About 5 weeks ago I noted that organizations representing pretty much the entire healthcare industry sent urgent letters to Donald Trump, HHS Secretary Tom Price, Treasury Secretary Steven Mnuchin, OMB Director Mick Mulveney and current CMS Administrator Seema Verma...basically, every major healthcare-related administration figure...practically begging them to fund the goddamned Cost Sharing Reduction reimbursements.
They made it crystal clear how vitally important doing this was, and Trump grudgingly went ahead and made the April payment, then later indicated that he was "probably" going to keep reimbursing carriers for the CSR funds legally owed to them on an ongoing basis, at least until the House vs. Price (formerly House vs. Burwell) lawsuit appeal process was completed.
Health insurers and state officials say Trump is undermining Obamacare, pushing up rates
Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management, inconsistent guidance and seeming lack of understanding of basic healthcare issues.
At the same time, state insurance regulators — both Democrat and Republican — have increasingly concluded they cannot count on the Trump administration to help them ensure that consumers will have access to a health plan next year.
As noted in my last post, it turns out that if the CBO score of the final version of the AHCA (that is, the one which passed two weeks ago) doesn't project the law to save at least $2 billion over a 10 year period, the House Republicans would have to start over again from scratch and re-vote on yet another version of their bill.
Now, the good news for them is that the CBO projected the prior version to save $150.3 billion over that period, so they have $148.3 billion worth of wiggle room, right? What are the odds of the CBO's new projection assuming that the passed version would eat up that much more money?
The key is does CBO assume lots of states waive benefits/community rating, and lots of healthy people use tax credits for skimpy insurance. https://t.co/vLx28MT5Bv
House May Be Forced to Vote Again on GOP's Obamacare Repeal Bill
House Republicans barely managed to pass their Obamacare repeal bill earlier this month, and they now face the possibility of having to vote again on their controversial health measure.
This Axios piece by Caitlin Owens is extremely short...a mere 139 words in all...so sticking with a "fair use" quote is tricky, but I'll do my best:
Senate Finance Committee chairman Orrin Hatch says he could support delaying the repeal of the Affordable Care Act's individual mandate for a while, or even indefinitely, as a way to stabilize the marketplaces. "I wouldn't mind" postponing the repeal until after 2020, he told reporters this afternoon. "It all comes down to budgetary concerns and how it's going to be written." And he didn't rule out keeping it even longer:
"I'd like to not have it at all, but you know, it all comes down to, what's the art of the doable?"
A few days ago, CMS announced that they're retooling the ACA's SHOP program (at least on the federal exchange) so that instead of small businesses using HealthCare.Gov for eligibility verification, enrollment and payments, going forward it will only be used for verification, with the businesses then being kicked over to the actual insurance carrier website in order to actually enroll in the policies and make payments.
Although the Trump Administration and HHS Secretary Tom Price are hell bent on killing off the ACA altogether, this move didn't bother me for several reasons. For one thing, the SHOP program has always been kind of a dud anyway, with only around 230,000 people being enrolled in it nationally. For another, a business signing up their employees for coverage is a very different animal from an individual signing their family up for a policy. Finally, for several reasons, SHOP enrollment across the dozen or so state-based exchanges is actually higher than it is across the 3 dozen states covered by HC.gov, and the state-based exchanges aren't impacted by this policy anyway.
Julie McPeak is the Tennessee Insurance Commissioner. She was appointed by a Republican Governor, Bill Haslam, and while the position itself appears to be nonpartisan, I've found several links indicating that yes, she's a Republican herself. This is hardly surprising in Tennessee, of course, and there's nothing wrong with it...but it's noteworthy given that Tennessee is among the 19 states which has been fairly hostile towards the ACA in general over the years (no state exchange, no Medicaid expansion, total GOP control and so forth).
Assuming this ratio hasn't shifted much over the past 8 years, around 28% of the total U.S. population are mothers,
Of course, women over 64 (mostly on Medicare) are much more likely than the general population to be mothers...but girls under 18 are far less likely to be (well...under 16, anyway...the birth rate varies from state to state, of course), so I'm assuming that these cancel each other out, resulting in that 28% rate being roughly accurate.
Senate Republicans are working on a potential breakthrough that could help push through an Obamacare repeal bill – by making insurance subsidies look a lot like Obamacare.
There’s growing support for the idea of pegging the tax credits in the House repeal bill to income and making aid more generous for poorer people. But those moves — while they may win consensus among Senate moderates — are unlikely to sit well with House conservatives.
The financial assistance in the House bill “is just not robust enough to make sure that low-income individuals can actually afford a [health] plan,” said Sen. John Hoeven (R-N.D.). “If you bring those income limits down for people who really need the help, you can give them more help.”
