Tag Archives: risk pools

Addressing the cost of the health reform wars

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The ceaseless political warfare over health care, ironically, has become a big obstacle to … fixing health care.

Because what Americans care most about is cost – and we can’t fix the rest of our coverage problems without also addressing cost. And we, as a nation, are not really talking about cost. The president’s budget would slash entitlement spending, particularly on Medicaid. But like all presidential budgets – it’s not going to pass and lowering federal spending on old, poor and sick people isn’t going to make the costs of taking care of old, poor and sick people go away. Continue reading →

Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.

A check-up on the status of the health exchanges

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Remember when Sen. Susan Collins, Maine’s moderate Republican, predicated her vote for the Senate tax bill that included the repeal of the individual mandate on Majority Leader Mitch McConnell’s promise to her that the Senate would vote on two ACA stabilization measures?

Those bills did not make it into short-term spending bill at the end of 2017, nor the last month’s short-term spending bill. We aren’t holding our breath that they will be in the next bill, or the one after that. To recap: Continue reading →

Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.

The promise and perils of ‘invisible’ risk pools

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Photo: Mark Harkin via Flickr

Among the many items on Congress’s January to-do list is legislation to stabilize the Affordable Care Act markets, such as the bill Sens. Susan Collins (R-ME) and Bill Nelson (D-FL) introduced last fall.

It would provide $4.5 billion in federal reinsurance payments over two years, 2018 and 2019. The idea is to compensate insurers for taking on costly patients to prevent shifting all that cost to higher premiums for everyone in the exchanges. There are several ways for states to construct reinsurance. The idea is a bipartisan one, with both blue and red states looking at various mechanisms. Alaska, for example, already has begun one under an ACA waiver. Continue reading →

Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.

Trump administration likely to face legal challenges to its double punch at ACA

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The Trump administration dealt a one-two punch to the Affordable Care Act on Thursday. Trump’s executive order would give Americans the option of buying lower-cost health insurance, but also could usher back the bare-bones insurance options that the Affordable Care Act was designed to eliminate.

In addition, Trump directed the U.S. Department of Health and Human Services to end the cost-sharing reduction payments (CSRs) to health insurers required under the ACA effective immediately. The payments always have been controversial, and the Trump administration, in justifying its action, noted that House Republicans earlier successfully challenged them in court. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.