The American taxpayer is screwed and tattooed. The only winner in this garbage healthcare system obama created is the insurance industry. That’s what happens when you let idiots that don’t even understand the basics of supply and demand and it’s affects on prices write these laws.
Life Support for ObamaCare
Republicans are caught between Democrats and the health insurers.
The Editorial BoardMarch 19, 2018 6:58 p.m. ET
The Capitol in Washington. Photo: J. Scott Applewhite/Associated Press
By
The Editorial Board
We said Republicans would pay dearly for failing to replace ObamaCare, and the bill is already coming due this week in a political extortion fight with health insurers. The GOP may pad the omnibus spending bill with enough cash to preserve the law through the 2020 election.
Congress is debating how to handle cost-sharing reductions, which are payments to insurers for defraying out-of-pocket costs or deductibles for low-income individuals. The Trump Administration stopped these payments last year. Congress had declined to appropriate the money, and a federal judge said the Obama Administration wrote the checks illegally.
Moderate Republicans demanded a “stability” deal for ObamaCare as the price of repealing the law’s penalty for declining to purchase health insurance in the tax bill. That included billions in cost-sharing payments as well as reinsurance, which subsidizes high-cost patients to lower premiums for everyone else.
But the latest proposal is $30 billion of reinsurance over three years. This is a blowout compared with the roughly $5 billion over two years in reinsurance proposed last year by Maine Republican Senator Susan Collins.
Many groups on the right oppose the package as a bailout for insurers, and they’re right that the Affordable Care Act is a wealth transfer to third-party payers. The problem is that Democrats wrote the law to make sure insurers get paid one way or another, and the lobby has only become more demanding.
Case in point: Premiums are higher without the cost-sharing payments. The law’s tax credits grow in generosity as premiums rise, so insurers get the money either way. Insurers in a phenomenon called “silver loading” have piled huge annual premium increases on the silver plans that are tethered to the tax credits. The dysfunctional reality is that cost-sharing payments are cheaper for taxpayers than expanding the tax credits. Some left-wing outfits now oppose the cost-sharing deal because the tax-credit formula is more lucrative.
What are Republicans extracting in return? Not much. Lamar Alexander of Tennessee has tried in good faith to negotiate with Patty Murray of Washington and has come up with modest improvements in state flexibility waivers. A leaked White House memo listed some ideas but these have been deemed politically unacceptable.
One is to clarify that short-term health insurance can be renewable without medical underwriting, and the Trump Administration has a forthcoming rule on short-term plans. That rule could revive an individual market in which consumers can choose options tailored to their price range or preferred benefits. John Barrasso (R., Wyo.) has a bill for codifying the directive, which should be the bare minimum for any deal.
The memo also mentioned health-savings accounts, which let individuals save pre-tax dollars for health expenses. The memo suggests increasing contribution limits and allowing the accounts “to be integrated with a broader number of plans.” Someone should ask why Democrats would object to such small tweaks in exchange for preserving ObamaCare’s architecture.
One sticking point has been the Hyde Amendment, which blocks taxpayer dollars from funding abortions. The White House and Speaker Paul Ryan say Hyde protections are nonnegotiable, and such restrictions are the norm in appropriations and apply even to Medicaid. But Democrats don’t want to choose between ObamaCare and the abortion lobby.
The question is whether a deal can move as part of this week’s government spending bill, and the politics aren’t hard to understand. Health insurers are telling Republicans that without cost-sharing and reinsurance payments, they’ll announce huge premium increases right before the midterms this fall. House Republicans are thus looking for a quick fix to lower premiums and are holding up the Senate for the $30 billion in reinsurance.
Most regrettable is that this three-year cash infusion probably pushes the political incentive for any serious legislative reform of ObamaCare past the 2020 election, which could be the entire Trump Presidency. Republicans are betting they can save their short-term political futures by keeping ObamaCare on life support. But without meaningful reform that offers more health-care freedom, the real price will be the law’s ultimate preservation.
Appeared in the March 20, 2018, print edition.
Life Support for ObamaCare
Republicans are caught between Democrats and the health insurers.
The Editorial BoardMarch 19, 2018 6:58 p.m. ET
The Capitol in Washington. Photo: J. Scott Applewhite/Associated Press
By
The Editorial Board
We said Republicans would pay dearly for failing to replace ObamaCare, and the bill is already coming due this week in a political extortion fight with health insurers. The GOP may pad the omnibus spending bill with enough cash to preserve the law through the 2020 election.
Congress is debating how to handle cost-sharing reductions, which are payments to insurers for defraying out-of-pocket costs or deductibles for low-income individuals. The Trump Administration stopped these payments last year. Congress had declined to appropriate the money, and a federal judge said the Obama Administration wrote the checks illegally.
Moderate Republicans demanded a “stability” deal for ObamaCare as the price of repealing the law’s penalty for declining to purchase health insurance in the tax bill. That included billions in cost-sharing payments as well as reinsurance, which subsidizes high-cost patients to lower premiums for everyone else.
But the latest proposal is $30 billion of reinsurance over three years. This is a blowout compared with the roughly $5 billion over two years in reinsurance proposed last year by Maine Republican Senator Susan Collins.
Many groups on the right oppose the package as a bailout for insurers, and they’re right that the Affordable Care Act is a wealth transfer to third-party payers. The problem is that Democrats wrote the law to make sure insurers get paid one way or another, and the lobby has only become more demanding.
Case in point: Premiums are higher without the cost-sharing payments. The law’s tax credits grow in generosity as premiums rise, so insurers get the money either way. Insurers in a phenomenon called “silver loading” have piled huge annual premium increases on the silver plans that are tethered to the tax credits. The dysfunctional reality is that cost-sharing payments are cheaper for taxpayers than expanding the tax credits. Some left-wing outfits now oppose the cost-sharing deal because the tax-credit formula is more lucrative.
What are Republicans extracting in return? Not much. Lamar Alexander of Tennessee has tried in good faith to negotiate with Patty Murray of Washington and has come up with modest improvements in state flexibility waivers. A leaked White House memo listed some ideas but these have been deemed politically unacceptable.
One is to clarify that short-term health insurance can be renewable without medical underwriting, and the Trump Administration has a forthcoming rule on short-term plans. That rule could revive an individual market in which consumers can choose options tailored to their price range or preferred benefits. John Barrasso (R., Wyo.) has a bill for codifying the directive, which should be the bare minimum for any deal.
The memo also mentioned health-savings accounts, which let individuals save pre-tax dollars for health expenses. The memo suggests increasing contribution limits and allowing the accounts “to be integrated with a broader number of plans.” Someone should ask why Democrats would object to such small tweaks in exchange for preserving ObamaCare’s architecture.
One sticking point has been the Hyde Amendment, which blocks taxpayer dollars from funding abortions. The White House and Speaker Paul Ryan say Hyde protections are nonnegotiable, and such restrictions are the norm in appropriations and apply even to Medicaid. But Democrats don’t want to choose between ObamaCare and the abortion lobby.
The question is whether a deal can move as part of this week’s government spending bill, and the politics aren’t hard to understand. Health insurers are telling Republicans that without cost-sharing and reinsurance payments, they’ll announce huge premium increases right before the midterms this fall. House Republicans are thus looking for a quick fix to lower premiums and are holding up the Senate for the $30 billion in reinsurance.
Most regrettable is that this three-year cash infusion probably pushes the political incentive for any serious legislative reform of ObamaCare past the 2020 election, which could be the entire Trump Presidency. Republicans are betting they can save their short-term political futures by keeping ObamaCare on life support. But without meaningful reform that offers more health-care freedom, the real price will be the law’s ultimate preservation.
Appeared in the March 20, 2018, print edition.
