Affordable Care Act

In more encouraging public health news, the Centers for Disease Control and Prevention reports that vaccination rates among kindergarteners have remained stable, with the median vaccine exemption rate at 2 percent. Some states even reported an increase in immunization rates. In a study published last week in CDC’s Morbidity and Mortality Weekly Report, researchers examined 2016-2017 data from 49 states regarding coverage of three vaccines: measles, mumps and rubella (MMR); diphtheria, tetanus and acellular pertussis (DTaP); and varicella, more commonly known as chickenpox. Researchers also…
We made it to October without letting Congressional Republicans ravage our healthcare system, so that's a relief. However, the fact that it's October also means funding for the Children's Health Insurance Program and federally qualified health centers has expired ... and Congress has been putting so much energy into trying to gut Medicaid and further restricting women's access to abortions that they neglected to renew funding for these two immensely popular bipartisan programs. Instead of funding these programs because they're crucial sources of coverage and care for large portions of our…
In yet another attempt to repeal and replace the Affordable Care Act, much of the GOP justification boils down to one argument: that the ACA isn’t working. Never mind that we don’t really know what constitutes a “working” health care system for Republicans. For a while, Republicans said the ACA wasn’t working because some U.S. counties didn’t have an insurer. Today, no county is without an insurer. Then there’s the argument that ACA premiums are too high. However, the research shows that while premiums have gone up, the rise in premiums has been slower under the ACA than it was before the ACA…
Many of us were cheered by Senator John McCain’s announcement of his opposition to the horrible Graham-Cassidy bill that would gut Medicaid and wreck the individual insurance market. But Senate Republicans could still pass this bill, and will keep trying until the clock runs out at midnight September 30th. Last week I explained why the bill is so damaging to public health, and Kim Krisberg rounded up opposition statements from major organizations that work on healthcare. Two items that have come out since then are also worth considering. Senate Republicans are rushing to vote before the…
Senate Republicans are again trying to ram through an Affordable Care Act replacement that threatens the health and well-being of millions of Americans. It’s shameful. But don’t take my word for it. Let’s look at what people who actually work in health care are saying about the Graham-Cassidy-Heller-Johnson bill. In this interview, Sen. Bill Cassidy insists that his bill would protect people with pre-existing conditions. Blue Cross Blue Shield Association disagrees. (Cassidy also says in that same interview that his bill would work through the Children’s Health Insurance Program (CHIP), which…
Republican Senators have proposed one more bill to repeal the ACA. The Graham-Cassidy (or Cassidy-Graham) proposal would dramatically shrink the pool of federal money going to healthcare and revise how it’s distributed to states, in a way that is especially damaging to states that accepted the ACA’s Medicaid expansion. They hope to pass this destructive bill before the end of September, due to the upcoming expiration of reconciliation rules that let them pass a healthcare-related bill with votes from 50 Senators and Vice President Mike Pence. Like Republican bills from earlier in the year,…
Earlier this week, members of the Senate Finance Committee announced an agreement to extend funding for the Children’s Health Insurance Program. The announcement had been anxiously awaited by families and advocates across the nation, as the program’s federal funding expires in about two weeks. The agreement is good news, but coverage for CHIP’s 8.9 million children isn’t safe just yet. According to reports, the agreement would extend CHIP’s funding for five years — a win for advocates worried that lawmakers might propose another two-year extension as it did in 2015. The agreement would also…
The idea that the Affordable Care Act is a job killer is one of those regularly debunked talking points that won’t disappear. So, here’s yet more evidence that the ACA has had very little impact on the labor market. In a new study from the National Bureau of Economic Research, a team of Stanford University economists found that even though different regions experienced varying labor market effects likely related to the ACA, the overall impact to jobs numbers was insignificant. In particular, researchers wrote: “Our findings indicate that the average labor supply effects of the ACA were close…
Umair Shah’s story isn’t an uncommon one in public health. Starting out in medicine, with a career as an emergency department doctor, he said it quickly became clear that most of what impacts our health happens outside the hospital and in the community. Today, that philosophy drives his work as executive director of Harris County Public Health (HCPH) in Houston, Texas — an agency that serves the third-largest county in the nation, home to about 4.5 million residents. In fact, Shah, who first joined the agency in 2004 and become director in 2013, said the agency’s mantra is this: “Health…
Like millions of others, I was hugely relieved to get the news early Friday morning that three Republican Senators had joined 48 of their Democratic and Independent colleagues to vote down the third Republican proposal to take healthcare away from millions of people. Now’s a good time to think about how we got here and what comes next.   The Affordable Care Act For much of 2009, Democratic members of Congress spent months negotiating with Republican colleagues and one another on the legislation that would eventually become the Patient Protect and Affordable Care Act. Over many hours of debate…
With the future of the Affordable Care Act still up in the air, most of the news coverage has gone to insurance coverage, premiums and Medicaid. And rightly so. But also included in the massive health reform law were a number of innovative measures to improve the quality and value of the medical care we actually get in the doctor’s office. With repeal still on the table, those measures are at risk too. One of those ACA efforts is the Hospital Readmissions Reduction Program, which reduces Medicare payments to hospitals with relatively high rates of often-preventable hospital readmissions. The…
Remember in the bad old days before the Affordable Care Act, when those who bought individual plans on the private market faced unpleasant surprises – like finding at out very inopportune times that their plans didn’t cover hospitalization or maternity care, or that they’d reached a lifetime limit and their insurer wouldn’t pay for any more care at all? When dysfunctional insurance markets meant individual coverage was effectively impossible to purchase for all but the healthiest or wealthiest? If Senate Majority Leader Mitch McConnell has his way, we’ll be going back to those hated…
While much public attention is (appropriately) focused on the Senate bill that would shred the Medicaid program, House Freedom Caucus members are pushing a proposal to shred other parts of the social safety net: welfare, or Temporary Assistance for Needy Families (TANF), and food stamps, or Supplemental Nutritional Assistance Program (SNAP). Both the Senate BCRA and the Freedom Caucus budget proposal aim to cut spending on these crucial assistance programs while granting large tax breaks that disproportionately benefit the wealthy. Representative Jim Jordan (R-Ohio) has put forward a budget…
The Congressional Budget Office’s initial score of the Senate’s “Better Care Reconciliation Act” calculated that 22 million people, 15 million of them Medicaid beneficiaries, would lose health insurance by 2026. For Medicaid recipients, though, the picture worsens steadily after that ten-year window, due to per-capita caps on how much the federal government would contribute. At the request of Senate Budget Committee Ranking Member Bernie Sanders and Finance Committee Ranking Member Ron Wyden, CBO has also estimated Medicaid spending for the post-2026 decade under current law vs the BCRA. They…
Kim Krisberg has already ably described how the Senate’s “Better Care Reconciliation Act” would gut Medicaid while giving massive tax breaks to the wealthiest, so I want to emphasize a few key points that are worth bearing in mind. The Congressional Budget Office score of the Senate bill finds that over the next 10 years, 22 million people would lose coverage (relative to keeping the current law), and 15 million of those people would be losing Medicaid. The worst of the Medicaid cuts would come after 2026, though, as the per-capita cap on the federal share of spending rises much more slowly…
In Cuyahoga County, Ohio, nearly 200 people have died from opioid-related overdoses in the first five months of this year. That means that this one U.S. county is on pace to lose more than 700 people to fatal overdoses by the end of 2017. Terry Allan, health commissioner at the Cuyahoga County Board of Health, and colleagues across the county have spent years building and scaling up a multifaceted response to the opioid addiction and overdose epidemic that includes getting people into treatment, changing clinical prescribing habits, preventing deadly overdoses, and dealing with the often-…
The House and Senate health care bills are overflowing with proposals that will strip Americans of access to quality, affordable health care. But perhaps the cruelest part is what they do to children — the most vulnerable and powerless among us. Children can’t show up at the ballot box to protect their health and so it truly is up to the rest of us. Right now, after decades of hard work, the U.S. has achieved near-universal insurance coverage of its littlest residents. About 95 percent of U.S. kids have health insurance. Unfortunately, the House and Senate proposals to replace the Affordable…
This is the harsh reality of the Senate health care bill: it provides tax cuts to the wealthiest Americans, while taking away access to timely medical care from the poorest, most vulnerable Americans. You’ve probably been hearing this point a lot about the GOP’s repeal-and-replace efforts, and it’s easy to relegate it to partisan hyperbole. But the sad truth is that, well, it’s the sad truth. The Senate’s “draft” health care bill, released this morning, proposes sweeping changes to the Medicaid system, which now provides health coverage for 76 percent of poor children, 60 percent of children…
Despite glowing reviews from the House GOP about their health care bill, the people that actually crunch the numbers say it’ll likely mean millions more uninsured and higher premiums for people in poorer health. Now comes more bad news: it’ll also result in more than 900,000 lost jobs and billions in lost state revenue. A new report from researchers at the Commonwealth Fund and George Washington University Milken Institute School of Public Health calculated the impact of the American Health Care Act (AHCA), which House Republicans passed in May, on employment and economic activity in every…
Because there’s so much at stake as the Senate considers the American Health Care Act, here are some important articles on healthcare legislation: Andy Slavitt in the Washington Post: The Senate’s three tools on health care: Sabotage, speed and secrecy Dylan Scott at Vox: Senate Republicans are closer to repealing Obamacare than you think Elena Marks in the Houston Chronicle: The American Health Care Act: a civic and moral failure Vann R. Newkirk II in The Atlantic: How the American Health Care Act Would Affect Mental-Health Coverage Emma Sandoe at her personal blog: How the HIV outbreak in…