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Tag Archives: ACA
Questions to Ask About the House Republican Health Reform Proposal
House Speaker Paul Ryan’s health-care task force is expected to outline its alternative to Obamacare this week. The outline reportedly will not include the level of detail that would allow much external analysis of its impact by health-care experts and the media, though Democrats are likely to attack its concepts, most of which will be familiar proposals that Republicans favor and that Democrats have opposed in the past. The outline is part of Mr. Ryan’s effort to add Republican policy ideas to the election debate, in particular to the presidential campaign, and seems aimed at helping down-ticket Republicans as a part of an agenda that can appeal to their base. Details will be needed to understand whether the plan is more progressive or regressive and how many uninsured people would be covered. Another big question is how Donald Trump will respond.
The Fundamentally Different Goals of the Affordable Care Act and Republican ‘Replacement’ Plans
Rep. Pete Sessions and Sen. Bill Cassidy introduced legislation last month calling for replacing elements of the Affordable Care Act. A House task force established by SpeakerPaul Ryan is expected to follow with more health-care proposals. These Republican health plans are generally referred to as “replacements” for the ACA–in the spirit of “repeal and replace”–as though they would accomplish the same objectives in ways that conservatives prefer. But the proposals are better understood as alternatives with very different goals, trade-offs, and consequences. Whether they are “better” or “worse” depends on your perspective.
To boil down to the most basic differences: The central focus of the Affordable Care Act is expanding coverage and strengthening consumer protections in the health insurance marketplace through government regulation. By contrast, the primary objective of Republican plans is to try to reduce health-care spending by giving people incentives to purchase less costly insurance with more “skin in the game,” with the expectation that they will become more prudent consumers of health services. They also aim to reduce federal spending on Medicare and Medicaid and the federal government’s role in both programs. Elements of the ACA were designed to reduce costs, such as the law’s Medicare payment reforms, and elements of Republican plans such as tax credits aim to expand access to insurance, but the primary aims of the ACA and the Republican plans differ.
301 people charged in massive $900 million false billings Medicare fraud
More than 60 of the defendants arrested are charged with fraud related to the Medicare prescription drug benefit program known as Part D.
Declining Charity Care Levels Raise Questions About 340B Hospital Eligibility
The 340B program was created for an important purpose: to help uninsured, needy patients access the medicines they need. However, a new analysis paints a very different picture of how the program is currently operating. While 340B hospitals are tasked with serving vulnerable patients, data show 64 percent of these hospitals provide less charity care than the national average for all hospitals, including for-profit entities. Not only is this low number concerning, it represents a decrease in charity care rates for 340B hospitals since 2011. This begs the question of whether hospitals or patients are benefitting more from the program.
Some Democrats Aren’t Giving Up on Universal Health Care
Democrats should push for universal health coverage ahead of the November election, several health care advocates urged the committee drafting the Democratic National Committee’s platform at a recent session focused on health policy.
Their liberal health care proposals echo a similar theme from an environment-themed session the same day, in which activists criticized DNC members for not pushing harder on climate change.
The hearing was part of a series of regional events held by the Democratic Platform Drafting Committee “designed to engage every voice in the party.”
Too many people are still uninsured six years after the passage of the Affordable Care Act, said many of the advocates who spoke before the committee in Phoenix on Friday. Still more are underinsured, they said, and people are struggling to pay for rising premiums and to afford prescription drugs.
Organizational Independence: Mission Impossible?
Adherence to a strict interpretation of the goal of independence can be a critical barrier to positioning the organization for a value-based environment.
Hospitals Off Track to Hit Value-Based Targets
Fewer than one in four hospitals are scheduled to hit the Obama Administration’s 2018 goal of providing at least half their care through value-based structures, research shows.
Not only are few hospitals scheduled to meet the 2018 value-based goal set by the Department of Health and Human Services, but only 3% meet that goal right now.
Further, only 23% expect to meet it even as late as 2019. The survey of 190 U.S. hospitals was conducted by Health Catalyst, a healthcare data and analytics company.
How Small Ideas Are Helping to Bend the Health Care Cost Curve
http://www.thefiscaltimes.com/2016/04/10/How-Small-Ideas-Are-Helping-Bend-Health-Care-Cost-Curve
Even as overall U.S. health care spending grew by 5.3 percent in 2014 – reaching a jaw-dropping $3 trillion — the healthcare industry has made some important strides in trying to bend the overall cost curve in the coming years, according to some experts. Since the advent of the Affordable Care Act in 2010, for instance, the move away from so-called fee-for-service that maximizes costs for insurers and patients by encouraging excessive billings has begun to make some inroads in overall spending.
This Obamacare Repeal Plan Cripples State Budgets—and Economies
http://www.thefiscaltimes.com/2016/06/14/Obamacare-Repeal-Plan-Cripples-State-Budgets-and-Economies
If Republicans finally make good on their vow to repeal the Affordable Care Act — but without adopting a suitable replacement — 24 million Americans would be removed from the health care insurance rolls in 2021. And federal spending on health care would decline by $927 billion over the next decade, according to a provocative new study by the Urban Institute and the Robert Wood Johnson Foundation.
HENRY KOTULA 