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12 Responses

  1. 58.9 Million Projected to be Uninsured in 2019 if ACA Repealed

    The Urban Institute recently published an analysis on the effects of a partial repeal of the Affordable Care Act through reconciliation. Here are some key findings from the report:

    • The number uninsured would rise from 28.9 million to 58.7 million in 2019.
    • The share of uninsured nonelderly people would increase from 11% to 21%.
    • 82% of the people becoming uninsured would be in working families.
    • There would be 12.9 million fewer people with Medicaid/CHIP coverage in 2019.
    • State spending on Medicaid/CHIP would fall by $76 billion from 2019-2028.
    • The uninsured would seek $1.1 trillion in uncompensated care from 2019-2028.

    Source: The Urban Institute, December, 2016


  2. Complete ACA Repeal Would Cost $350 Billion Through 2027

    The Committee for a Responsible Federal Budget recently released cost estimates for a full repeal of the Affordable Care Act. Here are some key findings from the report:

    • A complete repeal of the ACA would cost roughly $350 billion through 2027.
    • Repealing just the coverage provisions would save $1.55 trillion through 2027.
    • Coverage and revenue provisions repeal would save $750 billion through 2027.
    • Repealing ACA would increase the number of uninsured people by 23 million.
    • Delaying coverage provisions repeal 4 years would reduce savings to $300 billion.
    • Repealing the ACA tax increases would cost $800 billion.

    Source: The Committee for a Responsible Federal Budget, January 4, 2017


  3. 15.1% of PCPs Want the ACA Repealed In Its Entirety

    The New England Journal of Medicine recently published a survey on physicians’ perspectives on ACA repeal. Here are some key findings from the report:

    • 15.1% of PCPs said they wanted the ACA to be repealed in its entirety.
    • Among physicians who voted for Trump, 37.9% wanted the ACA repealed.
    • 95.1% say the regulations on preexisting conditions was “very important.”
    • 3 in 4 physicians support giving tax subsidies to individuals.
    • Half (49.5%) favor the tax penalty for individuals who don’t buy insurance.
    • 73.8% of PCPs favor making changes to the ACA.

    Source: NEJM, February 2017


  4. Senate Replacement Proposal Would Let States Keep Obamacare

    In an effort to appease their Democratic counterparts — and woo at least eight of them across the aisle — a pair of Senate Republicans have proposed an Affordable Care Act replacement that would give states the option of keeping the ACA intact. States also could opt to cover their uninsured population with a federally funded health savings account (HSA) combined with a high-deductible health plan (HDHP). But industry observers say there are flaws within the proposal. Moreover, some key elements already are allowed under the ACA through 1332 waivers or 1115 Medicaid waivers.

    Unlike other replacement bills that have been floating around Congress for years, this proposal would let states continue with Obamacare if they choose. A state such as California could continue to operate an exchange to distribute subsidies, and maintain an individual mandate and expanded Medicaid program.

    Source: Steve Davis
    AIS Health via Health Plan Week


  5. New GOP Bill to Replace Obamacare is Leaked

    In the latest leaked draft of their healthcare plan, House Republicans propose to cut off premium tax credits for wealthier Americans. But they haven’t decided on the details. A leaked draft, dated Feb. 10, 2017, emerged last week. It would offer refundable premium tax credits starting in 2020 based on age, unlike the Affordable Care Act’s income-based credits. People under 30 would receive $2,000, while people over 60 would get $4,000. Both lower-income and higher-income people would get the same amount.

    A document obtained by Politico describing revisions in the draft bill and dated Feb. 24, 2017, would set some type of higher-end cutoff of the tax credits. It still would phase out the ACA’s Medicaid expansion to low-income adults. And it would convert Medicaid from an open-ended entitlement to a program of capped federal payments to the states.

    Source: Harris Meyer, Modern Healthcare [3/3/17]


  6. 48% of Americans View the ACA Favorably

    Kaiser Family Foundation recently released results from their Health Tracking Poll on current attitudes toward the Affordable Care Act. Here are some key findings:

    • 48% of Americans view the ACA favorably, the highest percentage since 2010.
    • Most Democrats (73%) continue to view the law favorably.
    • Most Republicans (74%) view the law unfavorably.
    • 48% believe congress should not repeal the ACA, while 47% believe they should.
    • Half of independents view the ACA favorably.
    • 28% of those who favor repeal want to wait until replacement details are known.

    Source: Kaiser Family Foundation, February 24, 2017


  7. 19% Favors ACA Repeal in Advance of a Replacement Plan

    Kaiser Family Foundation recently released a Visualizing Health Policy infographic on public opinion of health care reform. Here are some key findings:

    • 63% of Republicans vs 21% of Democrats view ACA repeal as a top priority.
    • Half (49%) of the public views the ACA favorably and 44% view it unfavorably.
    • 19% of the public favors an immediate repeal in advance of a replacement plan.
    • 2 in 5 Republicans and 30% of independents favor the individual mandate.
    • 67% of Democrats view lowering the cost of prescription drugs as a top priority.
    • 64% of the public supports health coverage for seniors and low-income people.

    Source: Kaiser Family Foundation, March 29, 2017


  8. Executive Order Seeks to Weaken ACA Insurance Rules and End Cost-Sharing 
    Frustrated by the failure of GOP efforts to repeal the Affordable Care Act, President Donald Trump signed an executive order to ease ACA rules and give individuals and businesses access to cheaper health plans with fewer benefits and consumer protections. (Trump announced he would end cost-sharing subsidies to insurers.) The subsidies, which this year cost the federal government $7 billion, help low-income people pay for insurance coverage.
    The order easing the ACA rules will have to be implemented through the time-consuming federal rule-making process, making it unlikely the changes will take effect in time for the 2018 plan year.

    And experts said it’s likely to face legal challenges that could create further delays. The White House said the goal was to offer more affordable coverage to people if they band together through business and occupational associations to get plans. It could go a long way toward achieving the Republican goal of gutting ACA market rules and allowing consumers to buy stripped-down coverage in a less-regulated market. 
    Source: Harris Meyer, Modern Healthcare [10/12/17]


  9. GOP Tax Bill Repeals Obamacare’s Individual Mandate

    The GOP’s new tax bill, which passed Congress after one last vote in the House of Representatives and will be signed by President Donald Trump, is also a healthcare bill.

    The tax bill does at least as much (if not more) to upend Obamacare, or the Affordable Care Act, than even all of the Trump administration’s thousand cuts to the health law over the past year by repealing the individual mandate.

    Repealing Obamacare’s individual mandate won’t affect most people. That’s because the vast majority of Americans receive health coverage through their employer or through a public health program like Medicare, Medicaid, or military health services.

    Obamacare’s private, individual insurance markets (which will still be around after the mandate is gone, and more than 70% of consumers can purchase government-subsidized plans in them) will go through some turmoil, though.

    Source: Sy Mukherjee, Fortune [12/20/17]


  10. Maryland

    The federal Tax Cuts and Jobs Act, signed into law in December 2017, repealed the Obamacare individual mandate, which financially penalized taxpayers who failed to secure health insurance coverage during the previous year.

    But that’s not stopping Maryland legislators, who have introduced companion bills that would force Maryland residents to maintain minimum essential coverage or face a penalty of 2.5 percent of the sum of the individuals’ modified adjusted gross income, or $695 per adult and $347.50 per child, whichever amount is greater.




    Managed-care physician networks should be broken up; they are in violation of anti-trust laws.

    Sherman Acts 1 & 2. Here is good reading from the ABA:


    Any thoughts?


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