This is our second health care reporter’s sum-up, a weekly series for TPM Prime.
This weekend, at their annual party retreat, Republican lawmakers admitted openly what we’ve long suspected: With the midterm elections looming, Congress will not be able to pass a bill to repeal Obamacare in 2018.
That means that most major policy changes will happen on the state level, and the past week had no shortage of news. The Trump administration gave Indiana the green light to impose work requirements, premiums, and a 90-day lockout provision on its Medicaid population. This announcement follows a similar one in Kentucky. Indiana’s HHS waiver is expected to kick tens of thousands of people off of Medicaid.
Meanwhile, Idaho has decided to flout the Affordable Care Act. The state announced that it will allow health insurance companies to sell plans that violate the ACA’s regulations — for example, plans that exclude coverage for pre-existing conditions, or that charge sick people higher premiums. Some experts say the state’s move is “crazypants illegal,” arguing that states can’t simply ignore parts of federal laws that they don’t like. But it’s unclear whether Trump’s new HHS Secretary, Alex Azar, who is no fan of the ACA, will crack down on Idaho. If he doesn’t, it would open the door for other states to follow Idaho’s lead.
At the federal level, Congress must address a crisis hammering the nation’s Community Health Centers (CHC), which serve tens of millions of low-income Americans, many in rural areas. The program has for weeks been on the brink of running out of money. GOP lawmakers in the House have proposed including two years of funding in the next continuing resolution, which must pass by Thursday to avoid another government shutdown. In the meantime, health centers across the country are cutting their hours and staff in the face of the uncertainty.
Health care made a minor appearance in President Trump’s first State of the Union, where he inaccurately stated that Obamacare’s individual mandate is already gone. It’s not — not until 2019, at least. Americans are still required to have health insurance this year or pay a tax penalty. Trump also asserted that the individual mandate is the “core” of Obamacare — implying that, by getting rid of it, the GOP-controlled Congress had repealed the entire law. This is, at best, debatable. Killing the mandate will lead to a drop in coverage and a subsequent a bump in premiums, but the jury is out on how big of an impact this will have as long as federal subsidies for health plans remain available.
The health care section of the State of the Union was also notable for what was left out: namely, that the ACA had a gangbusters open-enrollment period despite the administration’s efforts to sabotage it. Several states that run their own exchanges saw enrollment reach record levels.
Read More →