Perspectives: Taking Stock Of The Health Reform Policy Paths Taken So Far And What Could Happen Next

The New England Journal Of Medicine: Moving In The Wrong Direction — Health Care Under The AHCA
On May 4, the U.S. House of Representatives resurrected Republican efforts to enact major health care legislation by narrowly passing the American Health Care Act (AHCA). A growing body of analytic work, including a Congressional Budget Office (CBO) assessment delivered on May 24,1 paints a dismal picture of how the AHCA would affect the health care system. The CBO analysis shows that the legislation would reduce the number of people with insurance coverage by 23 million, while narrowing coverage or increasing its cost for millions more. The resulting budgetary savings would finance tax cuts that would accrue disproportionately to high-income families. These effects contrast starkly with President Donald Trump’s promises that health care legislation would cover more people while lowering costs for families. (Matthew Fiedler, Henry J. Aaron, Loren Adler and Paul B. Ginsburg, 5/31)

The New England Journal Of Medicine: The First Hundred Days For Health Care
Like my predictions about what a Republican win in the 2016 election would mean for U.S. health policy, my expectations about the ease and speed of passing an Affordable Care Act (ACA) replacement bill during President Donald Trump’s first 100 days in office have not exactly come to fruition. But given the Republican focus over the past 7 years on “repealing and replacing” the ACA and Trump’s promise to make health care reform an early focus of his administration (at one point, he suggested having Congress meet even before his inauguration), Congress’s attention to the issue has not been surprising — even if it’s not directly in line with Trump’s dominant campaign theme of “making America great again.” Indeed, it’s been argued that the economy and jobs would have been a politically easier first target than health care — an argument that was made retrospectively for the Obama administration as well. (Gail R. Wilensky, 5/31)

The New England Journal Of Medicine: Prospects For Health Care Reform In The U.S. Senate
The acid test of any nation’s health care reform happens with a change in national administration. Only when a president or minister who instigated reform departs and a new regime assumes power can we judge the durability of any reform law or program. Like it or not, now is that moment for the Affordable Care Act (ACA) in the era of President Donald Trump. Over the coming months, U.S. society will decide, through the Congress, which of President Barack Obama’s reforms will survive and which will not. (John E. McDonough, 5/31)

Morning Consult: As Senate Debates Ending Obamacare, Latino Lives Hang In The Balance
When President Barack Obama signed the ACA into law in 2010 he enacted a piece of legislation that fundamentally changed and improved the lives of millions of Latinos throughout the United States. Families that had been priced out of health insurance could now afford coverage. Latinos denied coverage because of preexisting conditions, now could get the care they needed. Latinas who couldn’t afford important prenatal care, could now have a safe and successful pregnancy and, just as important, have contraception fully covered under preventative care. For a community besieged by high rates of chronic diseases such as diabetes, asthma, and low birth weight, the ACA has been, quite literally, a lifesaver. (José Calderón, 6/2)

Bloomberg: The 'Right' To Health Care Is The Wrong Question 
Is there a right to health care? Our arguments about health policy frequently highlight the question. The liberals at Slate magazine have answered yes, and the conservatives at the American Spectator have said no. Actress Laura Dern has affirmed such a right, and Republican Representative Raul Labrador denied it. Miss USA has been on both sides of the question. And all of this was just in May. As much as people argue about it, it’s not a very good question -- not, at least, in our society, in which nearly everyone agrees that all people must have access to some basic level of health care. Because of that consensus, conservatives who deny a right to health care don’t really mean it, and liberals who affirm it can’t use it to clinch the case for their favored policies. (Ramesh Ponnuru, 6/1)

Axios: What's Really At Stake In The Medicaid Spending Debate
The $834 billion cut in federal Medicaid spending in the American Health Care Act would kick off budget battles in the states that go way beyond Medicaid. We could see cuts to higher education, school funding, corrections, environmental protection or other state priorities — or new taxes, depending on the state. ... A new analysis from long time state Medicaid expert Vern Smith at HMA suggests why. To offset the $834 billion in reductions in federal Medicaid spending in the AHCA, states would need to increase their own general fund spending by an average of one third beginning in 2022, and 37% in 2026. (Drew Altman, 6/2)

Bloomberg: Americans Sure Seem To Like Universal Health Care
Americans, in general, support government-provided universal health care. A Pew Research Center survey taken in January found that 60 percent say that it’s the responsibility of the federal government to make sure that all Americans have health coverage. A Morning Consult/Politico poll in April found that support for a single-payer health system outweighs opposition, by 44 percent to 36 percent (with 19 percent unsure). A Gallup poll turned up similar results. In fact, support for universal health care isn’t a recent phenomenon; it was high before the bruising political battles over the Affordable Care Act. (Noah Smith, 6/1)

The Wall Street Journal: California’s ‘Free’ Health Care Won’t Come Cheap
Democrats in California’s state Senate spent Thursday hemming and hawing over Senate Bill 562, the Healthy California Act. When this column went to print, the Democratic caucus was still debating whether to bring the bill to a vote. The legislation would create a single-payer health-care system to cover all Golden State residents. This proposal would kneecap California’s economy and saddle millions with the life-threatening wait times, rationed care and out-of-control costs that plague all single-payer systems. (Sally C. Pipes, 6/1)

The Sacramento Bee: Californians Like Universal Care, Unless They’re Taxed
A new poll indicates that most Californians support changing the state’s immense, insurance-based medical care system to one in which the state provides universal coverage. (Dan Walters, 6/2)

The Des Moines Register: Who Needs Insurance They Can't Afford?
In a sense, Iowa’s high-risk insurance pool could be a safety net for individuals who might otherwise have no health coverage. But it’s a safety net that may not be accessible to those who need it most. As reported by the Register's Tony Leys, only three carriers sell individual policies in many Iowa counties right now: Aetna, Medica and Wellmark Blue Cross & Blue Shield. All three have said that in 2018 they’ll probably stop selling those policies. They cite market instability related to the Affordable Care Act and the GOP’s repeated efforts to not only weaken the law but also replace it with something that is as yet undefined. (6/1)

Forbes: Americans Are Baffled By Long-Term Care Financing, But Want Medicare To Pay For It
Americans age 40 and older continued to be flummoxed by the challenges of long-term care financing, but increasingly believe that Medicare ought to provide such supports and services. According to a new poll by the Associated Press-University of Chicago NORC Center for Public Affairs Research (AP-NORC), support for a Medicare long-term care benefit has grown significantly over the past five years. And for the first time since the survey began, a majority of Republicans favor Medicare long-term care. (Howard Gleckman, 5/30)