Tag Archives: Health Policy

Trump’s path on health care law intersects with a lawsuit

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http://www.seattletimes.com/business/trumps-path-on-health-care-law-intersects-with-a-lawsuit/

FILE – In this Oct. 24, 2016, file photo, the HealthCare.gov 2017 web site home page as seen in Washington. (AP Photo/Pablo Martinez Monsivais, File)

President-elect Donald Trump says he wants to preserve health insurance coverage even as he pursues repeal of the Obama-era overhaul that provided it to millions of uninsured people.

How his administration handles a pending lawsuit over billions of dollars in insurance subsidies will reveal whether Trump wants an orderly transition to a Republican-designed system or if he’d push “Obamacare” over a cliff. Stripping away the subsidies at issue in the case would put the program into a free-fall.

The question in the House v. Burwell case couldn’t be more technical: whether the Affordable Care Act specifically states in its hundreds of pages that the government can pay money to help reduce out-of-pocket costs for low-income consumers on HealthCare.gov and state insurance markets.

Those subsidies for deductibles and copayments are paid directly to insurers, on top of the law’s tax credits that reduce premiums for consumers. Since the ACA’s basic coverage is fairly skimpy, the cost-sharing subsidies make it work for millions of people when they seek treatment. For example, subsidies can bring a $1,500 hospital copayment down to $100.

House Republicans have taken the Obama administration to court. They argue that the law lacks a specific congressional “appropriation” for the subsidies, estimated to total $9 billion next year. A federal district judge in Washington, D.C., agreed with the House and the case is now on appeal.

The Health Care Industry Is in a Panic Over Obamacare Repeal

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http://www.thefiscaltimes.com/2016/11/22/Health-Care-Industry-Panic-Over-Obamacare-Repeal

The pledge by President-elect Donald Trump and congressional Republicans to swiftly repeal the Affordable Care Act — followed by months or even years of deliberation over a replacement – is no doubt troubling news to many of the roughly 20 million Obamacare beneficiaries.

House Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) have vowed to jam through legislation as early as January to dismantle the heart of President Obama’s signature 2010 health insurance program, while leaving the question of precisely how they would replace it and when that new system would be put in place unanswered.

California healthcare advocates rally against Trump

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http://www.sacbee.com/news/politics-government/capitol-alert/article116320043.html

California Secretary of State Alex Padilla the Democratic National Convention in Philadelphia on Wednesday, July 27, 2016.

They backed Obamacare, and they’re not letting it go without a fight.

The federal healthcare overhaul could be one of the first casualties of President-Elect Donald Trump, who has joined the Republicans controlling Congress in vowing to dismantle the law. Since winning the presidency Trump has softened his stance somewhat, speaking favorably about popular provisions that prohibit insurers from turning away people with pre-existing conditions and allow people to stay on their parents’ plans until they turn 26.

Still, Trump’s election has California healthcare advocates on high alert, not to mention the state’s new U.S. senator. California could forfeit billions of federal dollars that support Medi-Cal, the insurance program for poor Californians, and subsidize private insurance purchases. They’re worried about the fate of Medicare, a program that Speaker Paul Ryan, R-Wisconsin, said has “serious problems because of Obamacare” and is “going broke.”

 A rally today in Los Angeles offers the latest example of a policy rift between California and Washington, D.C., with elected officials joining healthcare workers and patients for an event billed as a push to “protect our health care.” Among the expected speakers are Senate Health Committee chair Ed Hernandez, D-West Covina, Los Angeles County Health Agency Director Mitch Katz, and California Secretary of State Alex Padilla, whose public denunciations of Trump have become a recurring feature.

BY THE NUMBERS: 13.6 million is the number of Californians enrolled in Medi-Cal as of June 2016, the most recent data available, a net increase of about 800,000 from a year earlier and about double Medi-Cal enrollment a decade ago. The total includes almost 3.4 million people who became eligible for Medi-Cal under the state’s optional Obamacare expansion. The Legislative Analyst’s Office last week reported that Medi-Cal caseload should grow by about 100,000 annually through mid-2021 among families, children and people covered by ACA expansion. Enrollment among senior citizens and people with disabilities will grow by an estimated 50,000.

California Braces For Medi-Cal’s Future Under Trump And The GOP

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California Braces For Medi-Cal’s Future Under Trump And The GOP

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California grabbed the first opportunity to expand Medicaid and ran with it, helping cut the number of uninsured people in half in a few short years.

Thanks in part to billions of dollars in federal funding, a third of California’s residents — including half its children — are insured by Medi-Cal, the state’s version of Medicaid.

Now, with the election of Donald Trump and a Republican-controlled Congress, the state that bet so heavily on the Medicaid expansion is bracing to see how much of its work will be undone. While no one knows yet exactly what will happen, many policymakers and advocates fear the federal government will end or severely limit funding for the expansion.

“There are no easy cuts in Medi-Cal,” said Stan Rosenstein, a former Medi-Cal administrator. Reduced federal funding “could have a major impact on the uninsurance rate, on the viability of our hospitals, and it could have a very negative impact on the economy.”

Medi-Cal cuts could restrict who is eligible for coverage, slash health care benefits, limit access to doctors and reduce payment rates to medical providers — already among the lowest in the nation, health policy experts and advocates said. Medi-Cal covers a host of services for low-income residents, including maternity care, prescription drugs, long-term care services, mental health treatment and hospital stays.

Laurel Lucia, a health care program manager at the University of California, Berkeley Labor Center, said a well-funded Medicaid program benefits everyone, not just those currently on the program.

“A lot of people are just a layoff away from needing Medicaid,” she said. “The Republican plans for Medicaid threaten to undermine that safety net.”

Why Some States Declined to Expand Medicaid

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http://www.definitivehc.com/medicare-cms/why-some-states-declined-to-expand-medicaid?source=newsltr-blog&utm_source=newsletter&utm_medium=email&utm_campaign=11-22-16

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The vast majority of healthcare organizations and professional groups support Medicaid expansion, the Obamacare initiative to widen eligibility for Medicaid to individuals earning up to 138% of the federal poverty level. To them, the benefits of expansion, such as less bad debt and uncollectible bills, better patient access to services, and an overall healthier patient population, outweigh the additional costs for states to bear after the full federal reimbursement period expires. But a subsequent Supreme Court ruling left the decision to implement Medicaid expansion up to the individual states. To date, 31 states and DC have implemented the expansion, the majority of them launching new Medicaid eligibility guidelines starting in 2014. Why hasn’t it been approved in the other 19? Often it is attributed to the state’s dominant political party, but that alone isn’t a reliable indicator, given that red states like Ohio and North Dakota expanded the program, while others like Maine and Virginia did not. Judging from a review of Definitive Healthcare data, there is another possibility: hospitals in non-expansion states were in a better financial position and so there was less political pressure to widen Medicaid eligibility.

Will Obamacare be repealed? If so, what then?

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Will Obamacare be repealed? If so, what then?

Image result for aca repeal

The election of Donald J. Trump gives the Republicans in Congress a chance to act ontheir often-stated desire to get rid of Obamacare, a wish that Mr. Trump mostly says he shares. Aaron E. Carroll and Austin Frakt, our health policy columnists, discuss: Then what?

Cost, Not Choice, Is Top Concern of Health Insurance Customers

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It is all about the price.

Millions of people buying insurance in the marketplaces created by the federal health care law have one feature in mind. It is not finding a favorite doctor, or even a trusted company. It is how much — or, more precisely, how little — they can pay in premiums each month.

And for many of them, especially those who are healthy, all the prices are too high.

The unexpected laser focus on price has contributed to hundreds of millions of dollars in losses among the country’s top insurers, as fewer healthy people than expected have signed up. And that has created two vexing questions: Will the major insurance companies stay in the marketplaces? And if they do, will the public have a wide array of plans to choose from — a central tenet of the 2010 Affordable Care Act?

“The marketplace has been and continues to be unsustainable,” said Joseph R. Swedish, chief executive of Anthem, one of the nation’s largest insurers.

Most Americans with health insurance get it through their employers or from government programs like Medicare and Medicaid. The marketplaces were created under the health care law to give the millions of people not covered in those ways a way to buy health plans.

While major insurers continue to make profits over all, they say that the economics of the marketplaces do not work for them. Insurers can offer marketplace plans at four different coverage tiers, and the government subsidizes the premiums for millions of people. The thinking was that enough healthy people would buy insurance to balance out the costs for the not-so-healthy.

But things are not going exactly as envisioned.

 

 

The Future of Health Care Mergers Under Trump

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Though there has been a flurry of merger and acquisition activity in recent years, industry experts are unsure whether the merger momentum will continue under President-elect Donald Trump’s administration, according to The New York Times.

Here are five things to know about how M&A activity in the healthcare industry may be affected under the Trump administration.

1. President-elect Trump nominated Sen. Jeff Sessions (R-Ala.) to replace Attorney General Loretta Lynch. While it is unclear how the department will handle antitrust cases under Sen. Sessions, the impact from the change in leadership will not be felt immediately. The outcomes of the two major antitrust cases in the insurance market, the Anthem-Cigna and Aetna-Humana mergers, are expected to be decided before Mr. Trump takes office in January. However, the new administration might still have an impact on the mergers, particularly if either the companies or the government decide to appeal the decision, according to the article.

2. According to the article, there is little expectation the Department of Justice under President-elect Trump would drop the cases if the insurers lost and appealed. However, any agreed upon settlement deal may be less onerous to the insurers involved.

3. There is a chance the federal government’s approach to healthcare mergers may not change, according to the article. “There is a history of bipartisan support for antitrust enforcement in healthcare,” said Leslie Overton, a partner at Alston & Bird and a former DOJ official. “I don’t think we should expect a wholesale shift, based on the change from Democratic to Republican.”

4. The Federal Trade Commission’s position on M&A activity may change even less, according to industry experts interviewed by The New York Times. The independent agency is less subject to the political preferences of the president and of Congress.

5. Industry experts also suggest the possible repeal of the ACA will not impede the increasing M&A activity of the past few years. According to the article, hospitals may feel more pressure to join together if the ACA is repealed due to reduced Medicare and Medicaid payments and increased volumes of uninsured patients.

Pence says Trump plans to repeal ACA right ‘out of the gate’

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http://www.beckershospitalreview.com/hospital-management-administration/pence-says-trump-plans-to-repeal-aca-right-out-of-the-gate.html

Image result for trump aca repeal

President-elect Donald Trump has decided repealing the ACA will officially be among his top priorities when he takes office, Vice President-elect Mike Pence told Chris Wallace on Fox News Sunday.

“Decisions have been made by the President-elect that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free market solutions that he campaigned on,” Mr. Pence said on Fox News.

The Trump-Pence transition team has been working with congressional leaders from both political parties to move Mr. Trump’s “aggressive policy agenda” forward, Mr. Pence said. This weekend Mr. Pence met with Senate Minority Leader Chuck Schumer, D-N.Y., Senate Majority Leader Mitch McConnell, R-Ky., House Minority Leader Nancy Pelosi, D-Calif., and House Speaker Paul Ryan, R-Wis., according to the interview.

Later on the show, Fox News spoke with Sen. Schumer, who said the ACA is one of the issues on which Democrats plan to “oppose [Mr. Trump] tooth and nail.” Sen. Schumer said Mr. Trump would not be successful in his efforts to repeal the healthcare reform law.

“He won’t be able to do it, because now even he, after his meeting with President Obama, said, ‘Oh, I want to keep the good things.’ Well, you can’t keep the good things without keeping [the] ACA,” Sen. Schumer told Fox News.

Scott Becker, publisher of Becker’s Hospital Review, says it is still unclear if Mr. Trump can or will be able to push through an ACA repeal. “It’s a fascinating statement because it’s not clear Republicans have the votes to repeal this without making complicated accommodations on a few levels, particularly for preexisting conditions and some funding issues,” Mr. Becker says.

It’s Easy for Obamacare Critics to Overlook the Merits of Medicaid Expansion

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At a national level, the expansion of Medicaid continues to yield benefits. Its coverage was increased, and its quality raised. Some states that have expanded Medicaid are even expecting net savings for the next few years. In states where Medicaid was expanded, hospitals had fewer uninsured visits.

Focusing on only the positives can be as misleading as focusing on only the negatives. Policy decisions, including those involving health, need to be considered in terms of trade-offs. It is true that providing Medicaid can cost the federal government, and even states, a lot of money, which can’t then be spent on other worthy pursuits. It is true that Medicaid reimburses physicians and hospitals less generously, and that it often leaves beneficiaries with fewer choices than private insurance might.

But when we look at the balance sheet for Medicaid — health benefits, financial security, societal improvements through education — it’s not hard to argue that money allocated to Medicaid is well spent.