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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jan 23 2017

Full Issue

'Repeal' Rekindles High-Risk Pool Talks, Evoking Memories Of Limited Coverage, Patients Dying On Waiting Lists

Covering sick patients is extremely expensive and both sides have scrambled to come up with a solution. For the Democrats it's the individual mandate, while Republicans are talking about high-risk pools again. Meanwhile, the former acting administrator of CMS takes on saving the health law as his personal mission.

Joanne Fitzgerald was getting divorced and was stressed out. When stomach pain kicked in, she saw a doctor to have it checked out.That was her mistake. The doctor diagnosed a mild form of gastritis, an inflammation of the stomach lining, and recommended some over-the-counter medicine. But when the divorce became final, in 2008, she lost health coverage from her husband鈥檚 employer, and insurer after insurer refused to cover her because of the condition. She was finally offered a policy that excluded coverage for anything related to her gastrointestinal tract. (Abelson, 1/22)

Andy Slavitt鈥檚 job was to run Obamacare. Now he鈥檚 trying to save it. Slavitt stepped down on Friday as acting administrator of CMS, the sprawling federal agency that oversees the Affordable Care Act. Later that day, President Donald Trump signed an executive order that could blow much of the law apart. (Kenen and Diamond, 1/23)

And media outlets report on the health law and what its possible repeal would mean to the industry and in the states聽鈥

Here is the problem Republicans face with their opposition to the 2010 health-care law signed by President Barack Obama: Getting rid of it without approving a substitute would increase the federal debt, provide wealthy people with a tax cut and cause as many as 20 million Americans to lose their health care. Although Vice President Mike Pence told CNN last week that "step one is to repeal the taxes and the mandates" in the law known as Obamacare and "at the same time pass a replacement bill," neither he nor congressional Republicans have provided specifics of a plan. (Torry, 1/22)

It's wonky stuff, health care payment reform, but if you care about your spiraling medical costs, you have to care about attempts to change the $3 trillion health care system to bring them down while still improving your care. Among the dozens of other pieces of the sprawling Affordable Care Act, the law funneled hundreds of millions of dollars in support for such attempts through a federal agency called the Center for Medicare and Medicaid Innovation. It particularly buttressed "Accountable Care Organizations" or ACOs, a central payment reform idea that boils down to paying doctors for how well you do rather than just for each thing they do for you. (Goldberg, 1/20)

Should gun owners have to share information with health professionals about their firearms and whether they鈥檙e stored safely at home? This controversial issue gets a nod in the federal health law. Tucked into the聽Affordable Care Act聽is a section that protects聽people聽from having to disclose information about guns they own聽to wellness programs and prohibits federal health law officials from collecting and keeping records about it. Insurers can鈥檛 factor gun ownership into health insurance premiums either under this section of the law. So gun owners may want to pay attention to the debate on revising Obamacare. (Andrews, 1/20)

Americans are watching and waiting 鈥斅爓ith anxiety, skepticism, optimism and sometimes all of the above 鈥斅爐o see what becomes of the Affordable Care Act, the mammoth health law that added 18-million people to the ranks of the insured.聽And even expert economists and physicians who have spent decades analyzing the complex system can't say with any certainty what could happen next. But watching the politics of "repeal and replace" can be just as painful for those in the know, said a panel of high-powered health policy authorities who gathered Thursday evening at the Inquirer to ponder the possibilities. (Wood, 1/20)

A repeal of the Affordable Care Act without a replacement could cost the nation 2.6 million jobs, with 36,000 of those coming in Connecticut. The study by The Commonwealth Fund and Milken Institute School of Public Health at George Washington University focuses mainly on federal premium tax credits and payments to states for Medicaid expansion. Should the administration repeal those components and not replace them with 鈥渟ound policies,鈥 the study shows that job losses in the state would be large in both number and scope. But only 40 percent of the 36,000 lost jobs would come from the health care industry, a finding that surprised the authors of the study. (Bosak, 1/22)

As Congress stands poised to repeal the Affordable Care Act in the early days of President Donald Trump's term, the debate for citizens continues over finding balance between maintaining good health and its cost. In Northwest Indiana, sentiments about the Affordable Care Act Indiana are mixed. Concerns have been raised about high monthly premiums and deductibles for those buying insurance through healthcare.gov. Concerns are also raised over fate of funding for federally qualified health centers, non-profits that typically provide services for people in underserved areas. (Webster, 1/20)

Two Republican lawmakers who want the repeal of Obamacare are pressing聽to strengthen another government聽insurance mandate passed in Wisconsin around the same time 鈥斅爐his one on drivers. As the Assembly Health Committee chairman, Rep. Joe Sanfelippo (R-West Allis) will help聽Wisconsin implement a repeal of the Affordable Care Act, the federal health law that mandates Americans buy health coverage or face financial penalties. Sanfelippo sees the law as an unwarranted government intrusion into private markets. (Stein, 1/20)

For most of last year, Sherry Hirota, chief executive of Asian Health Services, was planning to convert two floors of offices in its Oakland Chinatown facility to clinic space to accommodate more patients. But that changed on Nov. 8. Soon after the election 鈥 as Republicans in Congress began taking steps to repeal the Affordable Care Act 鈥 uncertainty over the future of the health care law forced Hirota鈥檚 group to scale back those plans. They are now going to build out just one floor of new clinic space instead. That鈥檚 because Asian Health Services stands to lose $8 million, about 15 percent of its annual revenue, if the Affordable Care Act is repealed without a comparable replacement. (Ho, 1/21)

Looming over the upcoming legislative session is the big unknown of whether Congress will repeal the Affordable Care Act and what it would mean for Nevada. It鈥檚 a worry for the administration and lawmakers, who have to build a two-year spending plan that could be blown to bits if the federal government yanks subsidies for Medicaid expansion and policies purchased through the state health exchange. Right now, there鈥檚 nothing they can do except wait. (Chereb, 1/22)

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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