Tag Archives: ACA

Biotech billionaire in talks with Trump about a senior health care role, sources say

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Biotech billionaire in talks with Trump about a senior health care role, sources say

Dr. Patrick Soon-Shiong, an audacious biotech billionaire who has pledged to “solve health care,” has been in talks with the Trump administration about the possibility of serving in a senior role overseeing the US health care system, according to individuals familiar with the discussions.

Soon-Shiong, a trained surgeon, has met with President Trump and his advisers at least twice in recent weeks. During those discussions, he raised the possibility that he could serve as a “health care czar” with a broad portfolio in the administration as it seeks to reshape the health care system and replace the Affordable Care Act, according to two individuals, who spoke on the condition of anonymity.

Asked about the discussions, an adviser to Soon-Shiong told STAT that the word “czar” had not been used but did not dispute that the biotech mogul has discussed the possibility of taking on a senior role overseeing health care in the Trump administration.

Trump’s Health Plan Would Convert Medicaid to Block Grants, Aide Says

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President Trump’s plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday.

The adviser, Kellyanne Conway, who is Mr. Trump’s White House counselor, said that converting Medicaid to a block grant would ensure that “those who are closest to the people in need will be administering” the program.

A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.

If Congress decides to create block grants for Medicaid, lawmakers will face thorny questions with huge political and financial implications: How much money will each state receive? How will the initial allotments be adjusted — for population changes, for general inflation, for increases in medical prices, for the discovery of new drugs and treatments? Will the federal government require states to cover certain populations and services? Will states receive extra money if they have not expanded Medicaid eligibility under the Affordable Care Act, but decide to do so in the future?

 

 

Women’s March: Protesters fight for healthcare access, reproductive health

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http://www.fiercehealthcare.com/healthcare/women-s-march-protestors-fight-for-healthcare-access-reproductive-health?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWW1JeU5XWTJNREUwWWpReCIsInQiOiJnXC83WGlnU0E3ZnV5YnRYSTBpbW1TYWdOaVhcL1gxU01Cb0pFSHM0dzVyUjJ5TTlVV2JSNmJhSFhoYnJOWjFGbzdmdCtpd0JcLzdlOENkcGE2alV6dkFPcHdXQlZ2VjFPZWgyb0p5RkV2N082NmYxQmw2N0hFQ01UK2QyMG9xM0EyMCJ9

Fears that the new White House administration will limit Americans’ access to healthcare inspired many physicians and healthcare advocates to join thousands of protesters and take to the streets Saturday as part of the Women’s March on Washington.

The protest was organized in response to the election of President Donald Trump. But concerns over the future of healthcare in the United States drove many to join the hundreds of thousands of women and men in rallies all over the country and the world.

“Right now, women’s health is in greater danger than it has been at any time in the last 3 or 4 decades,” Kyle Ragins, M.D., a board member of Doctors for America and an emergency resident at the University of California, Los Angeles, told Medscape Medical News.

Healthcare providers not only fear the impact of a repeal of the Affordable Care Act leaving millions without healthcare coverage, but they also worry that lawmakers aim to limit access and coverage for contraception, abortion and other women’s health services, and change the vaccination criteria for U.S. children.

Many protesters carried signs and banners with messages that support reproductive rights and “Medicare for All,” noted MedPage Today.

“We want women to have access to anything they need to make the right choices for their bodies,” Katie MacMillan, a fourth-year medical student at Quillen College of Medicine in Johnson City, Tennessee, told the publication.

The most immediate threat to healthcare access is the repeal of the Affordable Care Act. Shortly after Donald Trump was sworn in as president, he issued an executive order to push for a quick repeal of President Barack Obama’s signature healthcare legislation.

Although many of the physicians interviewed by MedPage Today noted that the ACA was flawed, they also praised the fact that 20 million previously uninsured people received healthcare coverage under the health reform law. It was one reason why Ragins joined the protest. He told Medscape that he wanted Congress and the Trump administration to know that doctors see the benefits of the ACA every day.

But protesters vowed to fight for their right to healthcare. During a postmarch event, Planned Parenthood urged participants to call their senators urging them to protect their access to healthcare, The New York Times reported. Repeal of the ACA and defunding Planned Parenthood is going to “create havoc,” Cecile Richards told David Axelrod on “The Axe Files,” a podcast from the University of Chicago Institute of Politics and CNN.

State Experiences Show Why Repealing the ACA’s Premium Subsidies and Individual Mandate Would Cripple Individual Health Insurance Markets

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http://www.commonwealthfund.org/publications/blog/2017/jan/state-experiences-aca-repeal?omnicid=EALERT1156084&mid=henrykotula@yahoo.com

Image result for aca repeal

President-elect Donald Trump and congressional Republicans favor repealing major provisions of the Affordable Care Act (ACA) early in the new administration. Republicans may have enough votes from within their own party to do away with the health law’s premium and cost-sharing subsidies, individual mandate, and Medicaid expansion. But a broader repeal of the ACA’s insurance market reforms, and adoption of a replacement health care plan, may be more challenging. These steps need bipartisan support for passage and require Republicans to resolve ongoing internal differences regarding what a replacement law should look like; they may do so, but haven’t yet.

With the substance of an alternative plan up in the air, uncertainty has grown over when the law might be replaced. Republican leaders have suggested Congress should repeal parts of the ACA now and leave the details of replacement until later. But “repeal and delay” has drawn criticism from stakeholders and policy experts who point out the strategy is likely to cause significant harm to insurance markets and consumers long before a replacement plan materializes, and a growing number of lawmakers have expressed discomfort about the proposal.

What happens if Congress and the new president push ahead with partial repeal without securing support for a replacement? The resulting regulatory landscape would look like what several states had in place prior to the ACA. Their experiences were poor.

As Healthcare Changes, So Must its CEOs, CFOs, COOs…

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http://www.healthleadersmedia.com/leadership/healthcare-changes-so-must-its-ceos-cfos-coos%E2%80%A6?spMailingID=10269321&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1081665555&spReportId=MTA4MTY2NTU1NQS2#

To keep up with big changes in how healthcare is administered, financed, and organized, top leaders are finding a need for new talents and organizational structures.

The Myth of a Cheap Obamacare Replacement

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http://www.latimes.com/business/hiltzik/la-fi-hiltzik-trump-paul-20170117-story.html?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=41037755&_hsenc=p2ANqtz-8pBWi30RdOLslYQ89FMuSTb8hSonUKKpIqWGUR6-WRPjXZJxVIUiM49YQ6dDiBROgviwVLxtxSEKFVcIPLyvnTm-UpMQ&_hsmi=41037755

The 10 essential health benefits required of any qualifying Obamacare plan: Which would you want to do without?

News on the Obamacare-replacement front was dominated this past weekend by Donald Trump and Sen. Rand Paul (R-Ky.), who both touted their Obamacare replacement plans.

To be absolutely precise, they touted the claim that they had Obamacare replacement plans. They didn’t go into any great detail about what would be in those plans. (That didn’t stop CNN from captioning its interview with Paul, “Rand Paul Releases Obamacare Replacement Details.”)

The few details, or guideposts, or guidelines that they did disclose only underscored how difficult it will be for Trump, Paul and the the Republicans on Capitol Hill to fashion a replacement that meets all their stated goals. For Trump, according to an interview with the Washington Post published Sunday, this includes “insurance for everybody” that will encompass “great health care … in a much simplified form. Much less expensive and much better.” He promised “lower numbers, much lower deductibles.”

Paul, speaking on CNN’s Sunday morning “State of the Union” program, said his plan would “insure the most amount of people, give access to the most amount of people, at the least amount of cost.” That sounds like a set of concrete goals, but actually they’re ambiguous. “Most people” compared to what? “Least cost” compared to what?

Before we get into the details, such as they are, we should recognize that if one takes as the goal of healthcare policy to provide universal coverage in which everyone is “beautifully covered,” as Trump promised, then a few limitations immediately appear. Health coverage is the product of three factors: How many people are covered; the benefits provided; and the cost of those benefits. Since the 1940s, U.S. politicians and policymakers have tried to find a balance among these factors. Every effort has been confounded by the immutable facts that treating the sick costs money and treating more people costs more money. One can save money by treating fewer people, or giving the same number of people less treatment. So any politician who says he can do more for less money is almost certainly blowing smoke.

How do the Trump and Paul “details” stack up?

Rampaging goats and $10 million mansions: your guide to the weird world of Obamacare rhetoric

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Rampaging goats and $10 million mansions: your guide to the weird world of Obamacare rhetoric

The Obamacare repeal effort is just getting underway and already the political wordplay is dizzying. On the GOP side, the rhetoric has gone from “repeal and replace” to “insurance for everybody” to “repair and rebuild.” Meanwhile, Democrats continually warn that the Republicans are trying to “rip apart our health care system.”

To help you keep pace with the debate, we’ve assembled this handy glossary of buzzwords and talking points. Enjoy.

From the Republicans:

Repair and rebuild

This is the GOP’s attempt to describe its legislative strategy for Obamacare, and an evolution of the phrase “repeal and replace.” As Politico reported Thursday, it is the mantra of Oregon Representative Greg Walden, who is leading the offensive against Obamacare in the House. It is meant to soften the GOP’s tone and suggest the replacement effort will be carefully staged and surgical. It also opens the door to delay tactics if things don’t quickly shape up in the GOP’s favor.

From the Democrats:

‘Make America Sick Again’

A play on Donald Trump’s campaign slogan, this phrase emerged in early January as Democrats held rallies to generate support for Obamacare. Judging by the nation’s $3.2 trillion tab for health care costs in 2015, a number expected to jump as high as $3.6 trillion this year, it seems clear a lot of us are pretty sick already. But you get the point.

Balance enrollee risk to sustain individual marketplaces, report says

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http://www.fiercehealthcare.com/payer/balancing-enrollee-risk-key-to-sustainable-individual-marketplaces-report?mkt_tok=eyJpIjoiTkRGbE9XWTBNVGcwTUROaSIsInQiOiJOZEtcLzhSNHFcL3A2UGlyd2JIQWNwK2ZoRGpWcENHODJZQTlLQ1R1OVo0b3JvdUdSdkN0a0FyTzhIdHVnYVhCN0lxNHRQbW5ibEVVWjBiR0VPU2tFdXBCVmxSYWtWcWZJQ2dyOUxIRnBlNURrakpFXC93Y2xHS21RdGFybUtZZVJlViJ9&mrkid=959610&utm_medium=nl&utm_source=internal

Document titled "Patient Protection and Affordable Care Act"

Stability and sustainability in health insurance marketplaces requires a more balanced risk profile for enrollees and rules that are communicated clearly and quickly to payers, according to a new report.

The analysis (PDF), published by the American Academy of Actuaries, examined the state of insurance markets under the Affordable Care Act and noted that, while the law’s implementation did slash uninsured rates, individual marketplace enrollment was lower than anticipated and many enrollees aren’t healthy. To be most effective, the report states that more healthy people need to enroll to help offset the costs of the most ill people.

Governors voice Medicaid concerns to GOP lawmakers

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http://www.fiercehealthcare.com/payer/governors-voice-medicaid-concerns-to-gop-lawmakers?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTkRGbE9XWTBNVGcwTUROaSIsInQiOiJOZEtcLzhSNHFcL3A2UGlyd2JIQWNwK2ZoRGpWcENHODJZQTlLQ1R1OVo0b3JvdUdSdkN0a0FyTzhIdHVnYVhCN0lxNHRQbW5ibEVVWjBiR0VPU2tFdXBCVmxSYWtWcWZJQ2dyOUxIRnBlNURrakpFXC93Y2xHS21RdGFybUtZZVJlViJ9

Capitol Hill

A group of governors met with congressional leaders on Thursday to express their mounting concerns about the consequences of an Affordable Care Act repeal—particularly for those who have benefited from Medicaid expansion.

The closed-door meeting included several Republican state leaders, who despite generally opposing the ACA have accepted federal funds to expand Medicaid eligibility and are wary of rolling back such coverage expansions.

Michigan Gov. Rick Snyder, for example, said after the meeting that the data show his state’s Healthy Michigan program “had a lot of success, both in terms of healthier behaviors and better outcomes helping people,” according to The Hill.

Ohio Gov. John Kasich, another Republican who attended the meeting, suggested that those who gained coverage under Medicaid expansion could instead be given either premium subsidies or tax credits to help them buy private health insurance, Reuters reports.

But Synder and Kasich have been among the more vocal governors in support of Medicaid expansion, with Kasich crediting the program for helping fund the fight against opioid abuse that is ravaging his state.

Hospitals in states that have chosen to expand Medicaid eligibility have seen reductions in their uncompensated care costs, leading some in the healthcare industry to worry about what will happen under an ACA repeal. In addition, 15.7 million more people now have Medicaid coverage than before the ACA’s major coverage provisions took effect.

Trump’s executive order on Obamacare

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Trump’s executive order on Obamacare

Image result for executive orders

Some misconceptions are floating around about what the executive order does and doesn’t do. Let me try to clarify.

As I explained in a post last week, “[a]uthority to implement the ACA … is vested in the Secretaries of HHS, Treasury, and Labor—not the President. In the context of the ACA, an executive order won’t be anything more than a document containing a president’s instructions to his subordinates.”

That’s all this E.O. is. It’s a set of marching orders. It has no legal force. It changes nothing on its own.

And these marching orders are pretty vague. After pruning away the bureaucratese, the executive order tells federal agencies, especially HHS, to do everything they can:

  • To eliminate any “fiscal burden on any State” or any “cost, fee, tax, penalty, or regulatory burden” on individuals and providers.
  • To give the states more flexibility.
  • To encourage the interstate sale of health insurance.

It remains to be seen how and when these orders will be carried out. But we can make some educated guesses (most of which we could’ve made even in the absence of the executive order).