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Health plans - policy

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White House: Federal Government to Make CSR Payments This Month
"The government will make this month's [cost-sharing reduction] payments to insurers ... a White House official said Wednesday.... The subsidies are snared in a legal dispute over whether the Obama health care law properly approved the payments to insurers. Adding to the confusion, other parts of the law clearly direct the government to reimburse the carriers." (Associated Press, via Insurance News Net)
Sen. Cassidy's Repeal-and-Replace Plan Is 'Only Game Left'
"The Cassidy-Graham-Heller legislation, which hasn't yet been scored by the [CBO], would scrap the ACA's individual and employer mandates to buy health insurance while largely block-granting Medicaid funding for states." (
Terminating CSR Payments Would Increase Deficits, CBO Finds
"The CBO affirms what earlier analyses have concluded: in the long run the primary loser if CSR payments are terminated would be the federal budget, which would see a net increase in the deficit of $194 billion over the 2017 to 2026 budget window. The report also projects, however, that market instability would increase in the short run[.]" (Timothy Jost, in Health Affairs)
Recess Update on the ACA and Its Repeal and Replacement
"To date, ACA rules on employers sponsoring group and individual health care coverage appear to have received little attention from regulators, and most of the requirements remain in place.... This means, among other things, that the Summary of Benefits and Coverage Rule template, updated effective April 1, 2017, must be addressed by employer plans and, as of now, employer reporting obligations will continue in January 2018." (Ballard Spahr LLP)
CBO Report: The Effects of Terminating Payments for Cost-Sharing Reductions (PDF)
14 pages. "As a result of the increase in total subsidies under the policy, CBO and JCT project these outcomes, compared with what would occur if the CSR payments were continued: [1] The fraction of people living in areas with no insurers offering nongroup plans would be greater during the next two years and about the same starting in 2020; [2] Gross premiums for silver plans offered through the marketplaces would be 20 percent higher in 2018 and 25 percent higher by 2020 -- boosting the amount of premium tax credits according to the statutory formula; [3] Most people would pay net premiums (after accounting for premium tax credits) for nongroup insurance throughout the next decade that were similar to or less than what they would pay otherwise -- although the share of people facing slight increases would be higher during the next two years; [4] Federal deficits would increase by $6 billion in 2018, $21 billion in 2020, and $26 billion in 2026; and [5] The number of people uninsured would be slightly higher in 2018 but slightly lower starting in 2020." (Congressional Budget Office [CBO])
If Cost-Sharing Reduction Payments End, States Can Use 1332 Waivers to Fund Their Own
"Creating a State-administered CSR mechanism will undoubtedly require expenditure from the State. While some will argue that the limited resources available in State budgets would render the idea all but theoretical, it would be beneficial to examine how States can use Section 1332 of the ACA to fund -- and potentially profit from -- providing CSR." (Health Affairs)
[Opinion] Subsidizing Health Insurance Cannot Ever Get U.S. to Universal Coverage
"This study looked at low-income individuals and showed that ... the willingness to pay for a percentage of the premium is far below the insurers' average costs. Even with 90% of the premium subsidized, 20% of the individuals would remain uninsured, and the percent insured dropped off rapidly as the individuals' share increased." (Physicians for a National Health Program [PNHP])
Subsidizing Health Insurance for Low-Income Adults: Evidence from Massachusetts
"Using administrative data from Massachusetts' subsidized insurance exchange, ... [the authors] estimate willingness to pay and costs of insurance among low-income adults. As subsidies decline, insurance take-up falls rapidly, dropping about 25% for each $40 increase in monthly enrollee premiums. Marginal enrollees tend to be lower-cost, consistent with adverse selection into insurance. But across the entire distribution we can observe -- approximately the bottom 70% of the willingness to pay distribution -- enrollee willingness to pay is always less than half of own expected costs." (National Bureau of Economic Research [NBER])
[Opinion] How Federal Regulators Can Reform Obamacare Without Help from Congress
"With health reform at an impasse in Congress for the time being, here are four ideas that HHS and the states can explore and expand. [1] Expand state reinsurance options.... [2] Allow innovative pilot plan designs for high cost patients.... [3] Give states more authority on how exchanges are run -- including contracting out to a private exchange.... [4] [A]llow unused federal tax credits to cover the employees' portion of insurance for small-to-medium sized businesses." (Manhattan Institute for Policy Research)
Third Circuit Determines Religious Exemption to Contraceptive Mandate Does Not Extend to Nonreligious Employers
" 'After careful review, but without any hesitation,' the Third Circuit U.S. Court of Appeals determined that the religious exemption to the [ACA's] contraceptive mandate does not apply to a secular anti-abortion group with no religious affiliation and affirmed the district court's grant of summary judgment to the federal government. It also found that an employee's religious beliefs are not substantially burdened by the mandate." [Real Alternatives v. HHS, No. 16-1275 (3d Cir. Aug. 4, 2017)] (Wolters Kluwer Law & Business)
[Opinion] Re-Thinking Employer-Provided Health Benefits
"Employer-sponsored coverage is shrinking.... What's covered and who is covered is shrinking.... Employees are paying more of the cost.... Employers blame hospitals and drug companies for excess costs.... Employers are implementing new strategies to rein in their costs.... Two issues have regulators' attention: Disparity in employee access ... Contracts with providers ... But beyond these issues, cost is the overriding employer concern that's likely to define the future for employer sponsored health benefits." (Paul Keckley)
Health Insurers Get More Time to Calculate Increases for 2018
"The Trump administration is giving health insurance companies more time to calculate price increases for 2018 because of uncertainty caused by the president's threat to cut off crucial subsidies paid to insurers on behalf of millions of low-income people. [CMS said] the deadline for insurers to file their rate requests would be extended by nearly three weeks, to Sept. 5.... It was the clearest evidence to date that the politics of health care in Washington could disrupt planning for 2018." (The New York Times; subscription may be required)
Freedom Caucus Brings Petition to House Floor in Attempt to Repeal Obamacare
"Among other things, the bill would remove language in IRC Sec. 223(d)(2) that requires drugs to be prescribed or to be insulin to be HSA-qualified medical expenses, and change the additional tax on HSA distributions not used for qualified medical expenses from the current 20 percent to 10 percent." (Ascensus)
Seventh Circuit: Plan's Forum-Selection Clause Is Not Precluded by ERISA (PDF)
"With support from the Secretary of Labor, Mathias argues that forum-selection clauses in plan documents are categorically invalid because they deprive plan participants and beneficiaries of the right to select from the menu of venue options offered by Section 1132(e)(2).... [F]orum-selection clauses promote uniformity in plan administration and reduce administrative costs and in that sense are consistent with the broader statutory goals of ERISA.... The forum-selection clause in the Caterpillar plan chooses from among the venue options listed in Section 1132(e)(2), and nothing in the statute makes that choice invalid. Accordingly, we hold that the plan's forum-selection clause is enforceable." [In re Mathias, No. 16-3808 (7th Cir. Aug. 10, 2017)] (U.S. Court of Appeals for the Seventh Circuit)
After ACA 'Repeal and Replace' Effort Fails, What's Next for Employers on Healthcare?
"The apparent end of the congressional effort to repeal and replace the ACA through the budget reconciliation process, which would have required only a simple majority vote to pass the Senate, has given rise to discussions about potential bipartisan legislation to stabilize the individual insurance market.... Pressure for bipartisan legislation to fund the cost-sharing reductions, currently the subject of a House lawsuit challenging their validity, will likely continue to rise. This could be the vehicle for additional ACA-related changes." (Littler)
[Opinion] The Case for Abolishing Obamacare's Individual Mandate
"[T]he individual mandate is not the only way to prevent people from waiting to get sick before purchasing health insurance coverage. Policymakers could allow individuals to opt out of regulatory guarantees for pre-existing conditions or impose waiting periods for those who fail to maintain continuous coverage." (U.S. News & World Report)
[Opinion] Suggestions for a Bipartisan Approach on Health Care
"[B]ipartisan discussion should focus [on:] [1] Stabilize the market In the short run.... [2] Improve support for the middle class.... [3] Strike a compromise on medicaid expansion and reform.... [4] Explore alternatives to the individual mandate.... [5] Make consumer-directed health plans available to all individual insurance market enrollees.... [6] Establish automatic enrollment.... [7] Replace the Cadillac Tax with a 'tax cap'.... [8] Improve the ACA's delivery system reform agenda.... [9] Repeal the IPAB." (Joseph Antos and James Capretta, in Health Affairs)
The ACA Stability 'Crisis' in Perspective
"84% of the enrollees in the marketplaces -- about 8.7 million people -- receive premium subsidies under the ACA and are insulated from these premium hikes. However, roughly 6.7 million people -- the ones who buy ACA-compliant plans inside or outside the marketplace and aren't subsidized -- will feel the full brunt of premium increases. They'll be hit if the uncertainty is not resolved and the rates do not come down before they are finalized. In many cases, there is as much as a 20 percentage point swing or more in rates depending on whether the CSRs are paid." (Drew Altman, Kaiser Family Foundation, via Axios)
[Opinion] Making the Exchanges More Competitive by Bringing Medicare Into the Fold
"Introducing Medicare wouldn't require significant new spending. It would provide competition in counties with only one or two insurers. And it would ensure that all counties would always have at least one insurance option available. What's more, Medicare could be used to provide new private plan options by allowing Medicare Advantage private plans to offer coverage to nonelderly Americans through the exchanges." (Gerard Anderson, Jacob S. Hacker, and Paul Starr, in Health Affairs)
Lawmakers Regroup to Consider Possible ACA Fix
"A group of more than 40 bipartisan House members ... vowed to [1] create a stability fund that states could use to reduce premiums and limit insurers' losses; [2] change the requirement that employers provide coverage to affect companies with 500 or more employees, as opposed to the current 50-employee minimum; and [3] repeal the medical device tax[.]" (
[Opinion] Has Obamacare Become Trumpcare?
"[O]pen enrollment for the ACA's marketplaces begins November 1, and insurers have to decide by late September whether they will participate. There are a host of actions the administration could take to make it successful. [1] Provide clarity around the rules ... [2] [Maintain] outreach and consumer assistance ... [3] [Encourage] insurers to participate ... [4] [G]ive states flexibility to experiment through Medicaid waivers and ACA waivers under section 1332 of the law." (JAMA Forum)
Supporting the Individual Health Insurance Market
"[T]he current market status can be traced back to a series of regulatory and implementation failures that served to undermine the market including lax enforcement of the individual mandate, incomplete payouts to insurers, and regulatory uncertainty. Looking ahead, a set of regulatory and legislative changes, alongside the assurance of operational and regulatory certainty for issuers, could put it back on track." (Michael Chernew and Christopher Barbey, in Health Affairs)
Seven Implications of Ending Obamacare's Cost Sharing Reduction Payments
"[1] The decision would affect only subsidized plans sold in the exchange market ... [2] As only Silver-level plans qualify for cost sharing reductions, it would also not affect customers buying plans at other levels of coverage ... [3] [T]he number of affected individuals ... would be about 5.8 million.... [4] [I]nsurers offering coverage in the Obamacare exchanges would still be required by law to reduce cost sharing amounts for qualified enrollees.... [5] [I]nsurers couldn't increase enrollee's premiums immediately -- that would have to wait until the next plan year.... [6] Taxpayers would pick up almost all of the additional premium cost.... [7] Continuing these subsidies will not help stabilize the broader individual-market, because the cost sharing reductions apply only to plans purchased through the Obamacare exchanges." (The Heritage Foundation)
Insurers Score Another Risk Corridor Win in Court
"Molina's win means that insurers have now prevailed on the merits in two of the 26 risk corridor cases pending in the Court of Claims while the government has prevailed in three." (Timothy Jost, in Health Affairs)
Court Rules That Government Owes Molina Healthcare $52M in Risk Corridor Payments
"The partial summary judgment ... is the second win for an insurer in a risk corridor case. The court ruled in February that the government owes Moda Health $214 million in payments from the program. The courts sided with the government, however, in a case brought by Maine Community Health Options and one brought by Land of Lincoln Mutual Health Insurance Company. In another case, brought by Blue Cross Blue Shield of North Carolina, the court ruled that the insurer's claims were premature. Cases brought by other insurers are still winding their way through the court system." (FierceHealthcare)
Why a Pennsylvania Insurer's Collapse Could Whack Insurers, Policyholders Across the Country
"Insurance company failures are rare, but when they happen, other companies are responsible to help pay off the company's claims and protect policyholders through groups known as state guarantee associations. Those industry assessments are typically based on market share, so larger insurers pay more.... Penn Treaty's liquidation poses a 'potential shock to the health marketplace' as the losses pile up ... Industry analysts estimate the parent company has long-term claims liabilities approaching $4 billion, but only about $700 million in assets." (Kaiser Health News)
[Opinion] An Open Letter to the Senate HELP Committee
"[T]he individual insurance market is only 4% of the 285 million who are insured.... The stability of individual insurance market is a legitimate issue but it's small relative to policies and strategies that impact every employer and household. Your charter must be bigger than reducing risks for insurers; it must be about the viability and sustainability of the entire health system." (Paul Keckley)
Breaking Down the Graham-Cassidy ACA Replacement Proposal
"In the aftermath of the HCFA's defeat, the only remaining proposal that appears to have any chance at seeing a Senate vote is a complex overhaul of the current ACA landscape from Republican Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. The crux of the Graham-Cassidy amendment is to replace the ACA's insurance subsidies and Medicaid expansion with comparatively smaller block grants to states." (Trucker Huss)
The Future of Healthcare Reform: Republican Efforts Stall in the Senate (PDF)
"Senate Republicans are now essentially out of options in the near-term, and shortly after the defeat of the bill Majority Leader McConnell conceded on the Senate floor that they would not be able to repeal the ACA. However, ... the dynamics around the healthcare debate in Washington are volatile, with a variety of proposals being floated by different factions in Congress, and President Trump continuing to make passage of an ACA repeal/replace bill a top priority, threatening a defunding of the ACA's cost sharing reductions to spur action[.]" (Groom Law Group)
What Happens If the Administration Stops Cost-Sharing Reduction Payments to Insurers?
"Some insurers might well decide that the government is an unreliable partner and give up on the exchanges for 2018.... The individual market makes up a small part of the business of large insurers; even though it has become more profitable in the recent past, some insurers might conclude that the premium increases that would be needed to make up for the loss of the CSRs would drive healthy enrollees out of the individual market. Rather than deal with a deteriorating risk pool, they might leave the individual market entirely[.]" (Timothy Jost, in Health Affairs)
ERISA Advisory Council to Meet August 22-24
"[T]the 187th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as the ERISA Advisory Council) will be held on August 22-24, 2017.... The Advisory Council will study the following topics: [1] Reducing the burden and increasing the effectiveness of mandated disclosures with respect to employment-based health benefit plans in the private sector, and [2] Mandated disclosure for retirement plans -- enhancing effectiveness for participants and sponsors." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])
Latest Motion in House v. Price Has Significant Impact on Future of CSR Payments
"The decision does not mean that the Trump administration is barred from ending the cost-sharing reduction payments. It does mean, however, that the administration cannot unilaterally stop the CSR payments, dismiss the appeal, and claim judicial imprimatur for its doing so. If the administration does stop making the payments, the states -- or insurers, or possibly consumers -- would be able to sue to require the payments to be made and the injunction entered by the lower court would not be as much of a 'roadblock' to their prevailing." [House v. Price, No. 16-5202 (D.C. Cir. Aug. 1, 2017)] (Health Affairs)
Lawmakers to Hold Hearings to Stabilize Insurance Markets
"[T]he Senate Health, Education, Labor and Pensions committee will hold bipartisan hearings on ways to stabilize the [ACA] marketplaces for 2018. The hearings will start the week of Sept. [4] Their aim is to act by Sept. 27, when insurers must sign contracts to sell individual insurance plans on for 2018." (National Public Radio)
[Opinion] Repairing the Healthcare Law: Tricky But Not Impossible
"There is widespread agreement that the first order of business is to calm very jittery insurance markets.... The most significant step would be to guarantee continued funding to reimburse insurers for waiving deductibles and co-payments for low-income customers, as the health law requires companies to do. The Trump administration has threatened to stop making the payments; insurers are now getting them on a month-to-month basis." (The New York Times; subscription may be required)
[Opinion] In the Aftermath of the Senate Vote to Repeal and Replace
"Congress needs to set up permanent appropriation to pay insurers for the cost sharing reductions they are required to offer lower-income enrollees in the marketplaces.... Congress should ensure that all Americans who buy coverage in the individual market have a health plan to enroll in.... Appropriating $10 billion to $15 billion for reinsurance ... would help insurers selling in the individual markets by partially reimbursing them for unexpectedly high enrollee costs." (The Commonwealth Fund)
Small Business Health Insurance and the ACA: Views from the Market 2017
"[W]hile trends in premium and offer rates have remained relatively stable, many of the ACA's goals have been stymied by an expanded set of health plan choices for small business owners. The authors further find that these new options provide more affordable coverage for employers with healthy employees, but pose a risk to the small-group market as a whole." (Urban Institute)
Rep. Mark Meadows: New Healthcare Bill Is Coming 'That Can Get to 51'
"Rep. Mark Meadows [R-NC], a key negotiator in the effort to repeal and replace Obamacare, said a new effort is underway to write a bill that can pass the Senate that would include proposals offered by Sens. Lindsey Graham, Bill Cassidy, Ted Cruz, and Rob Portman.... Meadows said he has talked to senators, including Graham, in the hours after this morning's failure to pass a 'skinny' repeal bill, and the mood is 'all hands on deck' to come up with a new deal." (Washington Examiner)
McCain Votes No, Derails 'Skinny Repeal' in Marathon Session
"The Senate struggled late into the night to craft and then vote on a 'skinny repeal' of the health law, but came up empty as the bill was defeated in a 51-49 vote ... McCain's vote was unexpected and ends -- for now -- the Republican Party's effort to kill Obamacare." (Kaiser Health News)
[Opinion] Republicans Fail to 'Repeal and Replace' Obamacare
"[T]here are two pre-conditions for any Congressional bipartisan solution: [1] Democrats will have to admit the problems with Obamacare are more than 'imperfections' -- they will have to admit that Obamacare has been a dismal failure for those who have no choice but to buy their health insurance in the individual health insurance market and make too much money to qualify for a subsidy -- 40% of American households make more than 400% of the federal poverty level, which is the cutoff point for subsidies. [2] Republicans will have to admit that most American households not eligible for Medicare, employer-based health insurance, or the pre-2014 Medicaid program, cannot afford to buy health insurance on their own -- even if we had 2013 premium rate levels." (Bob Laszewski's Health Care Policy and Marketplace Review)
[Opinion] Free-Marketers Shouldn't Give Up on Health Care Reform
"None of the legislation under consideration offers a full-fledged, consumer-driven alternative to Obamacare. A genuinely free-market reform package would wipe out Obamacare's insurance regulations and expansion of Medicaid, transition to age-based subsidies for insurance, and strongly incentivize people to maintain continuous coverage. These reforms would produce a vibrant, competitive insurance market where a wide range of affordable coverage is available to all who want it." (The Heartland Institute)
Provider Ordered to Return Millions to Health Plans
"[The DOL has reached an agreement with] a third-party administrator that provides employee health benefit plans with access to a network of doctors, hospitals and other medical providers ... in which the administrator has committed to improve its communications with health plans and to return certain fees.... Under the agreement, MagnaCare will return at least $14.5 million in network management fees to ERISA health benefit plans, 'with possible additional payments of $4.5 million based upon business volume through 2019.' " (PLANSPONSOR)
Senate Health Care Vote: Here's Where They Left Off and What's Next
"Senate Republicans have been trying to push through a repeal by using special budget rules that limit debate to 20 hours. That time is expected to be exhausted on Thursday.... Republicans seem increasingly likely to try to pass a slimmed-down bill that would repeal only a small number of the existing health law's provisions. By passing a so-called 'skinny' repeal bill, Senate Republicans would keep the repeal effort alive long enough to try to negotiate a broader compromise bill with the House of Representatives." (The New York Times; subscription may be required)
2016 Health Insurance Enrollment: Private Coverage Declined, Medicaid Growth Slowed (PDF)
"During 2016, individual-market enrollment decreased by 583,000 individuals and employer-group coverage decreased by 4,000 individuals for a net decrease in private-market coverage of 587,000 persons. For the employer-group coverage market, enrollment in fully insured plans decreased by 1.049 million individuals; enrollment in self-insured plans increased by 1.045 million individuals. The net effect was a decrease of 4,000 in the number of individuals with employer-sponsored coverage in 2016." (The Heritage Foundation)
'Sky-High' Pay for CEOs of Health Care Firms Raises Questions
"Based on corporate financial filings with the [SEC], [one reporter] did research on 113 heads of 70 of the largest U.S. health care companies in the last seven years. Cumulatively, he says, these CEOs have earned $9.8 billion since the ACA was first enacted." (National Public Radio)
[Opinion] Republicans Have a Chance to Eliminate the Individual Mandate. They Should Take It.
"Without a mandate, insurers would have to do what businesses have to do in every other sector of the economy: design products that you voluntarily want to buy because they represent a good value for you. Under Obamacare, they don't have to." (Avik Roy, in The Washington Post; subscription may be required)
HHS May Let States Decide Essential Health Benefits
"Changes in regulations governing the [ACA]'s essential health benefits are an area where [HHS] has legal latitude, and it may use it whether or not the ACA is changed substantially by Congress ... Under an HHS regulation issued in 2013, states can designate benchmark plans on which the EHBs are based, and most states designed the largest small group plans in their states.... HHS could change the rules governing which plans could be used as benchmarks[.]" (Bloomberg BNA)
[Opinion] Extending Marketplace Tax Credits Would Make Coverage More Affordable for Middle-Income Adults
"Extending tax-credit eligibility increases insurance enrollment by 1.2 million, at a total federal cost of $6.0 billion. Those who would benefit from the tax-credit extension are mostly middle-income adults ages 50 to 64. These new enrollees would be healthier than current enrollees their age, which would improve the risk pool and lower premiums. Eliminating the cliff at 400 percent of the federal poverty level is one policy option that may be considered to increase affordability of insurance." (The Commonwealth Fund)
GOP Overcomes Procedural Hurdle on Health Care Reform
"Senate Majority Leader Mitch McConnell's plan was to convince senators to open debate on the bill, which would require 50 votes, without the full text of the bill being known. That vote would technically be to bring up the House version of the bill, but senators would then be able to make amendments to completely change the bill. One of those amendments would make the bill a plan to repeal the [ACA], which the Senate passed in 2015 only to have it vetoed by then-President Obama." (Courthouse News Service)
[Opinion] Universal Health Coverage? Why?
"[T]he runaway cost and compromised quality of our present health care system are symptoms of a deeper diagnosis: powerful perverse incentives. Policy keeps missing the diagnosis and treating the symptoms.... [U]ntil those incentives are corrected, all the thousands of time-consuming, well-meant policies, studies, and recommendations, past and present, to lower cost and raise quality are just so much omnibus tinkering, mere symptom-curing missing the fundamental underlying cause." (Walter McClure, Alain Enthoven, and Tim McDonald, in Health Affairs)
[Opinion] 73% of CBO's 'Coverage Losses' Are in Fact Individual Choices After Repeal of ACA Mandate
"Nearly three-fourths of the difference in coverage between Obamacare and the various GOP plans derives from a single feature of the Republican bills: their repeal of Obamacare's individual mandate. But the CBO has never published a year-by-year breakout of the impact of the individual mandate on its coverage estimates.... [Of] the 22 million fewer people who will have health insurance in 2026 under the Senate bill, 16 million will voluntarily drop out of the market because they will no longer face a financial penalty for doing so: 73 percent of the total." (Avik Roy, in National Review)
[Opinion] 'Small Business Health Plans' Undermine State Authority
"States currently have a wide range of approaches to regulating health insurance. Some have enacted numerous consumer protections, others are more hands-off. Because insurers will most likely gravitate to states with the least regulation, SBHPs would undermine states' autonomy to determine the type of consumer protections and level of insurance oversight that is appropriate for their residents." (The Commonwealth Fund)
Effects of the ACA on Health Insurance Coverage and Labor Market Outcomes
"[T]he majority of the increase in health insurance coverage since 2013 is due to the ACA [and] areas in which the potential Medicaid and exchange enrollments were higher saw substantially larger increases in coverage. While labor market outcomes in the aggregate were not significantly affected, ... labor force participation reductions in areas with higher potential exchange enrollment were offset by increases in labor force participation in areas with higher potential Medicaid enrollment." (National Bureau of Economic Research [NBER])
Small Businesses Split Over Republican Health Plans
"With so many forces aligned in opposition to the Senate's proposed changes, the views of small-business owners have not been a decisive factor. But the enthusiasm that a growing number are voicing for the health care law weakened the argument, often cited by Republicans, that small businesses had been harmed by it and need a rollback." (The New York Times; subscription may be required)
[Opinion] The Truth Behind the CBO
"CBO economists are trained to apply Keynesian economic formulas to predict future consumer behavior, but their projections don't often account for common-sense realities, such as the wet blanket effect that Obamacare had on job creation and economic growth. Time and time again, their projections miss the mark because they don't consider economic reality.... [T]he updated CBO baseline for Obamacare showed that the exact same number of people would buy insurance in 2018 under the BCRA as would under Obamacare -- a figure which would be one million more than the 18 million currently on the individual market. More importantly, their projections miss the basic point that people are more likely to purchase an affordable product that meets their needs." (Reps. Mark Meadows and Jim Jordan, in Washington Examiner)
Senate Parliamentarian Upends GOP Hopes for Health Bill
"The official rules keeper in the Senate Friday tossed a bucket of cold water on the Senate Republican health bill by advising that major parts of the bill cannot be passed with a simple majority, but rather would require 60 votes.... Senate Parliamentarian Elizabeth MacDonough said that a super-majority is needed for the temporary defunding of Planned Parenthood, abortion coverage restrictions to health plans purchased with tax credits and the requirement that people with breaks in coverage wait six months before they can purchase new plans." (Kaiser Health News)
[Opinion] Waiving Federal Insurance Rules: How the Senate Bill Would Allow States to Improve Their Health Insurance Markets
"The Senate health reform bill allows states to take advantage of a broad waiver authority that would enable them to regulate their own health insurance markets. It would give states ample opportunity to pursue more aggressive reforms of the insurance markets. The Senate bill holds open the possibility of securing an even broader range of coverage options and more robust cost control." (Robert E. Moffit, for The Heritage Foundation)
Workers Gaining Health Insurance Coverage Under the ACA
"[M]ore than 9.5 million workers and 5.2 million of their family members gained coverage under the first six years of the ACA.... [C]overage gains were greater for occupations that, in 2010, had lower coverage rates, lower employer-sponsored insurance coverage rates, lower wage rates, and lower weekly earnings." (Urban Institute)
CBO Cost Estimate for the Better Care Reconciliation Act of 2017 (Amendment in the Nature of a Substitute, July 20, 2017)
"CBO and JCT estimate that enacting this legislation would reduce federal deficits by $420 billion over the 2017-2026 period ... [In] 2018, 15 million more people would be uninsured under this legislation than under current law. The increase in the number of uninsured people relative to the number under current law would reach 19 million in 2020 and 22 million in 2026. In 2026, an estimated 82 percent of all U.S. residents under age 65 would be insured, compared with 90 percent under current law." (Congressional Budget Office [CBO])
Senate Committee Releases Revised Discussion Draft of Better Care Reconciliation Act, Updated July 20, 2017
"Eliminates the individual and employer mandate penalties.... Expanded tax-free Health Savings Accounts to give Americans greater flexibility and control over medical costs; increased contribution limits to help pay for out-of-pocket health costs and expensive prescription medications. Additionally, for the first time, individuals will be able to use HSAs to pay for their premiums in excess of any tax benefit they already receive for the purchase of health care.... Repeals costly Obamacare taxes that contribute to premium increases and hurt life-saving health care innovation, like the taxes on health insurance, prescription drugs, medical devices, and 'high-cost' employer sponsored plans." (U.S. Senate Committee on the Budget)
The Obamacare Repeal Reconciliation Act: What Repeal and Delay Would Mean for Coverage, Premiums, and the Budget
"The main difference between the [Obamacare Repeal Reconciliation Act (ORRA) of 2017] and the 2015 reconciliation bill is that the effective dates are two years later. The bill does include a couple of provisions not included in the 2015 bill. First, it would prohibit the use of premium tax credits or small business tax credits for health plans that cover abortions (other than those necessary to save the life of the mother or in cases of rape or incest). The bill would also fund reimbursements to insurers for cost-sharing reductions through 2019, when the payment would end." (Timothy Jost, in Health Affairs)

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