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ObamaCare: Democrats Run the House — Will Anything Change?

Posted By staff reporter, Tuesday, January 29, 2019


House Speaker Nancy Pelosi is digging in and is working on the Affordable Care Act. Her idea is to improve ObamaCare by adding Medicare for all. She’ll also tackle lowering prescription drug costs and some other improvements.

Hearings will be held.

President Trump has also talked about fixing drug prices so Pelosi may find an ally there, but she’s likely to be going it alone with her Democrat colleagues on the rest of the plan. Republicans aren’t going to buy into an ObamaCare fix.

Believing the people put the Democrats in charge of the House for a reason, Pelosi is working a plan with three prongs. The first is to get the Energy and Commerce Committee, the Ways and Means Committee and the Workforce and Education Committee to bump up the number of people who can get financial assistance to pay premiums.

She also wants to pump up the Healthcare.gov advertising budget so more people know they can get financial assistance and assistance getting insurance.

Pelosi is also looking at blocking some of the insurance alternatives that have been floated recently by the Trump administration. One of the first things she did — however — since the Trump administration won’t defend the law, was to vote to defend the Affordable Care Act in court.

In an interview with the Associated Press, Pelosi said, “President Trump said he’d ‘negotiate like crazy’ to bring down Medicare prescription drug prices, and since the midterm election he’s spoken about working with Democrats. We have an opportunity to enact the tough legislative negotiating authority needed to actually lower prescription drug prices for consumers.”

Pelosi will get very little help in the Senate if she manages to get something passed in the House. Senate Finance Committee Chairman Chuck Grassley of Iowa says private insurers need to do that negotiation and not the government. “Part D is the only federal program I’ve been involved with that has come in under budget,” Grassley pointed out. “If it’s working, don’t mess with it.”

This is an area — however — where former Republican Health and Human Services (HHS) Secretary Mike Leavitt says the Trump administration might surprise Democrats.

“Prescription drug pricing is in a category where both the president and the Democrats have made a commitment,” he said. “There will be a lot of division, but in the end there is a very good chance they will find a way that they can both claim victory.”

Medicare for all is likely not going to happen. The government-run health care system would require huge tax increases and would be a big expansion of the power of the federal government.

The House Budget and Rules Committee will handle that one.

As for what’s happening now with ObamaCare. A study done by the Urban Institute and funded by the Robert Wood Johnson Foundation says 2019 will be a better year for consumers needing to get insurance from one of the ObamaCare exchanges — or marketplaces as they’re known.

The study looked at what’s happening in the PIA Western Alliance states of Washington and California, and in Florida, Georgia, Indiana, Maryland, Minnesota, Ohio, Virginia and West Virginia.

More insurers have been found to be willing to enter new markets and they did so in time for the 2019 enrollment season. That’s a big change from 2018 when the uncertainty of a new administration, the uncertainty of politics and uncertain policy changes caused them to decline to participate in some markets.

The Urban Institute’s John Holahan said, “I think the carriers that didn’t do well in this market have already left the marketplace.” Those that stayed have — in his words — hit the sweet spot.

“It comes down primarily to their ability to negotiate with providers and get enough providers to come in at lower payment rates than in the commercial market,” he said. “Then they’ll have a big enough network. And for these Medicaid plans that developed networks to participate in Medicaid, it’s not a giant leap for them to participate in the ACA market.”

Plus, he said, “From a provider point of view, providers are better with getting a lower payment rate than having people go uninsured and not able to pay their bills at all. There are enough of them willing to accept that bargain.”

While things are better on the marketplace front, the number of uninsured adults in the U.S. hit a four-year high in 2018 and highest rate since ObamaCare took effect in 2014. A fourth quarter survey said 13.7% of adults were without medical insurance.

That’s seven million more adults than in 2016 when the uninsured rate fell to an all-time low of 10.9%.

These stats come courtesy of a Gallup Poll, and the polling firm said there are a number of possible reasons for the decline.

“One may be an increase in the rates of insurance premiums in many states for some of the more popular ACA Insurance plans in 2018,” Gallup said. “For enrollees with incomes that do not qualify for government subsidies, the resulting hike in rates could have had the effect of driving them out of the marketplace.”

Another reason — as addressed earlier in this story — is the decline in the number of insurers participating in the Affordable Care Act’s exchanges. One more reason could be the shortening of the enrollment period.

Here are some more statistics:

  The percentage of uninsured adults under age 35 fell from 16.8% at the end of 2016 to 21.6% at the end of 2018

  Adults making less than $24,000 a year are the highest percentage of uninsured at 25.4%

  Adults making $24,000 to $48,000 wee the next highest at 19.1%

  The highest percentage of uninsured — 19.6% — is in the South

  The lowest percentage is in the East at 7.1%


Source links Insurance Business America, insurancenewsnet.com, UPI



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