Morning Briefing
Summaries of health policy coverage from major news organizations
Additional $8B For High-Risk Pools Swayed Lawmakers But Experts Say It Isn't Enough
The New York Times: Extra Billions For Health Bill? Researchers Say It’s Still Not Enough
Is $8 billion enough to get the House health bill passed? And is it enough to ensure that people with pre-existing medical conditions will still be able to get insurance if Congress repeals the Affordable Care Act? The answer to the first question is maybe. On the second, it’s very likely to be no. (Abelson and Sanger-Katz, 5/3)
The Washington Post: House GOP Strategy To Save Health-Care Bill Hinges On More Money For Preexisting Conditions
Even before the precise language was released Wednesday night, leading health policy experts said the amendment raises big questions about how — and how well — it would work in practice. Among the most significant: How many states would back away from the federal protections for people with medical conditions? And how many of those people would lose their coverage because of other changes in the House plan? “Does it really guarantee that all individuals who have preexisting conditions will be able to find insurance at affordable rates?” said Dan Mendelson, president of Avalere Health, a Washington-based consulting firm. (Goldstein, 5/3)
The Washington Post: Here’s What You Need To Know About Preexisting Conditions In The GOP Health Plan
Before the Affordable Care Act, insurance companies could consider a person’s health status when determining premiums, sometimes making coverage unaffordable or even unavailable if a person was already sick with a problem that required expensive treatment. The ACA prohibited that, in part by requiring everyone to purchase insurance. But that “individual mandate” was unpopular and Republicans would eliminate that requirement in their proposed American Health Care Act. (Kessler, 5/4)
The Wall Street Journal: Jumping Into High-Risk Insurance Pools
The sickest 10% of Americans account for about two-thirds of health-care spending, according to the Kaiser Family Foundation. The ACA requires almost everyone to have insurance or pay a fine so healthy customers would subsidize sick ones. High-risk pools take a different approach, separating the sickest people into their own pool so premiums for healthy customers would fall. (Hackman, 5/3)
Modern Healthcare: Extra $8 Billion May Push House Repeal Bill Over The Finish Line, Despite Policy Doubts
Some insurers are skeptical as well. "It's unclear what difference the amendment makes, besides leaving the funding for high-risk pools and pre-existing conditions marginally less underfunded," said Meg Murray, CEO of the Association for Community-Affiliated Plans. The additional funding "is a blip compared with the damage the bill does to the healthcare system." (Meyer, 5/3)
The New York Times: Pre-Existing Conditions: Evaluating Competing Claims
In the debate over how the effort to replace the Affordable Care Act would affect those with pre-existing health conditions, opponents and supporters alike have offered misleading talking points. Faced with polling indicating public support for protections, and after an emotional appeal by the television host Jimmy Kimmel that has gone viral, Republicans are making a dubious case that their updated bill provides similar coverage for those who are less healthy, while Democrats are overstating claims about how many are affected. Here’s an assessment. (Qiu, 5/3)
Politico: Extra Cash In Health Bill Gets Votes — But Not Coverage
“Short answer, this does not make any meaningful difference,” said Chris Sloan, a senior manager at consultant Avalere Health, who did an analysis of the legislation’s stability fund. “High-risk pools are incredibly expensive and an additional $8 billion over five years doesn’t lead to that [many] more people being able to be covered. ”Even Rep. Fred Upton (R-Mich.), the lawmaker who got the extra money in the bill, said he didn’t know if $8 billion extra money — added to the $130 billion already included in the bill — was the right number. (Cancryn, 5/3)
NPR: House To Vote On GOP Health Care Bill Thursday, Majority Leader Kevin McCarthy Says It Will Pass
Several states have tried high-risk pools in the past, but they were typically underfunded, leaving millions of people with no access to adequate health care. Lawmakers hope that by putting the heft and money of the federal government behind them, they may work better. The federal government is already in the business. It pays for the health care of more than 40 percent of the population, through Medicare, Medicaid, the military and the Department of Veterans Affairs, according to the Census Bureau. (Kodjak, 5/3)
The Wall Street Journal: Top 10 States For Pre-Existing Conditions All Went For Trump
[The] “yes’’ votes on the bill are coming largely from lawmakers whose states have the largest shares of people likely to be affected by changes to coverage for pre-existing conditions, the Kaiser figures suggest. These lawmakers as a group are arguing that the bill will cut insurance costs while offering “layers of protections,’’ as House Speaker Paul Ryan put it, for those with medical conditions. Data from the Kaiser Family Foundation gives a broad sense of which states have the most at stake in the debate over whether the House GOP bill leaves people with medical conditions protected or disadvantaged. (Chinni, 5/3)
Los Angeles Times: California Shows Why The Republican Plan To Rely On States To Replace Obamacare May Not Work
Richard Figueroa still shudders at the memory of the calls he fielded as enrollment director of California’s special health plan for sick patients who’d been rejected by insurers. Desperate callers pleaded to get off the waiting list as cancer or other illnesses worsened. Enrollees struggled to understand why the plan would not cover all the treatment they needed. (Levey, 5/3)
The New York Times: Jimmy Kimmel Sheds Light On Health Coverage For Infants With Birth Defects
Jimmy Kimmel’s tearful description of his newborn son’s heart defect has galvanized parents across the country. A few shared his experience as a frantic new father; many more gave silent thanks that they had been spared this ordeal. But the talk-show host’s monologue has also focused new attention on how infants with such birth defects were cared for before passage of the Affordable Care Act, and what may lie ahead for them should the legislation be repealed. (Kolata and Goodnough, 5/3)
The Hill: Experts: New GOP Funding For Health Bill Not Nearly Enough
Healthcare experts are panning the change to the House's ObamaCare repeal-and-replace bill on coverage for pre-existing conditions, saying it would not make much of a difference. The amendment from Rep. Fred Upton (R-Mich.) would add $8 billion over five years to help people with pre-existing conditions in states that elect to waive certain ObamaCare protections. (Sullivan, 5/3)
