Obamacare

Questions for Martha McSally re: health care

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Below is some recent reporting on health care to help you formulate your questions for Rep. Martha McSally for her “chicken bunker” tele-town hall tonight.

The largest health insurance companies in the United States reaped historically large profits in the first quarter of this year, despite all the noise you hear surrounding the Affordable Care Act’s individual marketplaces. Profits are booming at health insurance companies:

Aetna, Anthem, Cigna, Humana and UnitedHealth Group — the big five for-profit insurers — cumulatively collected $4.5 billion in net earnings in the first three months of 2017. That was by far the biggest first-quarter haul for the group since the ACA exchanges went live in 2014. Other major insurers, such as the Blue Cross and Blue Shield company Health Care Service Corp., also are improving their ACA operations.

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Aetna lost money only because it had to pay Humana a $1 billion break-up fee after their merger failed; otherwise it would have been in the black. Some other things to keep in mind:

  • The ACA exchanges represent a small amount of the insurance market, and most of the for-profit carriers have bailed on those plans.
  • Employer-based coverage is a profit center, but insurers continue to invest more in Medicare Advantage and Medicaid.
  • Congress suspended the ACA’s health insurance industry fee for 2017, which is creating a temporary windfall.
  • The first quarter of the year is usually good for health insurers. Deductibles are reset, leaving people on the hook for a lot of their out-of-pocket medical expenses. The fourth quarter usually is the worst, since people often reach their deductibles by the end of the year.

Uncertainty over the future of health care for millions of Americans grew deeper Monday after the administration and House Republicans asked an appeals court for a 90-day extension in a case that involves federal payments to reduce deductibles and copayments for people with modest incomes who buy their own policies. Insurers seek stability as Trump delays health care decision:

The fate of $7 billion in “cost-sharing subsidies” remains under a cloud as insurers finalize their premium requests for next year.

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GOP sabotage of ‘Obamacare’: delay for 90 days during the plan filing period

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I previously gave you a backgrounder on the House GOP lawsuit House v. Price (née House v. Burwell) for which the next status report to the Court is due today.

Politico reports that instead of filing the status report, the White House seeks 90-day delay in Obamacare subsidy suit:

The Trump administration and House of Representatives Monday asked a federal court for another 90-day delay in a lawsuit over Obamacare insurance subsidies, undermining the future of the health care marketplaces as insurers look for certainty from the government before committing to offer coverage next year.

“The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action,” the House and White House wrote to the court.

If the request is approved, the parties would have to file another update in 90 days.

“We continue to work with the Trump administration on a solution,” said AshLee Strong, spokeswoman for Speaker Paul Ryan.

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The GOP sabotage of ‘Obamacare’ may come to a climax next week

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There are a two events scheduled to occur next week on the “Obamacare” front that could affect the status of both “Obamacare” and the awful American Health Care Act passed in a rush by the Tea-Publican House a couple of weeks ago.

I previously gave you a backgrounder on the House GOP lawsuit House v. Price (née House v. Burwell) for which the next status report to the Court is due on Monday, May 22.  The Trump administration could opt to sabotage “Obamacare” by not funding the cost-sharing reductions (CSRs) and blowing up health insurance markets across the country.

The second scheduled event is the release of the nonpartisan Congresssional Budget Office (CBO) score for the American Health Care Act (AHCA), which is scheduled to be released on Wednesday, May 24. The CBO score for the Zombie Trumpcare bill is widely expected to be far worse than for the Trumpcare 2.0 bill.

And there is another complication that that “the zombie-eyed granny starver from the state of Wisconsin” and Ayn Rand fanboy, House Speaker Paul Ryan, did not seriously consider when he forced a House vote on the AHCA without the benefit of the CBO score.

NBC News reports, Uh-Oh: The House May Need to Vote on Health Care (Again!):

Speaker Paul Ryan confirmed on Friday that that the House may need to vote on the American Health Care Act a second time before the Senate can take up the bill, even as he stressed it was unlikely.

Republicans are using the budget “reconciliation” process to pass their health care bill, which allows them to push legislation through the Senate with a simple majority. But that depends on the bill meeting certain requirements — and one of them is that it reduces the deficit by at least $2 billion over the next decade.

The trouble is that Republicans voted on their House bill without waiting for the Congressional Budget Office, the federal agency that evaluates legislation, to finish its projections, which will be released on Wednesday.

Bloomberg News reported Thursday and NBC News confirmed that House leaders have not formally sent their bill to the Senate on the chance that it fails to meet the deficit requirements.

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Think the Senate will save us from the disastrous House AHCA bill? Think again

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The conventional wisdom is that the U.S. Senate intends to rewrite its own health care bill from the wreckage of the disastrous American Health Care Act (AHCA) passed by the House last week. The implication is that the Senate bill will be much better than the House bill.

The problem with conventional wisdom is that it is frequently wrong. There are Tea-Publicans in the Senate who are just as reckless and irresponsible, if not more so, than their counterparts in the House. Putting your faith in these “12 angry (white) men” and the Septuagenarian Ninja Turtle Mitch McConnell on the Senate AHCA working group is a foolish and risky bet.

AHCA Working Group

The Washington Post reports, Senate hard-liners outline health-care demands with Medicaid in the crosshairs:

Senate conservatives, once seen as an impediment to the Obamacare repeal push, are instead lobbying for changes that would drop millions of adults from Medicaid, limit the value of tax credits over concerns about funding abortion and weaken or cancel consumer protections.

Senators like Mike Lee (R-Utah) believe these changes will help reduce health-care spending, prevent tax-credit dollars from paying for abortions and expand access to health insurance by lowering premiums — all arguments supported by conservative advocacy groups.

And such changes are also looked on favorably by some House Republicans who don’t expect their version of the American Health Care Act to survive the Senate.

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AHCA ‘tattooed to their foreheads’

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House Minority Leader Nancy Pelosi, D-Calif., warned Republicans who voted in support of the American Health Care Act: “What is happening today is a lose-lose situation for the Republicans. It’s a lose-lose for the American people, that’s for sure. But the people who vote for this will have this vote tattooed to their foreheads as … Read more