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Friday, Mar 17 2017

Full Issue

Policy Perspectives: Examining The Issues And Answers In The Health Law Repeal-And-Replace Debate

Opinion writers across the country detail some of the key issues, winners and losers that are emerging as Republicans attempt to undo the Affordable Care Act and replace it with the House GOP's American Health Care Act.

The assertion that "health care is a right, not a privilege" has become one of my favorites as we debate Obamacare vs. Trumpcare. But, as I've learned in my email and comment threads, them's fightin' words to many conservatives and sticklers for the Constitution. Our founding documents and their amendments make no direct or even indirect mention of health care as a "right," critics of this sentiment maintain. Americans no more have a "right" to see a doctor than they have a "right" to own a car or to have a place to live, food on their tables or clothes on their backs. (Eric Zorn, 3/16)

The Lord giveth and the Lord taketh away, but for governments it鈥檚 not that easy. Once something is given 鈥 say, health insurance coverage to 20 million Americans 鈥 you take it away at your peril. This is true for any government benefit, but especially for health care. There鈥檚 a reason not one Western democracy with some system of national health care has ever abolished it. (Charles Krauthammer, 3/17)

For proponents of the American Health Care Act, perhaps the most encouraging nugget in the Congressional Budget Office鈥檚 otherwise critical analysis is that insurance premiums could fall by 10 percent on average by 2026. Even this prediction is more mirage than reality, however, in part because of an obscure concept known as 鈥渁ctuarial value.鈥 (Peter R. Orszag, 3/17)

Since Louisiana started adding new Medicaid patients in July 2016, more than 62,000 patients have gotten preventive care. More than 5,700 patients have gotten breast cancer screenings, and 74 were diagnosed with cancer. More than 1,300 people have been diagnosed with diabetes, and 5,900 have gotten colon cancer screenings. Those statistics have real consequences for people. The Louisianians newly diagnosed with breast cancer or diabetes should be able to get ongoing treatment for their illnesses. That could improve their health and extend their lives. (3/17)

In the summer of 2016, Representative Paul Ryan (R-WI) released 鈥淎 Better Way,鈥 a wide-ranging proposal that included a plan for reforming Medicaid. Its fate depended heavily on the presidential election, and now that Republicans hold majorities in both the Senate and the House of Representatives and Donald Trump is President, Ryan鈥檚 plan seems much more likely to become reality. The proposal would eliminate many aspects of the Affordable Care Act and make fundamental changes to the entire Medicaid program by setting a limit 鈥 a per capita cap 鈥 on federal Medicaid spending. (Andrew J. Goodman-Bacon and Sayeh S. Nikpay, 3/16)

In the nine months since Louisiana opted to expand Medicaid聽last June, health care in this state has completely changed, and as current medical students and future physicians, we do not want to go back. Under the Affordable Care Act and the subsequent Medicaid expansion, almost half a million more Louisianians gained insurance. Suddenly, in a state that has some of the worst -- and often the very worst -- health outcomes in the country, working mothers can afford to get checkups, young college grads struggling in service industry jobs can afford antibiotics, and Louisianians with pre-existing conditions (think diabetes, think genetic diseases, think cancer) are guaranteed the right to be able to purchase health insurance and to strive towards health. And so for the first time, we treated health care as a human right, rather than a privilege reserved for those who could afford it. (Frances Gill and Eric Schultz, 3/16)

Using conservative assumptions, the same study estimates that government recoups at least 56 cents for each $1 spent on childhood Medicaid by the time those children reach 60. Using another set of realistic assumptions, the same study estimates that the government鈥檚 entire investment is recouped by the time the child is 36. Medicaid is a cost-effective tool to improve economic mobility, a core principle of the American Dream. (Marianne Page, 3/16)

HHS estimates that since passage of the ACA, 55.6 million women now have access to contraception without copays. Although early research has not yet shown dramatic changes in contraceptive use post-ACA, in previous studies, eliminating contraceptive copays has increased women鈥檚 use of the most effective methods, and reduced rates of unintended pregnancies and abortions. (Lydia Pace and Eve Rittenberg, 3/16)

As a businessman who runs a large health care company, I can say that the Affordable Care Act 鈥 including its 2,600 pages of regulations 鈥 is the worst operational plan in government history. That鈥檚 because it was designed by bureaucrats and academics who don鈥檛 understand how health care works and how to make it operate efficiently. (Richard Jackson, 3/17)

When it comes to saving money on health care, it is so true that you can save a bundle by eliminating the sick. They鈥檙e tiresome, always complaining, they smell bad, and they鈥檙e ruining it for the rest of us. Put the seriously ill out of their misery, get them to die 10 days earlier than they normally would, you can run the system at a profit. Simple as that. (Garrison Keillor, 3/16)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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