Today’s outcome allows the nation to continue its historic progress of the last seven years under the Affordable Care Act.
Despite days of intense negotiations and last-minute concessions to win over wavering GOP conservatives and moderates, House Republican leaders Friday failed to win enough support to pass their plan to partially repeal and replace the Affordable Care Act.
House Speaker Paul Ryan made the announcement at the Capitol after rushing to the White House to meet with President Donald Trump. The decision came after a fluid 24 hours of negotiation among Republican leaders and different factions of the party. The leadership had hoped to have a vote on their bill Thursday but put that off after it was clear they didn’t have enough “yes” votes. Trump issued an ultimatum to House members Thursday night, saying he was done with concessions and they needed to vote Friday to get the legislation moving. But the gambit did not change enough votes to push the bill through the House.
Story is developing. Check back here for more details shortly.
We explained earlier today why a Republican leadership plan to add $15 billion for behavioral health treatment and maternity coverage and newborn care to the House health bill would do little to offset the enormous damage that the underlying bill would do to millions who would lose these important categories of care.
Here, more specifically, are four ways that the House bill would harm people with mental health and substance use disorders:
Due to the proposal in the House Republican health bill to convert Medicaid to a per capita cap or block grant, the aging of baby boomers would likely exacerbate the federal Medicaid spending cuts over the long run.
How can you get started with design if you are not a professional designer? TechSoup makes it easy for you to learn. For this article, we've curated a series of video tips especially for nonprofits and libraries to get started using Adobe Illustrator Creative Cloud (CC).
I’ve already explained that if the pending House bill to repeal the Affordable Care Act (ACA) becomes law, plans that people buy on their own will be far skimpier — as bad as, or worse than, before the ACA.
Republicans argue that repealing the ten “essential health benefits” that the Affordable Care Act (ACA) requires every health plan to cover would simply allow states to make their own choices about what benefits to require.
The House GOP’s embattled health care bill has plenty of detractors: Democrats, hospitals, the American Medical Association and the House Freedom Caucus all oppose it. But the insurance industry is not on that list — even though it stands to lose millions of customers.
One reason the industry has been hanging back: Insurers’ profits are expected to fatten under the bill.
The House Republicans’ replacement plan would likely attract more younger, healthier consumers to the individual market than the Affordable Care Act did, according to Standard & Poor’s, the corporate credit rating firm. The ACA tilted the opposite way, offering more options for older, sicker Americans whose health care claims eroded insurers’ profits.
“Profitability will likely improve, as the replacement plan can result in an improved risk pool in the individual market,” S&P said in a report on the House leadership’s initial plan.
A vote on the GOP “Trumpcare” bill is expected Friday, but by late Thursday it remained unclear whether there were enough votes to pass it. The Trump administration has said if the measure doesn’t pass Friday, it will abandon the effort to replace Obamacare.This KHN story also ran on NPR. It can be republished for free (details).
Under the current health law, an insurer is allowed to charge a 64-year-old consumer a premium that’s three times what it charges a 21-year-old. The House bill allows insurers to charge older consumers premiums that are five times higher.
That change would reduce premiums for younger consumers but boost them significantly for people in their 50s and 60s – even with tax credits that increase for older people under the GOP plan.
Not all insurers are enthusiastic about what’s in the House bill. Those that are also mainly in the business of managing Medicaid services to enrollees under contract with states — such as Molina Healthcare — oppose the bill because of the expected sharp reductions in Medicaid if the House measure is enacted.
In a new analysis of the House bill that was released Thursday, the Congressional Budget Office predicted 9 million people would fall off Medicaid rolls by 2020 and 14 million by 2026. Overall, 52 million Americans under 65 would be uninsured by 2026 compared with 28 million that year under current law, the CBO said.
America’s Health Insurance Plans (AHIP), which has expressed concerns about the bill but hasn’t taken a formal position for or against the bill, has said the legislation’s provisions would give short-term relief to insurers that have been mostly losing money since the exchanges started in 2014.
Those include giving states $100 billion over 10 years to start high-risk pools and stabilization funds to help insurers deal with higher-risk customers.
One of the most significant positives for insurers in the GOP bill is the elimination of a tax that all insurers paid under the ACA. The industry paid $8 billion in 2014 and is expected to pay $14.3 billion in 2018. Congress temporarily suspended the fee for this year.
Insurers’ opposition to the tax was one of the main reasons why the insurance industry chose not to support the ACA when it was approved in 2010. However, the insurance industry built support for the law by throwing its weight behind a requirement preventing insurers from refusing coverage to consumers with preexisting conditions in exchange for a mandate that most Americans have health coverage.
Although many conservative Republicans favor ending the individual mandate, the GOP bill as originally proposed would instead require that Americans keep continuous health coverage or pay a 30 percent penalty when they do buy private coverage.
Many of the nation’s largest insurers, such as UnitedHealthcare, Cigna and Aetna, were never large players in the health law’s exchanges or they have pulled out citing steep financial losses. For them, the elimination of the health insurer tax makes the GOP bill look appealing, said Ana Gupte, a health analyst with Leerink, an investment bank. “The GOP bill is a net positive” for those insurers, she said.
Even insurers with many customers on ACA policies now will be better off financially in the GOP bill, Gupte said. “They will make a bigger [profit] margin on a smaller number of people,” she said.
Anthem, a larger player in the Obamacare marketplaces, has said the GOP bill would benefit insurers and individuals by ensuring that remaining insurers stay in the market to provide choices for consumers.
Health insurers’ cautious optimism about the bill contrasts with the rest of the health industry. Lobbying groups representing doctors, hospitals and nurses have objected vehemently to the legislation. AHIP spokeswoman Kristine Grow said the group remains concerned about the long term stability of the Medicaid health plan market because the GOP bill would kill the Medicaid expansion and reduce federal Medicaid funding to states. She also said it’s too early to know how insurers’ 2018 premiums would be affected under the GOP bill.
A big uncertainty for insurers is whether the Trump administration will continue to allow a key program under Obamacare that helps low-income individuals with out-of-pocket health costs. House Republicans suspended a lawsuit that claimed the $7 billion federal funding of the program was illegal.
The program’s future is of concern to Dr. J. Mario Molina, CEO of Molina Healthcare, which has 3 million Medicaid members and nearly 1 million customers on Obamacare exchange plans. The Long Beach, Calif.-based company operates in about a dozen states.
But Molina said his biggest concern is the GOP bill will return the country to the broken individual market system in place before 2014. “The main thing I am worried about is this bill will cause millions of people to lose insurance coverage,” he said.
Regardless of what Congress and the Trump administration decide to do with Medicaid’s federal funding, Molina predicted more states will shift Medicaid recipients into managed care plans to control costs. “In the short term, we will still grow,” he said.
Speaker Paul Ryan says the House Republican health bill would lower premiums by 10 percent, but that’s highly misleading. It doesn’t mean that the price of your insurance plan would be lower, as Ryan implies. In fact, people who wanted to keep the insurance plan that they have would face premium increases averaging 13 percent, according to a Brookings I
States Have Requested Waivers from SNAP’s Time Limit in High Unemployment Areas for the Past Two Decades
The Supplemental Nutrition Assistance Program (SNAP) limits most working-age adults not raising minor children to three months of food assistance out of every 36 months unless they are working at least 20 hours a week or otherwise exempt. This law allows states to seek temporary waivers from the time limit for higher-unemployment areas. Every state but Delaware has sought a waiver at some point.