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Morning Briefing

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Thursday, Oct 19 2017

Full Issue

Parsing Health Policies And Politics: Examining The Alexander-Murray Obamacare 'Fix'; Why Does It Have To Be So Difficult?

Opinion writers offer a variety of takes on the deal announced this week by Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) as well as what it can and cannot accomplish. They also take a tough inventory of the politics in play and examine other health policy issues, such as Medicare Advantage networks and the status of the Children's Health Insurance Program reauthorization.

The new bipartisan health proposal is far from a cure-all for Obamacare鈥檚 problems, but if it passed it would send health insurers a message they have sought all year: that it鈥檚 safe to stay in the marketplaces. Insurers have already signed contracts and are making final arrangements to sell their products in time for next year鈥檚 enrollment period, which begins on Nov. 1. (Reed Abelson and Margot Sanger-Katz, 10/19)

Time for another test of whether this Congress can do the easy things -- on health care this time. Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington have reached a deal to "fix" the Affordable Care Act -- a seemingly reasonable agreement designed, in very general terms, to help the insurance markets work better while giving states more flexibility to administer things. Both parties have incentives to approve something like this. Democrats care about preserving their big policy win in the original Affordable Care Act; Republicans don't want chaos in health insurance while they control the White House and have majorities in both chambers of Congress. Sure, Republicans in theory would rather repeal and replace Obamacare, but if they didn't realize earlier that they don't actually have any realistic plan for doing so, most of them surely know it now. (Jonathan Bernstein, 10/18)

A bipartisan proposal聽to shore up the Affordable Care Act and guarantee the U.S. government keeps helping insurers cover low-income patients would have been something like聽a best-case scenario for聽the聽companies participating in the market -- if it happened聽several months ago. As it stands, the bill, spearheaded by Senators Patty Murray and Lamar Alexander, has only a small chance of passing. And even if it does pass, it is unlikely to entirely mitigate the Trump administration's active sabotage of the ACA. (Max Nisen, 10/18)

Bipartisan negotiators announced Tuesday that they had struck a deal to temporarily stabilize Obamacare markets. Republican Sen. Lamar Alexander (Tenn.) agreed to continue paying 鈥渃ost-sharing reduction鈥 payments that the government promised insurance companies, and Democratic Sen. Patty Murray (Wash.) agreed to relax health-market regulations a bit. Both sides of this deal contain good policy. (10/18)

While there is plenty of blame to go around for Republicans鈥 inability to repeal and replace Obama Care, the effort was all but doomed as soon as the GOP chose to fight on the wrong battlefield. Trying to pass a replacement through the budget process known as reconciliation was powerfully attractive, since it would have permitted the Senate to act on ObamaCare with only 51 votes. (Phil Gramm, 10/18)

For seven years, congressional Republicans and Democrats battling over Obamacare have agreed on only one thing: They couldn鈥檛 agree on anything. As more Americans dropped or skipped coverage because of soaring premiums, lawmakers of the two parties couldn鈥檛 鈥 wouldn鈥檛 鈥 agree on how to fix the 2010 law. (10/18)

That鈥檚 the question to ask about this week鈥檚 deal between Republican Lamar Alexander and Democrat Patty Murray to appropriate two years of funding for Obama Care鈥檚 鈥渃ost-sharing鈥 reductions that flow to insurers. The Trump Administration last week cut off these subsidies, which the Obama Administration paid without an appropriation from Congress. A federal judge ruled last year that those payments are illegal. Democrats would also get about $100 million for advertising ObamaCare. (10/18)

President Trump and Republicans in Congress have brought chaos to the American health care system by trying to destroy the Affordable Care Act and failing to reauthorize the Children鈥檚 Health Insurance Program, which, with bipartisan support for the past 20 years, has provided care for millions of children. Over the next few weeks they can choose to set things right or to destroy them. (10/18)

The recent, strong growth of Medicare Advantage鈥攑rivate plan alternatives to traditional Medicare鈥攎akes understanding the program a priority for policy makers. Of the 57 million Medicare beneficiaries, approximately 33% are now enrolled in Medicare Advantage, an increase from 13% in 2004. Although we know a great deal about Medicare Advantage, there鈥檚 one thing we know almost nothing about: the extent and value of plans鈥 networks of physicians and hospitals at which enrollees can obtain covered care. This is important, because establishment and oversight of networks is a principal way Medicare Advantage plans manage cost and quality, and there has been a trend toward more narrow networks in insurance markets, raising concerns about access and patient cost. (Austin Frakt, 10/18)

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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