Issue Brief posted November 23, 2016
The ACA’s Risk Programs: Why Congress Needs to Prevent Insurer Bailouts
The Affordable Care Act (ACA) put in place three separate programs designed to mitigate some of the risks assumed by health insurers participating in the markets that are most significantly affected by the health care law. The three programs are reinsurance, risk corridors, and risk adjustment.
As a result of the ACA’s inherent flaws and questionable actions taken by…
Backgrounder posted May 28, 2015
Medicare Advantage Under the ACA: Replace Payment Cuts with Market-Based Reforms
Medicare Advantage (MA) offers seniors the option of private health plans as an alternative to traditional Medicare. The private plans in Medicare Advantage provide more comprehensive coverage and are typically more generous that traditional Medicare. Today, more than 30 percent of Medicare beneficiaries are enrolled in an MA plan.
The Affordable Care Act of 2010 (ACA),…
Issue Brief posted February 23, 2015
Eight Groups Harmed by the ACA’s Flawed Policies
The Supreme Court will hear oral arguments on March 4 in the case of King v. Burwell—a challenge to an IRS rule under the Affordable Care Act (ACA) allowing the payment of premium subsidies to individuals enrolled in the federal exchange. Supporters of the ACA have made various claims about the harm that would supposedly occur were the court to find for the plaintiffs…
Issue Brief posted January 21, 2015
Replacing Medicare’s SGR: Four Bipartisan Options to Finance a Permanent Fix
The new Congress must stop irresponsible federal spending. This applies to replacing the Medicare Sustainable Growth Rate (SGR) formula that annually updates Medicare physician payment with a workable alternative.
In 2014, House and Senate negotiators, representing three major congressional committees, worked long and hard to hammer out a compromise SGR replacement…
Issue Brief posted December 22, 2014
Measuring Choice and Competition in the Exchanges: Still Worse than Before the ACA
My guiding principle is, and always has been, that consumers do better when there is choice and competition. That’s how the market works. Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. And without competition, the price of insurance goes up and…
Backgrounder posted November 6, 2014
Understanding the CBO’s Changes in Medicare Spending Projections
Changes in the Medicare spending projections by the Congressional Budget Office (CBO) have prompted a new debate over the fiscal health of the Medicare program. Some journalists and commentators have interpreted the CBO’s lowering of its Medicare spending projections over the past nine years as a possible indication that Medicare’s fiscal crisis is tapering. The New York…
Backgrounder posted October 30, 2014
A Fresh Start for Health Care Reform
Despite President Barack Obama’s insistence that the national health care debate is over, and that he will not “re-litigate” the misnamed Patient Protection and Affordable Care Act (PPACA), the practical concerns, aggravated by implementation glitches and policy failures, guarantee that the debate over the PPACA is far from over.
In the next phase of the health care…
Backgrounder posted September 4, 2014
Progress in Medicare Advantage: Key Lessons for Medicare Reform
Medicare Advantage (MA) is a program of competing private health plans. For the vast majority of senior citizens, it is the only viable alternative to enrollment in traditional Medicare. For Members of Congress, its record also provides valuable lessons for comprehensive Medicare reform.
MA is an increasingly attractive option for millions of senior and disabled…
Issue Brief posted August 1, 2014
The 2014 Medicare Trustees Report: A Dire Future for Seniors and Taxpayers Without Reform
The recently released annual Medicare trustees report reiterates a decades-old message: The Medicare program faces an unsustainable financial future. Unless the program is reformed, it will impose a huge financial burden on American taxpayers and jeopardize access to care for seniors.
While these facts are incontrovertible, the Obama Administration’s allies and some in…
Issue Brief posted March 11, 2014
Proposed Rules for Part D Would Create Undue Disruption for Seniors
The Obama Administration’s Centers for Medicare and Medicaid Services (CMS) has announced that it will not finalize controversial elements of its proposed Medicare rule. The proposed rule would have undercut patient choice and reduced the competition that controls costs in the Medicare drug program (Part D). Many key stakeholders and Members of Congress expressed…
Issue Brief posted February 11, 2014
“Junk” Health Plans and Other Obamacare Insurance Myths
Obamacare affects nearly all areas of health care, but the most disruptive provisions of the law affect insurance sold in the individual market. In 2013, at least 4.7 million policyholders across 31 states and the District of Columbia were notified that their current coverage was being discontinued. The number is likely even higher, since data were not available for 19…