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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Apr 27 2017

Full Issue

Contemplating Health System Reform: Trump Could Save Obamacare; Anthem's Earnings Alter The Narrative

Opinion writers offer their thoughts on what is happening with efforts to repeal and replace the health law as well as other steps that could result in meaningful health care change.

In this case, improving the Affordable Care Act would not only be good policy for millions of Americans but would also be farsighted politics for Mr. Trump. The obvious obstacles are his repeated claim that the law is a 鈥渄isaster鈥 and internal Republican Party dynamics. But his endorsement of the House Republican bill last month ended in one of the biggest embarrassments of his first 100 days. And the new attempt this week to revive the effort might have a similar fate. So he shouldn鈥檛 let his past criticisms preclude him from pivoting from 鈥渞epeal and replace鈥 to 鈥渞epair and rebrand.鈥 A rebranded Affordable Care Act would be consistent with the vision Mr. Trump offered during the campaign. Then, he promised that everyone would be 鈥渂eautifully covered,鈥 with 鈥渕uch lower deductibles,鈥 and 鈥渢aken care of much better than they鈥檙e taken care of now.鈥 He said he wouldn鈥檛 cut Medicaid and would provide coverage for those who can鈥檛 afford care.(Nanacy-Ann DeParle and Phil Schiliro, 4/27)

At a time of extreme uncertainty in the health-insurance market, Anthem Inc. just posted its best quarterly earnings since 2013. The company's first-quarter results, announced Wednesday morning, beat analyst expectations on just about every measure, driven by growth in its Medicare and Medicaid businesses and a lot of new and healthier-than-expected patients enrolled via the Affordable Care Act's individual exchanges. Anthem says it intends to stay in the exchanges in 2018 -- something I (mea culpa) previously thought unlikely -- though that is based on a risky assumption Congress will fund payments to insurers that lower costs for people insured under the ACA. (Max Nisen, 4/26)

Largely absent from the current health-care debate in Washington is one astonishing number: We waste fully one-third of our medical care dollars, about $1 trillion out of $3 trillion annually, according to a paper by Donald Berwick and Andrew Hackbarth that was published in The Journal of the American Medical Association. After practicing medicine for almost 40 years, including 20 in health policy, I鈥檝e become convinced that to achieve adequate, affordable health care for all Americans, the cost of care must be reduced. (Arthur Garson Jr., 4/26)

When the One Nation Health Coalition launched we argued that Congress has a once-in-a-generation opportunity to get health reform right. That is still the case. Congress can get this done. And they must get it done. As Congress returns this week they have the opportunity to restart the work of reform. The task has been challenging because the issue is so complex. But there has also been movement on key issues. For instance, giving states flexibility and letting the market define essential health benefits can give patients more choices at a lower cost. (Dave Hoppe and David Wilson, 4/27)

In early March, America鈥檚 Health Insurance Plans (AHIP), the national association of private US health insurers, released an interesting report that presents, for insured patients younger than 65 years, financial statistics for 2014 of commercial and nonprofit health insurance companies. According to the report, 鈥淲here Does Your Premium Dollar Go?,鈥 an average of 79.7 cents per premium dollar is spent by insurers on health care proper and 17.8 cents on the insurers鈥 鈥渙perating costs,鈥 leaving only 2.7 cents per premium dollar as profits. (Uwe Reinhardt, 4/25)

Congress left Washington last week without passing a plan to repeal and replace Obamacare. They are now back with an amendment to the failed American Health Care Act. A growing number of Americans aren't waiting for lawmakers to figure out how to make health insurance more accessible and affordable. They're reclaiming control of their health care dollars from their insurers and assuming responsibility for spending that money themselves. (Sally Satel, 4/27)

Take the issue of health care. Few doubt that the individual health insurance market is in serious trouble under Obamacare. Yet Republicans can鈥檛 agree on the extent to which they want to repeal Obamacare or what they want to replace it. Democrats get to criticize Republicans for wanting to repeal Obamacare, but face no pressure, and have no incentive, to advance serious proposals to fix it. (Robert Robb, 4/26)

Time is running out for retired coal miners and their dependents, again. If Congress fails to act this week, the beleaguered miners and dependents will be without health insurance, something that came perilously close to happening in December 2016. Sen. Mitch McConnell engineered a short-term deal then, kicking the can down the road until the end of April. (4/26)

House Republicans are suing to stop the federal government from paying subsidies that substantially cut the deductibles and out-of-pocket costs of 7 million low-wage Americans with Obamacare silver plans. President Trump, who promised to cover all Americans, threatens to join them in attacking these life-saving subsidies. As a volunteer Certified Application Counselor in Cincinnati, I meet many working people who are able to get the care they need because of the cost-sharing these Republicans want to end. (Ariel Miller, 4/26)

Enrollment data released last week shows a record number of people bought health insurance through Washington鈥檚 insurance marketplace, Washington Healthplanfinder, during the open enrollment period that ended Jan. 31. Washington has more than 38,000 new people buying insurance through the exchange this year and an additional 60,000 getting free insurance through Washington Apple Health. Under the Affordable Care Act, nearly 2 million people in Washington state and tens of millions more across the country have health insurance coverage. (4/25)

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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