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Why single-payer momentum is overstated The stunning failure of Republicans to repeal and replace Obamacare has left many supporters of single-payer feeling like the wind is at their backs. After all, not only did Republicans fail to make a dent in Obamacare, they were actually emerging as guardians of Medicaid. The idea that government has a role in making sure individuals have coverage, it seems, has taken hold in both parties. While viewed one way, the GOP failure to repeal and replace could be seen as evidence of renewed public acceptance of a government role in healthcare, on the flip side, it could be viewed as an affirmation of the power of the status quo bias that has traditionally doomed any major overhaul of the U.S. healthcare system.
For decades, Democrats tried and failed to pass some sort of national healthcare plan, and the biggest obstacle had always been Americans’ fears that it would disrupt their current coverage. It was why the Clinton effort went down in flames. It was the central reason why President Barack Obama abandoned the idea of single-payer. And it was why he made his infamous promise about people getting to keep their doctors and plans if they liked them. By the time Republicans had the power to do anything, Obamacare had become the new status quo and tinkering with it would have implications for the health coverage of millions of Americans. Suddenly, it was Republicans who looked like they were engaging in a radical plan of social engineering, while Democrats were sounding reasonable by suggesting they would be open to more modest changes.
While the Republican bill would have affected millions on Medicaid and on the individual market, any true single-payer bill would have to affect the employer-based healthcare system, which covers 49 percent of the country, or 156 million people, according to the Kaiser Family Foundation. That doesn’t even get into the massive tax increases required to support a single-payer system. An analysis of Sen. Bernie Sanders single-payer plan from the liberal Urban Institute projected that it would cost $32 trillion over a decade.
This doesn’t mean that conservatives should rest easy and assume the single-payer threat is over. It doesn’t mean liberals can’t achieve smaller victories that, over time, could move the system closer and closer toward something akin to single-payer. But, after witnessing the collapse of one party’s seven year-pledge on healthcare, the lesson we take from it maybe shouldn’t be that the public is primed for another major political battle to radically overhaul the system in a way that could disrupt the coverage of hundreds of millions of people.
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NRCC Chairman Steve Stivers: ‘Clear’ mistake by Republicans to push healthcare reform first. Instead, the GOP should have focused on other topics, including tax reform, the chairman of the National Republican Congressional Committee said, and he cast doubt on the idea that the Senate would be able to pass any Obamacare repeal bill this year. “Oh, in hindsight, it’s clear,” the Ohio Republican told the Washington Examiner. “But it is what it is. You had to do them in some order. I would argue healthcare is pretty much…” Stivers said before catching himself. “We’re shifting focus,” he added, referring to issues such as tax reform and other more achievable goals. When asked if healthcare could resurface, he said it’s possible, but “I doubt it.” “I think we’re moving on to tax reform,” he said. “It’s time to move on to things we can get done and the Senate can get done. The Senate couldn’t pass the skinny repeal bill. It is what it is. It time to move to — we have precious time given to us by our voters. We need to focus on the things we can get done.” Stivers said healthcare is a tricky issue for Republicans as 2018 approaches, one that suggests that the GOP is unable to govern. The Senate has been unable to coalesce around a bill since the House passed the American Health Care Act in early May. “I think it worries some people because some American citizens are losing confidence in our ability to get things done,” Stivers said. “We need to reclaim their confidence and regain their confidence by getting things done. Healthcare was always the hardest of all the topics we were dealing with. There’s just no consensus. We had a plan out there, but it didn’t have 218 co-sponsors. It passed the House, but it didn’t have the 50 votes needed, plus the vice president, in the Senate.”
Senate hearing features five insurance regulators: The Sante Health, Education, Labor and Pensions Committee will hear from insurance commissioners in Tennessee, Washington, Pennsylvania, Alaska and Oklahoma about how to stabilize premiums on Obamacare’s individual market on Sept. 6. The hearing is part of a series that the panel is holding on stabilizing the individual market, which is used by people that don’t get insurance through work and includes Obamacare’s exchanges. On Sept. 7 the HELP committee will hold a hearing featuring several state governors. Govs. Charlie Baker of Massachusetts, Steve Bullock of Montana, Bill Haslam of Tennessee, Gary Herbert of Utah and John Hickenlooper of Colorado will appear.
South Carolina governor cuts all state and local abortion funding. Republican Gov. Henry McMaster on Friday cut off all state and local funding to the state’s three abortion clinics, according to a report. McMaster not only cut off all funding but also called for the state’s Medicaid agency to ask the federal government to exclude abortion clinics from its Medicaid provider network, according to the Post and Courier. It was not immediately clear how much money is involved. One of the three abortion clinics is a Planned Parenthood clinic. Several states have tried to block Medicaid funding to the women’s health and abortion provider, but some have been blocked by court orders.
New York Obamacare insurer shuts down after losses. Northwell Health announced Thursday it will withdraw its insurer branch, CareConnect, from New York’s individual insurance market. The company cited a huge bill from the federal government and uncertainty in Washington over Obamacare’s future as primary factors for the withdrawal. CareConnect is the latest insurer to withdraw from Obamacare because of a mix of poor profitability and uncertainty over whether Congress or President Trump will make Obamacare payments to insurers. Of the 126,000 CareConnect customers, about 13,000 are on the exchange and the rest are off the exchange. New York’s insurance regulator is reviewing the company’s withdrawal plan. Until it is approved, CareConnect must accept new members, a company representative said. A major reason for the departure was payments the insurer had to make under Obamacare’s risk adjustment program. The program requires insurers with healthier customers to give money to insurers with sicker customers. CareConnect was expected to be profitable this year, if not for a $112 risk adjustment payment to the federal government. The company would have faced another payment of more than $100 million next year, it said.
Every county will have an Obamacare insurer next year. An insurer has stepped in to offer Obamacare coverage to a rural Ohio county next year, the last county in the nation that had faced having no insurers to sell Obamacare plans to its residents. The decision announced Thursday undercuts a key criticism from Republicans that some counties won’t have any Obamacare insurer next year. Insurer CareSource, a nonprofit insurer headquartered in Ohio, said it would offer insurance in rural Paulding County, Ohio, according to a report in Dayton Daily News. The move comes a few days after Wisconsin’s insurance regulator said that rural Menominee County would have an insurer as well. The insurer did not specify its rate request for next year.
HHS: Obamacare not offering ‘choice’ just because all counties are covered. The Trump administration warned Thursday that just because every county in the country will now be covered by an Obamacare insurer in 2018, that doesn’t mean people will have a choice as they look to buy a health insurance plan under the law. “Nearly half of counties across the nation only have one health insurance option which, by definition, is not a choice,” a representative for the Department of Health and Human Services told the Washington Examiner. Critics of the law have pointed to the lack of insurance options as a reason the law is imploding. “Under Obamacare, Americans were promised access to a wide variety of high-quality, affordable coverage options,” the spokesman said. “Obamacare has failed to deliver.” HHS also pointed to high premiums as a reason for the law’s collapse. However, some insurers have raised premiums due to uncertainty from the Trump administration, specifically over whether it will make payments to insurers for lowering out-of-pocket costs for low-income Obamacare customers. HHS is responsible for running healthcare.gov, a website used by residents in 39 states and the District of Columbia to buy Obamacare plans. The agency has received criticism from Democrats, who are calling for a briefing on whether the agency is doing all it can for Obamacare enrollment.
RUNDOWN
Axios The implications of opioid lawsuits
The Hill Congress facing deadline to renew healthcare for children
Washington Post Aetna accidentally exposed customer HIV status in clear envelope windows
The Mercury News Single payer revived? California lawmakers to hold hearings this fall
Reuters Adamas Pharmaceuticals wins FDA approval for reformulated Parkinson’s drug
CNN The opioid epidemic is not an official national emergency
LA Times Trump’s foes, questioning his mental fitness, are citing the 25th Amendment. So how does that work?
Wall Street Journal New York City calorie count law under legal fire
STAT News and Boston Globe Behind the luxury: Shoddy care and turmoil at five-star addiction treatment centers
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Calendar
FRIDAY | Aug. 25
11 a.m. PST/1 p.m. EST. Seaside City Council Chambers. Sen. Ron Wyden, D-Ore., to hold town hall. Details.
12:30 MDT/2:30 EST. Northwest Kansas Technical College, Memorial Student Union. Sen. Jerry Moran, R-Kansas, to hold town hall. Details.
2 p.m. PST/5 p.m. EST. Pine Grove Community House. Sen. Ron Wyden, D-Ore., to hold town hall. Details.
5:30 p.m. EST. Concord-Carlisle High School. Sen. Elizabeth Warren, D-Mass., to hold town hall. Details.
MONDAY | Aug. 28
Aug. 28-31. Paralyzed Veterans of America Annual Summit. Details.
