Tag: "ObamaCare"

Obama Just Partially Repealed Obamacare, Proving Republicans Can Succeed

Upton(A version of this Health Alert was published by Forbes.)

Since the election, there has been a lot of sturm und drang around what the alternative to Obamacare will look like. It looks like we can be highly confident the Republican-majority Congress will repeal Obamacare very quickly starting in January. However, there is some question about what exactly will be repealed.

Last year’s repeal bill, H.R. 3762, repealed Obamacare’s spending and taxes, but not its over regulation of health insurance. Further, Republican politicians have promised not only to repeal Obamacare, but replace it with a better payment system than existed previously. People’s primary concern about the previous system was that people in the individual market could be denied coverage for pre-existing conditions or charged higher premiums as a result of underwriting.

Politically, it would not be possible for Republicans to walk back from this commitment. According to the Kaiser Family Foundation’s November tracking poll:

Among those who want to see the ACA repealed, 38 percent (meaning 10 percent of the public overall) change their opinion after hearing the argument made by proponents that repealing the ACA would mean that insurance companies would be able to deny coverage to people with pre-existing conditions.

Trump voters react similarly, with a larger share changing their opinion after hearing that repealing the ACA would mean that insurance companies would be able to deny coverage to people with pre-existing conditions (27 percent) than changing their opinion after hearing that more than 20 million Americans could lose their coverage (8 percent).

The economics of health insurance make this very difficult to achieve without some sort of mandate or penalty for not maintaining coverage, which is politically unpopular – and especially toxic to Republicans. This poses a challenge; and we all know Republican politicians have promised to solve this for six years without result. Fortunately, we also have recent evidence that Republicans can lead and succeed on complex health reform legislation.

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Dec 16, 2016 | 45 comments | by

Puzder Pick a Second Win on Health Reform

puzderSoon after announcing his intention to nominate Tom Price, MD as U.S. Secretary of Health & Human Services, Donald Trump announced his intention to nominate Andrew Puzder Secretary of Labor. This is yet another good sign for the repeal of Obamacare.

Since the election, the media have asserted repealing Obamacare will yank health insurance from over 20 million people. This refers to Obamacare’s having increased welfare dependency (via expanding Medicaid) and the expensive individual policies offered in its exchanges, subsidized by tax credits.

This has sucked oxygen out of another important part of the debate, which is Obamacare’s regulations on employment. The Congressional Budget Office projects Obamacare will shrink the workforce by 2 million full-time equivalent (FTE) jobs in 2025.

The CEO of CKE Restaurants, which owns the Carl’s Junior and Hardee’s brands, Mr. Puzder warned of the harm to jobs in chain restaurants from Obamacare’s mandate to offer employees overpriced health insurance as far back as July 2013:

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Dec 12, 2016 | 46 comments | by

Repealing Obamacare Demands Deliberate & Thoughtful Process

index1The next Congress is likely to repeal Obamacare by “reconciliation,” a parliamentary maneuver that allows a simple majority in the U.S. Senate to pass a bill. With fewer than 60 Republican Senators in the next Congress, reconciliation is the only way to move quickly to solve the problems Obamacare created. Otherwise, we could expect Democratic Senators to filibuster a repeal bill.

However, not every jot and tittle of Obamacare can be repealed through reconciliation, which sets up a challenging couple of years (at least) for those who wish to repeal Obamacare and replace it with patient-centered health care.

Read this entire Health Alert in The Hill.

Dec 08, 2016 | 43 comments | by

The Price is Right! Trump’s Choice Indicates Push to Repeal and Replace Obamacare

220px-Tom_PriceDonald Trump’s choice of Dr. Tom Price as his nominee for U.S. Secretary of Health & Human Services indicates the Trump Administration will make a serious effort to repeal and replace Obamacare with patient-centered health reform.

After some initial signs of hesitation at actually trying to achieve this six-year old campaign promise, Obamacare’s opponents can now be confident that skilled leadership will wage a sophisticated and likely successful effort to restart health reform. Here are four reasons why:

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Nov 30, 2016 | 30 comments | by

The White Man’s Burden: More Drinking, Drugs, and Suicides Since 2000

Senior Man ThinkingMore nonsense has been written about white nationalism/supremacy in the wake of Donald Trump’s election than anyone should have to read. So, it is a pleasure to find some actual data analysis on the role of non-college educated white citizens in the success of the Trump candidacy, especially versus Mitt Romney’s failed 2012 campaign.

The Economist has estimated health status explains the Trump vote better than being a non-college educated white citizen does. The sicker you are, the more likely you are to have voted for Mr. Trump. Non-college educated whites are also likely to be sicker, so the two variables are not independent. Nevertheless:

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Nov 28, 2016 | 7 comments | by

Will Trump Really Kick 22 Million Off Health Insurance?

Healthcaredotgov(A version of this Health Alert was published by Forbes.)

Now that repeal of Obamacare is within striking distance, Obamacare’s supporters and the media are aghast at over 20 million people potentially losing their overly expensive health insurance.

If Republican politicians cannot overcome this objection, they will never move forward with repealing and replacing Obamacare. U.S. Senator Lamar Alexander, Chairman of the Senate’s Health, Education, Labor, & Pensions (HELP) Committee anticipates it will take “several years” to transition out of Obamacare to a patient-centered health system.

Why would Republican politicians balk at fulfilling a promise on which they have campaigned successfully since 2010? The answer lies in the swamp which President-elect Trump promises to drain – Washington, DC. Remember every industry in the health sector acceded to Obamacare in 2010 because it would permanently divert funds from the rest of the economy into the health sector.

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Nov 23, 2016 | 1 comment | by

What Will TrumpCare Look Like?

Five people waiting in waiting roomPresident-elect Donald Trump made repealing Obamacare the cornerstone of his campaign. Now that he has won, his future administration is faced with the daunting task of unraveling nearly seven years of Obamacare.  It will not be easy. The most pressing goal should be to replace all the costly provisions in Obamacare with the consumer-friendly health plans most Americans prefer. In the process, reformers must change the way medical care is financed so that consumers have control over their health care dollars as well as the means to pay for medical care over their lifetimes.

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Nov 21, 2016 | 12 comments | by

Bill Clinton Is Right: Obamacare is Crazy for Workers

Five college students.(A version of this Health Alert was published by The Hill.)

Bill Clinton’s pre-election criticism of Obamacare reflected a good understanding of labor economics. In October, he explained:

So you’ve got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world.”

Clinton was referring to high marginal income tax rates that Obamacare imposes on workers through the design of its tax credits, which get clawed back in a very unfair way. The Administration recently confessed premiums for the benchmark Obamacare plans are going up 25 percent, on average. Trying to appease angry enrollees, the Administration feebly claims tax credits reduce net premiums people pay.

Nobody is satisfied by this excuse. However, even if Obamacare premiums were reasonable, they would still punish the people for whom Bill Clinton claims to speak. The more you work, the more you earn; and the more you earn, the higher net premium you pay. This is not a characteristic of the employer-based group market in which most of us participate.

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Nov 17, 2016 | 29 comments | by

Obamacare Coverage 10 Percent Less Expensive Than Job-Based Benefits

nnScholars at the Urban Institute, staunch defenders of Obamacare, have previously struggled to find ways to report Obamacare’s good news by pointing out “there is no meaningful national average” of premium hikes. More recently, they have concluded that Obamacare coverage is 10 percent less expensive than employer-based coverage.

Comparing average employer-based premiums to the second-lowest cost Silver benchmark Obamacare plans, the Urban Institute scholars found lower Obamacare premiums in 38 states plus Washington, DC. These are the unsubsidized Obamacare premiums, adjusted for age, actuarial value, and utilization associated with actuarial value.

What to make of this finding?

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Nov 03, 2016 | 7 comments | by

Divided on Obamacare, Trump and Clinton Both Threaten Medical Innovation

(A version of this Health Alert was published by Forbes.)

Confident Doctors

The recently announced 25 percent rise in Obamacare health insurance premiums has brought renewed attention to health policy. As this is my last column before Election Day, it is time to review how the presidential candidates would address the continuing challenge of skyrocketing health costs.

We should not kid ourselves that Obamacare’s failure is enough to cause the next President or Congress to act energetically to fix the problems Obamacare exacerbated. The interest groups which brought us Obamacare have cut bait and moved on. The health care sector – interests for which the $3.35 trillion spent on health care counts as revenue rather than cost – has bigger fish to fry.

Although insurers are losing money in Obamacare’s exchanges, they are far more concerned with employer-based group benefits, Medicare Advantage, and Medicaid managed care than Obamacare exchanges. Obamacare exchanges cover fewer than 13 million people at any time during the year; and only about four million stick with Obamacare coverage throughout the year. Those poor souls comprise a powerless political constituency, unlike employers or seniors on Medicare.

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Nov 02, 2016 | 8 comments | by
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