The Health Implications of Tax Reform
This post breaks down the key components of 2017 Federal tax reform and its impact on the health care sector....
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Navigating The Section 1332 Waiver Process: For States, A Treacherous Road Ahead
In light of the mounting legislative efforts to make changes to the section 1332 waiver process, especially in the Alexander-Murray market stabilization package, and enhanced state interest in availing themselves of this opportunity, we figured it timely to provide an overview of this aspect of the Affordable Care Act (ACA), the record of how state applications have been adjudicated so far, and the prospects of change to the policy in the near term. Unfortunately, given the considerable uncertainty in both the legislative and executive branches regarding the future of these waivers, states cannot safely expend meaningful resources on developing new applications for the program at this time....
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Breaking Down The MACRA Final Rule
On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released a final rule making changes to the 2018 Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP includes both the Merit-Based Incentive Program (MIPS) and Advanced Payment Models (APMs). This post explains the key policies implemented in the final rule....
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Creating Medicare Advantage Premium Support for All, Part 2: Benefit Design
This is the second installment in my series examining the potential for a bipartisan Medicare-for-all approach that leverages competition among private payers and consumer choice via an advanceable tax credit....
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The Alexander-Murray Market Stabilization Package: Whatâs In It And Whereâs It Going?
They may have done it. The apocryphal bipartisan deal to âfixâ Obamacare is being struck (at least by two important Senators, for now, in part âŠ). Today, Senators Lamar Alexander of Tennessee and Patty Murray of Washington announced they are converging on an agreement on a short-term package to help stabilize the individual insurance market. Even better, the policies included would likely be somewhat successful in achieving their purported purpose...
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The CHRONIC Care Act Passes Senate, Obstacles Remain
his post outlines the key components of the now adopted Chronic Care Act, assessed its outlook in the House, and considered what its progress may tell us about the prospect for more bipartisan action on health care in the future. ...
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Senate Bill Isnât âBetter Careâ for Anyone
With the release of the Senateâs âBetter Care Reconciliation Act of 2017 (BCRA),â the public finally gets a glimpse of legislation crafted in utter secrecy for the past two months, and now we know why. Despite the fanfare and feigned earnestness of the upper chamberâs efforts to improve on the âmeanâ House-passed American Health Care Act (AHCA), the Senate bill would be disastrous for low-income families, patients with pre-existing conditions, children, and the aged, while undermining health care security for virtually everyone else....
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CBO and America’s AHCA Headache
The much-anticipated Congressional Budget Office (CBO) score of the American Health Care Act (AHCA), the GOPâs effort to dismantle the Affordable Care Act (ACA) released yesterday, indicates that the bill would cause 23 million people to become uninsured while reducing the federal deficit by $119 billion. In that sense, there is little change from their assessment of the original version of AHCA. ...
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The Bipartisan âSingle Payerâ Solution: Medicare Advantage Premium Support For All
In my last Health Affairs Blog post, I outlined a potentially bipartisan four-step plan to move past the American Health Care Actâs (AHCAâs) disastrous framework toward a more stable, less expensive health care system. For those seeking incremental, near-term solutions, I hope those recommendations provide helpful guidance. But the AHCAâs reckless drive through the US House of Representatives has taught us something about the current status of health care politics and may have opened the window to more significant, ultimately more successful, reforms....
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100 Days of Health Care
Before November 8, no one anticipated that health care would be the predominant focus of the next presidentâs first 100 days. Now, let the record reflect, that is precisely what has happened. What have we learned in the process and what do we have to show for it? The latter question is easier to answer: nothing, save for considerable uncertainty and burgeoning disruption for the health care system. As for the former, Republicans have hoisted their own petard in epic fashion. ...
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What Now?: A Four Step Plan For Bipartisan Health Reform
As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind....
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