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  • Commentary posted March 30, 2015 by Alyene Senger Are we better off now, five years into Obamacare?

    Obamacare just passed its fifth anniversary as a law, but don't be surprised if you didn't hear much about it. After all this time, polls show the public still doesn't like it. Results are more important than perception, of course. So let's ask: If Obamacare is measured on four important metrics - cost, coverage, competition and choice - are we better off now? Cost.…

  • Issue Brief posted March 30, 2015 by Edmund F. Haislmaier King v. Burwell: A Loss of Subsidy Does Not Mean a Loss of Coverage

    An important distinction is getting lost in commentary on the possible effects of a Supreme Court decision in the case of King v. Burwell. It is the distinction between how the Court’s ruling would affect “insurance subsidies” versus how it would affect “insurance coverage.” Should the Court reject the Obama Administration’s regulatory interpretation of the provisions of…

  • Issue Brief posted March 5, 2015 by Edmund F. Haislmaier King v. Burwell: What State Lawmakers Should Do

    State lawmakers—particularly those in states that would be affected by a Supreme Court ruling against the Obama Administration in the King case—should take steps to encourage Congress to put forth a legislative response to the case, specifically by exempting affected states from the costly Obamacare rules, regulations, and mandates.[1] Reject a State Exchange State…

  • Issue Brief posted February 27, 2015 by Nina Owcharenko, Edmund F. Haislmaier King v. Burwell: An Opportunity for Congress and the States to Clear Away Obamacare’s Failed Policies

    On March 4, the Supreme Court will hear oral arguments in King v. Burwell—a case challenging the Obama Administration’s IRS ruling granting premium support subsidies to those enrolled in federal exchanges under the Affordable Care Act (ACA). While a ruling against the Administration would preclude paying those subsidies to individuals who obtain coverage through the…

  • First Principles Series Report posted February 25, 2015 by Robert E. Moffit, Ph.D. Federalism and Freedom: Orestes Brownson’s Case for the Federal Constitution

    Over the past 100 years, conservatives and Progressives have battled over the meaning and relevance of the U.S. Constitution. Many of these disagreements have focused especially on the relationship between the federal government and the states. Progressives old and new have long dismissed states’ powers as annoying relics of a bygone era. Progressives assert that…

  • Issue Brief posted February 23, 2015 by Alyene Senger 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 February 20, 2015 by Edmund F. Haislmaier Impact of King v. Burwell: The ACA’s Key Design Flaws

    On March 4, the Supreme Court will hear oral arguments in King v. Burwell, a challenge to an IRS ruling related to the Affordable Care Act (ACA) granting premium support subsidies to those enrolled in federal exchanges. While claims that a ruling in favor of King would disrupt coverage to millions,[1] it is important to recognize that the ultimate source of any…

  • Issue Brief posted February 20, 2015 by Edmund F. Haislmaier King v. Burwell: Assessing the Claimed Effects of a Decision for the Plaintiffs

    Should the Supreme Court rule in King v. Burwell—a case challenging the Obama Administration’s implementation of the premium tax credit provisions of the Affordable Care Act (ACA)—that the statute restricts the payment of premium tax credits only to individuals obtaining coverage “through an Exchange established by [a] State,” its ruling would preclude the Treasury paying…

  • Commentary posted February 3, 2015 by Robert E. Moffit, Ph.D. Memo to 114th Congress: First, repudiate Washington's ruling class

    The majority of newly elected members of Congress are men and women who ran and won in direct opposition to President Obama’s policies. But there is more to their victory than a triumph over liberal policies. The 2014 election also represents a repudiation of an attitude and style of governance that has become entrenched in Washington’s political culture:  an arrogant,…

  • 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…