration could expand use of demonstration authority to introduce deeper structural changes into Medicaid, such as eligibility restrictions tied to work, required premium contributions and lock-out for nonpayment, annual enrollment periods, and coverage limits and exclusions. Together, these changes would have far-reaching implications for Medicaid’s continued role as the nation’s safety-net insurer.