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  • Backgrounder posted January 29, 2015 by Edmund F. Haislmaier, Drew Gonshorowski Q3 2014 Health Insurance Enrollment: Employer Coverage Continues to Decline, Medicaid Keeps Growing

    During the third quarter (Q3) of 2014, enrollment in employer-sponsored coverage continued to decline, while Medicaid enrollment continued to grow. However, enrollment in individual-market plans—which substantially increased in both of the first two quarters—also declined by 357,000 during the third quarter. The net result was that total enrollment decreased by 160,000…

  • Issue Brief posted January 21, 2015 by Robert E. Moffit, Ph.D., Alyene Senger 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…

  • Backgrounder posted December 29, 2014 by John S. O'Shea, M.D. Reforming Graduate Medical Education in the U.S.

    The U.S. health care system has some of the most highly qualified, competent doctors in the world, and the care that they provide is generally as good as—and in many cases, superior to—that in other nations. However, America’s current system for training doctors after graduation from medical school needs substantial reform. The primary deficiency is an uncoordinated and…

  • Issue Brief posted December 22, 2014 by Alyene Senger 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…

  • Commentary posted December 15, 2014 by Robert E. Moffit, Ph.D. Obamacare: A Brewing Fiscal Fiasco

    There is more to this week’s House hearing with Massachusetts Institute of Technology economist Jonathan Gruber than just an examination of his disparaging comments about the American public’s understanding of Obamacare. Rep. Jason Chaffetz (R-Utah) of the House Committee on Oversight and Government Reform asked Gruber for copies of his taxpayer-funded modeling results,…

  • Commentary posted December 11, 2014 by Edmund F. Haislmaier Should Obamacare be Repealed, Replaced or Left Alone?

    In the wake of Republican mid-term electoral victories, and with support for the President’s health care law registering new lows in the Gallup survey, it is time to consider what a “repeal and replace” strategy for Obamacare might actually look like. While it is true that the politics and timing remain fluid, it is still possible to outline substantive changes. At the…

  • Commentary posted December 9, 2014 by Robert E. Moffit, Ph.D. How to Reform Medicare

    Every year, Medicare physician payment rates spark a legislative fire drill. The complex formula for updating doctors’ reimbursements, the sustainable growth rate formula, routinely threatens Medicare physicians with draconian payment cuts. Next year, the formula mandates a 21 percent pay cut. The sustainable growth rate formula, created in 1997, has never been…

  • Commentary posted December 9, 2014 by Robert E. Moffit, Ph.D. Another Bad Checkup for the Affordable Care Act

    The implementation of the Affordable Care Act seems like an unending nightmare. Desperate for some good news, the White House is justly relieved and celebrating the fact that the government website is not plagued with last year’s disasters. But other big challenges loom, including the administration of the law’s hideously complex insurance subsidy system, as well as…

  • Backgrounder posted December 8, 2014 by Patrick Louis Knudsen, Robert E. Moffit, Ph.D. The Affordable Care Act’s Mounting Budgetary Pressures

    Throughout the development of their ambitious national health insurance plan, President Barack Obama and his congressional allies vowed that the sprawling new entitlement program would not worsen the government’s already disturbing fiscal outlook. “I will not sign a plan that adds one dime to our deficits,” the President had declared, “either now or in the future.”[1] It…

  • Issue Brief posted November 20, 2014 by Robert E. Moffit, Ph.D. Medicare’s SGR: Fixing It the Right Way, Not in a Lame Duck Session

    Congress needs to junk the sustainable growth rate (SGR) formula that governs Medicare physician payment. Under the formula, if Medicare physicians’ payments in any given year increase by more than the economy’s growth, an automatic and proportionate reduction in their reimbursements is imposed the following year. Conceptually flawed and practically draconian, the formula…

  • Commentary posted November 10, 2014 by Nina Owcharenko, Robert E. Moffit, Ph.D. Lame duck legislators ought not act on complex health policy issues

    A lame-duck Congress typically is driven by a desire to "get things done." But lawmakers should resist ramming last-minute deals on Medicare physician payments and the Children's Health Insurance Program through this Congress. These are complex and highly consequential health policy issues. They deserve prudent deliberation by the people's chosen representatives, i.e.,…

  • Backgrounder posted November 6, 2014 by Alyene Senger 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…

  • Commentary posted November 6, 2014 by Edmund F. Haislmaier The Truth Behind Obamacare Numbers

    As a presidential candidate, Barack Obama promised that his health reform plan would "lower premiums by up to $2,500 for a typical family." So it's not surprising that many people are dismayed by the rising costs under the health reform law he subsequently signed. But the president and the lawmakers who created Obamacare were always far more focused on increasing…

  • Commentary posted November 4, 2014 by Robert E. Moffit, Ph.D. Can Congress Find a Cure for Medicare's Growing Troubles?

    Medicare: an entitlement program “too big to fail.” With the challenges the program faces—some of which are thanks to Obamacare—the new Congress will have a big challenge to overcome. It’s an entitlement program “too big to fail.” Medicare now covers 52 million seniors and disabled citizens. That’s why you can expect the seemingly unending debate on Medicare to resume…

  • Backgrounder posted October 30, 2014 by Edmund F. Haislmaier, Robert E. Moffit, Ph.D., Nina Owcharenko, Alyene Senger 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.[1] In the next phase of the health care…