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Republicans take critical first step to protect health insurance coverage for millions

After a couple of false starts, Republicans in the U.S. House passed a bill to follow through on their promise to repeal and replace Obamacare. Getting this bill passed was a critical first step in saving health coverage for the millions of Americans who are experiencing the collapse of the individual health insurance market under the weight of Obamacare’s regulations. Several state insurance markets are in the throes of a death spiral—a situation where a market implodes after cycles of rising premiums prompt healthy people to abandon the market, leaving behind an unsustainably sick and expensive pool. The benchmark plan the Kaiser Family...

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House bill to repeal and replace Obamacare strengthens pre-existing condition protections

Several moderate Republicans remain opposed to the American Health Care Act (AHCA) because, as they see it, the bill weakens Obamacare’s protections for people with pre-existing conditions. These Republicans must not understand the crisis unfolding in individual health insurance markets across the country and the risk this poses to people with pre-existing conditions.  The fact is, the AHCA will strengthen protections to people with pre-existing conditions by giving states the flexibility they need to stabilize insurance markets and the funding they need to develop new programs to guarantee robust coverage to people with high risks. Premium increases threaten coverage for people with pre-existing conditions Premium...

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The GOP’s Current Obamacare Bill, Coherently Explained

Pretty much all conservatives have been frustrated by the House's inability to pass Obamacare repeal and replacement. Something that seemed simple on the campaign trail has turned out not to be simple in practice. House Republicans now have produced a second version of the bill, which has been improved so as to draw support from the Freedom Caucus. But what exactly is going on? What would the new House bill do? Can the Senate improve it, and if so, how? And, should conservatives support the current House proposal? By far the most coherent discussion of these questions that I have seen...

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MN Medicaid Fraud Case Worth $12 Million, Feds Seize $2 Million

Another alleged case of Medicaid fraud in Minnesota is currently being investigated by the U.S. Attorney’s office. The Star Tribune reports: In a highly unusual move, federal prosecutors have seized $2 million from a former Twin Cities mental-health agency accused of submitting fraudulent bills for home services involving hundreds of Minnesota children and adults. Medicaid-funded care services are a hot-spot for health care abuse. And without major changes to the scam-ridden system, Medicaid rip-offs will continue at the expense of both recipients and taxpayers. ...

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How to Thread the Repeal and Replace Needle

The Trump administration just revived talks on repealing and replacing Obamacare with a new offer to the House Freedom Caucus.  The proposal would allow states to opt out of certain Obamacare regulations that are inflicting the most damage and risk to the individual health insurance market. This is an incredibly positive step that tracks an approach I proposed a couple weeks ago.  However, it likely won’t seal the deal when moderates were already skittish over the previous package, which is likely why The Hill reports Speaker Paul Ryan tried to tamp down expectations today.  As Ryan explained to reporters, “These are...

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Fraud Strikes Again: MN Medicaid Scam Worth $1 Million

The jig is up, again. Three individuals have been charged with allegedly scheming to defraud Medicaid by preying on behavioral health patients. Two drivers and an interpreter serving low-income patients seeking mental health services allegedly conspired with the owner of a Northfield clinic to defraud the federal-state Medical Assistance program out of $1 million through false claims over more than three years, according to a federal grand jury indictment unsealed this week....

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A possible path to give states more control over health insurance markets

Last week the Congressional Budget Office (CBO) released its analysis of the American Health Care Act (AHCA)—the House bill to repeal and replace Obamacare. While the headlines focused on the CBO’s estimate that 24 million people would lose coverage if the House bill passes, I was more interested to see what the analysis reveals about how Obamacare’s insurance regulations might be modified or repealed under the budget reconciliation process. After taking a closer look, the House bill may be missing an opportunity to put states back in control of their insurance markets. To fully repeal Obamacare today, Republicans would need a filibuster-proof...

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Unattainable expectation to fully and immediately repeal Obamacare risks deflating conservatives

On Monday House Republicans revealed draft language to repeal and replace Obamacare. The proposal met an immediate backlash from conservatives. Sen. Rand Paul called it “Obamacare Lite.” FreedomWorks, Heritage Action, the Club for Growth and Americans for Prosperity (AFP) all offered similar critiques and pledged to launch campaigns to oppose the current language. Critics do have reason to complain and demand change, but the current response recklessly sets up the expectation of a full repeal among those in the conservative base, an expectation that Congress cannot meet. Upon failing to meet this expectation, the base may become needlessly demoralized and distrustful. Nearly everyone who pays close attention...

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How a Medicaid program for people who are disabled is funding politics

This is a classic tale of good and evil, and the little guy getting pushed around by the big guy. In the 1970s, our country moved away from institutionalizing disabled people, in favor of keeping them at home, with their family, whenever possible. Today some disabled people get certain benefits from Medicaid. They can use their Medicaid grant to hire personal care attendants (PCAs) to help them with daily living. Not only does this offer a superior care model, it is less expensive for taxpayers. Under a program known as “PCA Choice” disabled adults are able to hire a PCA, often a...

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