Insurance Coverage and Medical Care

President Trump signed an executive order today that will allow businesses and individuals to buy association health plans that will not have to comply with the Affordable Care Act. See the official White House release about the provisions of the executive order here

The Georgetown University Center on Health Insurance Reforms has released a...

President Trump signed an executive order today that will allow businesses and individuals to buy association health plans that will not have to comply with the Affordable Care Act. See a video of the signing ceremony at the White House here. Read Washington Post coverage...

Today, NBC news published a report that President Trump has said he is about to sign an executive order to allow Americans to purchase health insurance policies across state lines. The ACA already has a provision for selling insurance across state lines so long as the plans meet certain minimum standards of coverage and five states have such laws on the books already. However, no insurer currently sells such policies.

Remember that after the Affordable Care Act passed, numerous commentators predicted that increased insurance coverage, achieved through purchase of individual plans through the ACA marketplace or expanded Medicaid coverage, would precipitate a primary care shortage? Experts feared that those with new coverage would not actually have access to care and those previously insured might experience decreased access to primary care. Studies have shown that primary care availability hasn’t suffered as expected.

Remember that after the Affordable Care Act passed, numerous commentators predicted that increased insurance coverage, achieved through purchase of individual plans through the ACA marketplace or expanded Medicaid coverage, would precipitate a primary care shortage? Experts feared that those with new coverage would not actually have access to care and those previously insured might experience decreased access to primary care. Studies have shown that primary care availability hasn’t suffered as expected.

The bill proposed this week by Senators Graham and Cassidy would repeal many provisions of the  Affordable Care Act and redesign the Medicaid program. Through 2026 the federal government would  provide each state a block grant in lieu of funding for Medicaid expansion and subsidies for health insurance purchased through the ACA marketplaces. Federal funding for Medicaid, absent the expansion, would be converted to a per capita cap basis, reducing federal expenditures over time. After 2026, the block grant would disappear. The bill would also eliminate consumer insurance protections of the ACA including prohibitions against annual and lifetime limits and underwriting practices related to pre-existing conditions.  

In Washington, the philosophical and political questions about the future of health care in the U.S. are swirling. A House bill to repeal and replace the Affordable Care Act and change Medicaid financing was considered early in 2017 and failed. Notably absent from the debate surrounding this bill was how to fix the underlying cost drivers of health care. If and when other proposals are considered, the question of cost drivers will likely be absent from those debates as well. The action to tackle affordability is in the states. Medicaid directors are transforming the way health care is paid for and delivered to contain costs and improve health outcomes. This transformation is taking place in partnership with consumers, providers and other payers.

Proceedings of the Medicaid 201 Leadership Policy Academy, Sept. 13-15, 2017

 

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On Aug. 30, Ohio Gov. John Kasich and a bipartisan group of 7 other governors released a letter to congressional leaders that outlines reforms Congress should consider to strengthen states’ health insurance markets. 

CSG South

A vital tool for policymakers across the region, Comparative Data Reports (CDRs) offer a snapshot of conditions on a number of issues. Published annually, the CDRs track a multitude of revenue sources, appropriations levels, and performance measures in Southern states, and provide a useful tool to state government officials and staff.

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