Believe It Or Not, The Republican Obamacare Replacement Plan Might Come Together – Forbes

February 20, 2016

Earlier this month, Speaker Paul Ryan announced six task forces, each comprised of House Committee Chairmen, to develop a “bold, pro-growth agenda.” What was remarkable was that one of the task forces was on health care reform. Many had thought Congressional Republicans were investing too much time and energy grandstanding Obamacare repeal, and not enough developing a credible alternative.

That may have changed with the selection of four Committee Chairman to the Health Care Reform Task Force. They are: Budget Committee Chairman Tom Price (R-GA), Education & the Workforce Committee Chairman John Kline (R-MN), Energy & Commerce Committee Chairman Fred Upton (R-MI), and Ways & Means Committee Chairman Kevin Brady (R-TX).

Source: Believe It Or Not, The Republican Obamacare Replacement Plan Might Come Together – Forbes

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Entry Regulation and Rural Health Care: Certificate-of-Need Laws, Ambulatory Surgical Centers, and Community Hospitals | Mercatus

February 20, 2016

Certificate-of-need (CON) laws in 36 states and the District of Columbia restrict competition in healthcare facilities markets by requiring healthcare providers to obtain permission before adding or expanding any regulated facilities or services. One such CON program, currently implemented by 26 states, regulates the establishment and expansion of ambulatory surgical centers (ASCs), “hospital substitutes” that provide select out-patient surgeries and procedures.

Proponents of regulating ASCs through a CON program express concern that ASCs will engage in “cream skimming,” selectively treating more profitable, less complicated, well-insured patients and leaving hospitals to treat the less profitable, more complicated, and uninsured patients. Under these circumstances, ASCs might cause hospitals to close, especially rural hospitals with slim profit margins—thus depriving rural populations of important medical services.

In a new empirical study for the Mercatus Center at George Mason University, scholars Thomas Stratmann and Christopher Koopman evaluate the impact of ASC CON regulations on the availability of rural health care. Their research shows that, despite the expressed goal of ensuring that rural populations have access to health care, CON states have fewer hospitals and ASCs on average—and fewer in rural areas—than non-CON states.

Source: Entry Regulation and Rural Health Care: Certificate-of-Need Laws, Ambulatory Surgical Centers, and Community Hospitals | Mercatus


HHS $3.5 Billion Heist? | Doug’s Brief Case

February 19, 2016

The Department of Health and Human Services (HHS) announced Friday night that it was in the process of shorting the U.S. Treasury $3.5 billion.

Well, they didn’t exactly announce it.  You had to read between the lines.The theft of $3.5 billion will help prop up insurers that have agreed to sell Obamacare policies in the individual market.  Behind all the happy talk from Administration officials about the program’s success lies an unpleasant truth: insurers that participate in Obamacare exchanges are bleeding money.

Those losses are coming despite billions of dollars in handouts the government is providing the industry.  Some of those handouts are entirely lawful; others, not so much.

Source: HHS $3.5 Billion Heist? | Doug’s Brief Case


CRS | Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

February 17, 2016

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

Annie L. Mach Analyst in Health Care Financing Bernadette Fernandez Specialist in Health Care Financing February 10, 2016

Full report: http://www.fas.org/sgp/crs/misc/R42069.pdf


Federal health officials, insurers agree on how to rate doctors’ quality – The Washington Post

February 17, 2016

For the first time, the Medicare program and the health insurance industry have agreed on a set of ratings to gauge how well doctors do their jobs.Leaders of the federal Centers for Medicare and Medicaid Services and the trade group America’s Health Insurance Plans announced Tuesday that they have reached a consensus on how to measure physician quality in seven medical areas, from primary care to treatment of patients with cancer or AIDS.

Source: Federal health officials, insurers agree on how to rate doctors’ quality – The Washington Post


Biden Was Right: Medicaid Provider Taxes A “Scam” That Should Be Scrapped – Forbes

February 16, 2016

Every state except Alaska (and Alaska recently awarded a contract to a firm “to study and develop” a tax proposal) uses Medicaid provider taxes. Since provider taxes are essentially a kick-back, the providers who benefit the most are generally those serving a larger number of Medicaid enrollees. They receive higher Medicaid payments than they would have received in the absence of the tax.

The kick-back often involves extra payments, dubbed supplemental payments, to providers. These extra payments raise serious questions of political influence and cronyism. For example, in 2014 GAO identified two New York City hospitals—Coler Memorial and Coler Goldwater— that received $416 million in extra Medicaid payments in 2011 in addition to $70 million in regular Medicaid payments. These Medicaid payments were nearly five times what Medicare would have paid these hospitals for these services, which is supposed to be the legal limit on what Medicaid can pay.

Source: Biden Was Right: Medicaid Provider Taxes A “Scam” That Should Be Scrapped – Forbes


Left-Leaning Economists Question Cost of Bernie Sanders’s Plans – The New York Times

February 16, 2016

“The single-payer idea has enormous appeal: coverage for everyone, some effort to use the government’s bargaining power to hold down overall costs, clean out the godawful administrative mess that the U.S. health care system is and save money there,” said Henry J. Aaron, a longtime health economist at the Brookings Institution in Washington.

But he called it a “fairy tale” in this political climate. Along with other economists in a “lefty chat group” he joins online, Mr. Aaron said, he believes that if Mr. Sanders were elected and fought for a single-payer plan, it “would rapidly destroy his administration by using up every ounce of political capital he’s got.”

Source: Left-Leaning Economists Question Cost of Bernie Sanders’s Plans – The New York Times