Reversal of fortune: Obamacare rate hike pose headache for Republicans

Obamacare premiums are once again poised to spike by double digits in 2019, causing heartburn for politicians as voters will head to the polls within days of learning about the looming hit to their pocketbooks.

But unlike recent campaign cycles, when Republicans capitalized on Obamacare sticker shock to help propel them to complete control of Congress and the White House, they’re now likely to be the ones feeling the wrath of voters.

That’s because Republicans are now in total control of the federal government and therefore on the hook for the health care system’s chronic shortcomings. Polling data has consistently suggested that more voters will blame Republicans for future problems with Obamacare. In addition, the GOP’s repeated failures to repeal Obamacare after eight years of campaign promises will make it difficult to galvanize the base on health care.

Democrats and their allies have been hammering President Donald Trump and congressional Continue reading “Reversal of fortune: Obamacare rate hike pose headache for Republicans”

Trump’s new health insurance rules expected to hurt Obamacare

Obamacare will suffer another blow on Tuesday when the Trump administration finalizes plans to make it easier for small businesses and trade groups to band together to purchase health coverage outside of the law’s insurance markets.

The White House is touting the expansion of so-called association health plans — which offer fewer consumer protections than Obamacare coverage — as a much-needed cheaper alternative. The administration will also soon finalize rules boosting short-term plans that offer skimpier coverage than the 2010 health care law.

The new rules, which the Labor Department will release Tuesday afternoon, are an effort to follow through on President Donald Trump’s frequent campaign promise to allow the sale of health insurance across state lines. Critics have warned Tuesday’s announcement will further drive up Obamacare premiums and weaken the law.

“They’ll be able to cross state lines and they will get great competitive health care and it will Continue reading “Trump’s new health insurance rules expected to hurt Obamacare”

Court: Federal government doesn’t owe insurers Obamacare payments

The federal government doesn’t have to pay health insurers money they claim they’re owed from an Obamacare program, a federal appellate court ruled Thursday morning in a case with billions of dollars at stake.

A divided three-judge panel rejected claims from two Obamacare insurers that the federal government was required to make good on payments from a program meant to protect insurers who attracted customers who were sicker and more expensive than anticipated.

The two insurers were seeking hundreds of millions of dollars in payments from Obamacare’s risk corridors program, and at least three dozen other insurers have filed similar lawsuits. In all, insurers say they’re owed more than $12 billion from the risk corridors program.

The court, siding with the Trump administration, said that the federal government didn’t have to make the payments because Congress took action requiring the program to be budget neutral.

“Congress clearly indicated its intent Continue reading “Court: Federal government doesn’t owe insurers Obamacare payments”

Medicare to go broke three years earlier than expected, trustees say

Medicare’s hospital trust fund is expected to run out of money in 2026, three years earlier than previously projected, the program’s trustees said in a new report published this afternoon.

The more pessimistic outlook is largely due to reduced revenues from payroll and Social Security taxes and higher payments than expected to hospitals and private Medicare plans last year.

The solvency report is the first since the repeal of Obamacare’s Independent Payment Advisory Board earlier this year as part of a massive spending agreement in Congress. The panel of outside experts was designed to tame excessive Medicare spending growth, but costs never grew fast enough to trigger the controversial board and no members were ever appointed.

Social Security faces depletion in 2034, the program’s trustees also said today. That’s identical to last year’s projection.

President Donald Trump has avoided major changes to Medicare or Social Security after promising not to Continue reading “Medicare to go broke three years earlier than expected, trustees say”

Opioid court fights risk repeating tobacco’s failures

The litigation stemming from the opioid crisis is staggering in its scope: hundreds of cities, counties, states, Native American tribes and hospitals seeking damages from drugmakers and distributors.

It’s arguably the most complex, potentially lucrative litigation since the $240 billion tobacco settlements 20 years ago. And this time around, public health experts want to ensure that resources to combat the opioid epidemic aren’t squandered.

Only a pittance of the billions in tobacco company payouts has been spent on combating tobacco use. Instead, much of the money, which the industry continues to pay out, is plowed into state slush funds and used to patch budget shortfalls. In the most extreme cases, states sacrificed future payments for much smaller, but immediate infusions of cash to pay workers, or build schools and roads. One state even renovated a morgue.

“It didn’t matter if it was a blue state or a red state,” said Continue reading “Opioid court fights risk repeating tobacco’s failures”

Obamacare insurers just had their best year ever — despite Trump

Obamacare is no longer busting the bank for insurers.

After three years of financial bloodletting under the law — and despite constant repeal threats and efforts by the Trump administration to dismantle it — many of the remaining insurers made money on individual health plans for the first time last year, according to a POLITICO analysis of financial filings for 29 regional Blue Cross Blue Shield plans, often the dominant player in their markets.

The biggest reason for the improvement is simple: big premium spikes. The Blue plans increased premiums by more than 25 percent on average in 2017, meaning many insurers charged enough to cover their customers’ medical costs for the first time since the Affordable Care Act marketplaces launched in 2014 with robust coverage requirements.

“2017 was the first year we got our head above water in the individual market since the ACA passed,” said Steven Udvarhelyi, CEO Continue reading “Obamacare insurers just had their best year ever — despite Trump”

Head of major insurer lobby stepping down after turbulent term

Marilyn Tavenner is stepping down after three tumultuous years at the helm of America’s Health Insurance Plans, a K Street powerhouse that’s seen its influence decline as Washington grew more hostile to Obamacare.

Tavenner oversaw AHIP as Republicans took full control of the federal government, hellbent on dismantling the 2010 health care law. The industry group was forced to take on that fight with diminished resources, with three of the country’s largest insurers — UnitedHealth Group, Aetna and Humana — dropping out of the organization in recent years. AHIP spent $6.5 million on lobbying last year — a nearly 40 percent decline from four years earlier.

Tavenner will be replaced by Matt Eyles, who is currently the lobby’s chief operating officer.

The 2015 hiring of Tavenner, who served as CMS administrator under former President Barack Obama, was initially seen as a coup following the departure of AHIP’s longtime, dynamic Continue reading “Head of major insurer lobby stepping down after turbulent term”

White House pitch to bolster Obamacare includes tough trade-offs for Democrats

The White House is seeking a package of conservative policy concessions — some of which are certain to antagonize Democrats — in return for backing a legislative package bolstering Obamacare markets, according to a document obtained by POLITICO.

The document indicates the administration will support congressional efforts to prop up the wobbly marketplaces, in exchange for significantly expanding short-term health plans and loosening other insurance regulations.

The document also makes several references to abortion language that will be problematic for Democrats. A potential stumbling block in passing any stabilization package is whether conservatives will insist on including language prohibiting the use of government dollars to pay for abortions.

"Although congressional efforts to provide taxpayer money to prop up the exchanges is understandable, any such efforts must also provide relief to middle-class families harmed by the law and protect life," the document states.

The source of the document provided to POLITICO Continue reading “White House pitch to bolster Obamacare includes tough trade-offs for Democrats”

Trump proposal boosts skimpy insurance plans, again undercutting Obamacare

The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as “junk insurance” — an effort that could give consumers cheaper coverage options but undermine Obamacare’s marketplaces and popular protections for pre-existing medical conditions.

Proposed rules issued this morning follow an executive order from President Donald Trump this fall seeking to expand access to more affordable health insurance alternatives to comprehensive, but pricey Obamacare plans. The HHS proposal, released weeks after the Trump administration issued a rule encouraging small businesses to find coverage outside the Affordable Care Act marketplaces, represents the administration’s latest effort to unwind the health care law with repeal efforts stalled in Congress.

“The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices," said Health and Human Services Secretary Alex Azar in a statement. "The Trump Administration is taking action so individuals and Continue reading “Trump proposal boosts skimpy insurance plans, again undercutting Obamacare”

Amazon’s new health care business could shake up industry after others have failed

Three corporate behemoths are promising to shake up the health care industry — a notoriously inefficient sector that represents nearly a fifth of the U.S. economy.

Though the surprise Tuesday morning announcement from Amazon, JPMorgan Chase and Berkshire Hathaway was grand in ambition, it was scarce in details, leaving plenty of questions about just how the companies could tackle an unsustainable $3.3 trillion health care system when so many others have tried and failed.

“The ballooning costs of healthcare act as a hungry tapeworm on the American economy,” Berkshire Hathaway CEO Warren Buffett said in a statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable.”

Their partnership, at least at the outset, may be limited. The three companies said they will band together to provide cheaper coverage to their employees, relying on technology in some unspecified Continue reading “Amazon’s new health care business could shake up industry after others have failed”

Trump administration rolls out bid to expand association health plans

The Trump administration Thursday proposed new rules following up on the president’s pledge to let certain small businesses and trade groups band together to buy health care, a move that could weaken the Obamacare insurance marketplaces.

The expansion of so-called association health plans is part of a broader effort to encourage the rise of cheaper coverage options that don’t comply with certain Obamacare patient protections and benefit rules.

The proposed rules stem from an executive order President Donald Trump signed in October directing federal agencies to loosen restrictions on short-term health insurance and association health plans, in a bid to create more competition and drive down premiums. However, state insurance regulators and Obamacare advocates have warned the lax rules could open the door to a new wave of poorly regulated health plans that offer limited coverage.

The proposed rule issued Thursday by the Labor Department would rewrite existing regulations under Continue reading “Trump administration rolls out bid to expand association health plans”

Obamacare sign ups surge, despite Trump’s declaration on ‘repeal’

The latest HealthCare.gov enrollment season closed with a surge of sign-ups, unexpectedly putting Obamacare enrollment on track to potentially match last year’s figures despite the GOP’s attacks on the health care law.

A total of 8.8 million individuals signed up for coverage through the Dec. 15 deadline in the 39 states relying on HealthCare.gov, a top Trump administration health official announced on Twitter Thursday afternoon. And more than 2.5 million have so far enrolled through state-run insurance marketplaces, many of which are still allowing people to sign up over the new few weeks.

The robust enrollment pace defies President Donald Trump’s insistence that Obamacare is "dead" and will likely make Republican efforts to dismantle the 2010 health care law even more challenging after failed repeal efforts this year.

Obamacare supporters say sign-ups far surpassed their expectations, given the ongoing repeal effort in Congress, the president’s harsh Continue reading “Obamacare sign ups surge, despite Trump’s declaration on ‘repeal’”

Obamacare sign-ups expected to lag at the end of enrollment this week

Obamacare’s open-enrollment season is headed for a disappointing ending this Friday despite its surprisingly robust start.

The reasons for the expected lag include the Trump administration’s decision to cut the sign-up period in half and slash outreach and marketing, skyrocketing premiums and general confusion about the status of the health law after repeated failed Republican attempts to dismantle it.

“There’s a clear relationship between increasing premiums and decreasing enrollment,” said Sen. Bill Cassidy (R-La.), co-sponsor of a GOP plan to replace the Obamacare in part with block grants to states. “We’re losing people who don’t get subsidies. That’s the reason we’ve got to do something about it.”

More than 80 percent of enrollees got subsidies in past years and the figure is expected to be significantly higher this year.

Democrats point the finger squarely at the Trump administration, which has slashed federal spending on marketing Obamacare coverage by Continue reading “Obamacare sign-ups expected to lag at the end of enrollment this week”

POLITICO survey: Insurers on pace to record Obamacare profits for first time

Insurers have finally figured out how to make money in the Obamacare markets: Charge more.

After taking a beating for three years, health plans jacked up their rates for 2017, with the average premium on the most popular products rising more than 20 percent. That created sticker shock for many Obamacare customers while putting many insurers on pace to record profits this year for the first time, according to a POLITICO analysis of 31 regional Blue Cross Blue Shield plans, many of which dominate Obamacare markets in their states.

But the turnaround comes just as Republican efforts to dismantle the health law are creating new threats to the viability of the marketplaces. That leaves the plans in a bewildering situation, trying to improve their margins while the GOP declares Obamacare a failure and mounts another push to dismantle the system, starting with rolling back the health law’s individual mandate.

“The Continue reading “POLITICO survey: Insurers on pace to record Obamacare profits for first time”

Aetna-CVS behemoth would nudge patients toward the drug store counter

The proposed $69 billion merger between pharmacy giant CVS and health insurer Aetna would create a new type of health care behemoth.

Unlike most recent blockbuster deals, it would combine two companies that are huge players in different sectors of the $3 trillion industry.

CVS has more than 10,000 stores and clinics across the country, and is one of the country’s largest pharmacy benefit managers. Aetna is the country’s third biggest insurer with more than 22 million members.

The companies say that together, they can provide better care with convenient clinics, incentives to buy their medications and visit CVS instead of the doctor. The combination would also result in a massive data combination that would enable Aetna to, say, know when a customer was pregnant, or buying harmful dietary supplements.

But experts are generally skeptical that they can complete the task: Customers don’t necessarily like receiving complex medical care from Continue reading “Aetna-CVS behemoth would nudge patients toward the drug store counter”

Obamacare mandate repeal may not deliver predicted blow

Repealing Obamacare’s individual mandate might not be the devastating blow to health insurance markets that supporters of the law fear.

Because the tax penalty for not having insurance is far less costly than what many Americans would have to pay for coverage, many have chosen to take the fine. Eliminating it, therefore, might not radically change behavior — or fulfill the dire predictions of spiking premiums and vast increases in uninsured people that economists, health providers and politicians once predicted.

Even the Congressional Budget Office says it’s rethinking its estimates of the consequences.

“We’ve always said the mandate is ineffective; it’s such a weak mandate,” said Deep Banerjee, an analyst at Standard & Poor’s who has closely tracked the Obamacare markets. “We don’t think many people would lose insurance if the mandate goes away.” The ratings service projects repeal would increase the number of uninsured by 3 million to Continue reading “Obamacare mandate repeal may not deliver predicted blow”

Defying gloomy predictions, Obamacare enrollment surges

Doomsday headlines about Obamacare enrollment may be having an unforeseen consequence: booming sign-ups in the troubled insurance marketplaces.

Obamacare’s fifth open enrollment season, the first under President Donald Trump, is off to a surprisingly robust start despite the brutal developments of the past year — skyrocketing premiums, dwindling competition, unremitting Republican efforts to eradicate it.

Sign-ups surged as soon as enrollment opened Nov. 1, easily surpassing the number of Americans getting coverage during the opening days of the final two sign-up periods under the Obama administration. CMS on Wednesday reported nearly 1.5 million people had selected plans through Nov. 11.

In other words, there might be no such thing as bad news for Obamacare.

“As P.T. Barnum would say, as long as my name is in the papers and it’s spelled correctly, it’s all good,” said Michael Marchand, chief marketing officer for Washington state’s Obamacare marketplace, which saw Continue reading “Defying gloomy predictions, Obamacare enrollment surges”

Trump may use executive power to weaken Obamacare’s individual mandate

President Donald Trump remains intent on undoing the Obamacare individual mandate one way or another.

Encouraged by Trump, a group of congressional conservatives want to add repeal of the mandate to the GOP’s overhaul of the tax code. But other Republicans fear the toxic politics of Obamacare could jeopardize the tax fight, and so far have kept repeal language out of both Senate and House versions of the tax package.

That means it could be left to Trump to act unilaterally to neutralize what polls consistently show to be the most unpopular part of the Affordable Care Act.

Most legal observers believe the administration has the necessary authority to interpret the law and substantially weaken enforcement of the tax penalty levied on most Americans who fail to obtain coverage. The downside is that unraveling the mandate might ultimately make it harder for Republicans to follow through on their long-standing promise Continue reading “Trump may use executive power to weaken Obamacare’s individual mandate”

Obamacare sign-ups surge despite Trump cuts

Obamacare’s open-enrollment season is off to a booming start despite widespread fears the Trump administration is seeking to sabotage the sign-up period.

The number of individuals signing up for coverage through HealthCare.gov during the first week of open enrollment is “roughly double” the pace of the previous year, according to an HHS source familiar with the enrollment data.

It’s way too early to determine whether more Americans will ultimately sign up for coverage this season. One big reason to treat the initial surge with caution: The enrollment period is just six weeks long, half the length of last year’s sign-up period.

But the early outpouring suggests that fears that the Trump administration’s actions — particularly gutting federal spending on outreach and marketing — would lead to a lackluster sign-up period may be overblown. Analysts at Standard & Poor’s projected that up to 1.6 million fewer Americans could sign Continue reading “Obamacare sign-ups surge despite Trump cuts”

Conservatives push to repeal Obamacare mandate in tax package

Conservatives are attempting to revive efforts to gut Obamacare’s individual mandate as part of the Republican overhaul of the tax code.

Despite a public push last week by Sens. Tom Cotton (R-Ark.) and Ron Johnson (R-Wisc.) to include repeal of the mandate in the tax package, tax bill writers didn’t include that in the measure released Thursday. But POLITICO Playbook reports there may be new momentum for adding the repeal into the bill.

Cotton and Johnson have been joined by conservative stalwarts like Sen. Ted Cruz (R-Texas) and House Freedom Caucus Chairman Mark Meadows (R-N.C.).

President Donald Trump also indicated his approval of using the tax vehicle to scrap the mandate this week.

“Wouldn’t it be great to Repeal the very unfair and unpopular Individual Mandate in ObamaCare and use those savings for further Tax Cuts,” he wrote on Twitter Wednesday.

But there are formidable political Continue reading “Conservatives push to repeal Obamacare mandate in tax package”