Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Effects Of A 'Market-Driven' Health System; Administration's Poor Accounting
As the Affordable Care Act moved into its second open enrollment period on Nov. 15, critics seized on the fact that some beneficiaries are in for unpleasant surprises. Some of those who enrolled last time will face higher premiums if they stay with their current plans. They will have to shop around on the exchange to find a plan with a lower price. When they return to the Web site, they are likely to find more plans to choose from than they did last year. More choices 鈥 how confusing! ... Oh, dear! That all sounds complicated, inconvenient and unfair. What have these 鈥渟ocialist Democrats鈥 done to us? But wait a minute: Isn鈥檛 that how markets are supposed to work? (Alice M. Rivlin, 11/20)
Many political analysts were surprised by how close I came to winning the Virginia Senate race earlier this month. I received more than a million votes running on a five-point plan for economic growth, and the first point was a specific proposal to replace the Affordable Care Act. In a purple state like Virginia, I could not have gotten so close to defeating Mark R. Warner, a popular incumbent, by talking only about 鈥渞epeal.鈥 But while I wasn鈥檛 elected to the Senate, those who were might find these reforms worthy of their support, in part because they were well received in a swing state of considerable importance in the Electoral College. (Ed Gillespie, 11/20)
Just as Ronald Reagan鈥檚 1981 tax reforms did not drop out of the sky when he took office, but had been developed in Congress for years by Jack Kemp and William V. Roth, the newly elected Congress has the opportunity and responsibility to pursue a consensus on post-Obamacare health reform that puts patients鈥 needs in front of politicians鈥 delusions, so the next president has something with which to replace Obamacare. Will health insurers resist, focused on consolidating their Obamacare gains, or will they accept the need for real reform? Although not immediately apparent, there is hope that health insurers will be ready to move beyond Obamacare. (John R. Graham, 11/19)
The Obama administration鈥檚 overcounting of the number of people enrolled in Affordable Care Act health plans reveals how all the glitches in the government鈥檚 computer system have yet to be worked out. Instead of the 7.3 million people that the government reported were enrolled in health insurance plans in September, congressional investigators discovered that the number was 6.97 million. A more recent estimate of 7.1 million should have been 6.7 million, Sylvia Mathews Burwell, Secretary of Health and Human Services, acknowledged Thursday. (Margot Sanger-Katz, 11/20)
Yikes. Enrollment in Obamacare insurance plans this fall was lower than the Department of Health and Human Services reported at the time. The difference was about 400,000 people, or about 6 percent of the total. Conservative critics say it鈥檚 proof that Obama is 鈥渃ooking the books,鈥 just as they have claimed all along. Senior Administration officials swear they made an honest mistake. They've offered what sounds (at least to me) like a plausible explanation. But even if that explanation is accurate, the error would still be inexcusable. (Jonathan Cohn, 11/20)
Health and Human Services Secretary Sylvia Mathews Burwell seems to be saying that this was some sort of mistake. And it鈥檚 possible that this is all it is. But I would be more inclined to give the benefit of the doubt if the administration hadn鈥檛 otherwise been managing enrollment data so aggressively, releasing good figures as soon as it had them but sitting on bad data as long as possible, and ceasing to issue regular reports as soon as open enrollment stopped and the numbers began to decline rather than rise. (Megan McArdle, 11/20)
When I was growing up in Lexington, Ky., in the late 1970s, we used to go to an all-you-can-eat buffet called Duff鈥檚. It was the cheapest restaurant in town. My father and mother ate for $2 apiece, my brother and I were charged $1, and my little sister, who was 3, ate free. After my father paid the cashier, we鈥檇 sprint over to the smorgasbord and fill our plates. We鈥檇 fill them again and again. If the fried chicken got cold, my father would tell us to throw it out and get more. We gorged; we took advantage; we were wasteful 鈥 because we perceived it as free. We鈥檇 eat so much that one of us would invariably get sick on the way home. In many ways, Duff鈥檚 is like our health care system. Someone else appears to be paying for it, so who cares how much it costs? (Dr. Sandeep Jauhar, 11/20)
Under Obama's plan, the government will defer for three years the deportation of parents of children who are U.S. citizens or legal permanent residents, if the parents pass a background check and have been in the country for five years. He will also expand the pool of so-called Dreamers 鈥 those who came to this country illegally as children 鈥 who are eligible for deferrals. He will not offer deferrals to their parents. ... People receiving deferrals will not be eligible for health coverage under the Affordable Care Act, nor will they qualify for other federal programs, such as food stamps, that support low-income citizens, permanent residents and others here legally. (11/20)