KHN Morning Briefing

Summaries of health policy coverage from major news organizations

full issue

Perspectives On Insurance Markets And Mergers; Preexisting Conditions; Medicaid Reform

Opinion writers explore a variety of health policy issues in play as lawmakers continue to debate changes to the health care system.

The New England Journal Of Medicine: Good Riddance To Big Insurance Mergers
Eighteen months after four of the five largest U.S. health insurers announced multibillion-dollar merger deals, federal judges, siding with the Department of Justice (DOJ), have issued preliminary injunctions halting the two transactions. These decisions will cost the insurers: they spent over $2 billion trying to get the deals done, and the would-be acquirers are due to pay $2.85 billion in breakup fees — and possibly billions more in damages. Moreover, the parties’ conduct has further damaged the public’s view of the insurance industry. (Leemore S. Dafny, 5/11)

The Wall Street Journal: Aetna Says Sayonara To ObamaCare
For all the media think pieces about the nature of truth in the Trump era, Democrats have their own alternative facts about ObamaCare. To undermine the GOP case for repeal and replace, they claim the entitlement is working beautifully. But then what about the latest insurance giant to dump its ObamaCare ballast? (5/11)

Lexington Herald Leader: One Woman’s Cautionary Health Insurance Tale: Living Is A Pre-Existing Condition
Now that a new healthcare bill has passed the House and moved on to the Senate, there is much discussion about the changes proposed. No one knows how the final bill will read, but it looks as if two groups in particular could be subject to significantly higher premiums: those approaching retirement age and those deemed to have preexisting conditions. Remembering my own entry into the individual insurance market in 2003, I shudder to think how this scenario might play out in the lives of millions of Americans. (Susan Owens, 5/10)

The Charlotte Observer: Frightening Times For Families Who Are Fighting Chronic Illness
With the passage of the American Health Care Act by the U.S. House, the United States is one step closer to a country in which people battling chronic illnesses are denied access to the care they need to survive. The ongoing health care debate in Washington has created uncertainty for families fighting chronic diseases. I am the parent of a 21-year-old son who has cystic fibrosis (CF). These are frightening times. (Peter Barry, 5/11)

The Charlotte Observer: What I Meant When I Suggested People With Pre-Existing Conditions Could Move To Another State
About 600,000 North Carolinians were at risk of having zero health insurance options this year when Blue Cross, the only Obamacare option in 95 out of 100 counties, seriously considered pulling out. Humana will pull out of Obamacare nationwide in 2018, and Aetna and CareFirst are on record that Obamacare “is in a death spiral.” While some would have us stick our heads in the sand, House passage of the American Health Care Act was “first base” in a responsible, multiple-step effort with the Senate to repair America’s health care system. (Rep. Robert Pittenger, 5/11)

RealClear Health: Why America Needs A ‘Do-Over’ On Medicaid Reform
One of the most important pieces of the newly passed House health bill is a possible US$800 billion cut over 10 years to Medicaid, the federal program designed to provide insurance coverage to the poor. That bill, entitled the American Health Care Act (AHCA), rolls back part of the expansion of Medicaid that took place under the Affordable Care Act (ACA) by limiting federal contributions toward state coverage of individuals with annual incomes above US$16,643 or families of four with annual incomes above $33,948. With the reduction in federal support, states will now have to decide if they can afford to cover adults with incomes just above the federal poverty line. In addition, the AHCA freezes federal spending per Medicaid beneficiary at its 2016 levels. (Jay Bhattacharya, Anup Malani and Darius Lakdawalla, 5/11)

RealClear Health: Will Senate Republicans Throw Medicaid Under The Bus?
It’s really happening. After the chaos of last week’s House vote, the American Health Care Act (AHCA) is headed to the Senate. Progressives accustomed to watching bills languish in the Senate due to the filibuster can’t afford to be complacent: thanks to budget reconciliation rules and Vice President Mike Pence’s role as tie-breaker, the AHCA only needs 50 votes to pass. In other words, it can pass even if every Democrat and two Republicans vote against it. (Thomas Huelskoetter, 5/12)

Bloomberg: What Democrats Won't Admit About Voters And Health Care
But keep in mind that the American Health Care Act of 2017 does not prevent states from spending whatever is needed to cover pre-existing conditions, if they so choose. The underlying truth is that voters at the state level just aren’t that interested in paying for these benefits, preferring instead to lower taxes, or to spend the money on roads, schools and prisons .In other words, when American voters are given a direct bill for health-care expenditures, they recoil, even when the beneficiaries are in needy or desperate situations. The Democrats are good at tarring the Republicans for indifference to the plight of these people, but less keen to admit that the larger popular indifference plagues their own health-care visions as well. (Tyler Cowen, 5/11)

The Kansas City Star: The Health Care Coverage Gap Is Very Real
With Episcopal Community Services, a nonprofit that has been working to feed the hungry and fight poverty throughout the Kansas City area for 30 years, I meet members of our community every day who are working hard to improve their own lives under very challenging circumstances. Most of these adults fall into the “coverage gap” under existing law: They are too poor to qualify for tax credits to purchase private insurance, and they do not fall into the narrow eligibility categories of existing Medicaid in Kansas and Missouri (poor children, pregnant women with low income, or severely disabled). Or, as Glendening describes them, “able-bodied, childless, working-age adults.” That phrase is used to suggest that those in the coverage gap are not hardworking citizens and are somehow less deserving than other vulnerable citizens. (Beau Heyen, 5/11)

NewsHour: What Medicare Can Teach The GOP About This Basic Rule Of Insurance
Republican efforts to replace Obamacare are delivering many teachable moments, along with a big bucket of stress inflicted on people fearful of losing their health insurance. Will it dawn on GOP House members and President Trump that Americans want guaranteed access to health insurance and do not want to return to the days when they could be denied insurance due to preexisting conditions? One of these teachable moments, yet to be realized, is in plain sight every day in Medicare. It involves the very nature of insurance itself, the fundamentals of which seem to have escaped many critics of Obamacare. (Philip Moeller, 5/10)

Kansas City Star: The U.S. Constitution Mandates National Health Care 
So what exactly is the relationship between our federal government, as framed in our Constitution, and our health care? Although Congress has been debating the topic, it unfortunately merely discusses who gets covered, what gets covered and how expensive it might be. Missing from these debates is a principled discussion about the government’s essential connection to health care. (Thomas Stroik, 5/11)

Lexington Herald Leader: Health Care Is A Public Good, Not A Marketplace Commodity
Most developed countries in the world understand health care to be a public good, provided by government action to ensure all citizens have access to care. America considers health care to exist in the marketplace, a commodity to be purchased by consumers. The result: Many people cannot access health care as they cannot afford to purchase it. (David A. Nash, 5/11)

Milwaukee Journal Sentinel: Moving State Employees To Self-Insurance Program Saves Dollars Without Disrupting Care
The state can save at least $60 million in the next two-year budget by simply changing the way it pays for state employee health benefits. Those savings grow by $22 million more in general purpose revenue if repeal or delay of an Obamacare tax does not occur. These are savings, based on actual bids to the state, that could be used for tax cuts, schools or other government programs.  (John Shiely, 5/11)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.