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Is Obamacare Already Dead?

Mother Jones

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Paul Ryan and President Trump have been insisting for months that Obamacare is collapsing, failing, imploding, spiraling quickly into death. This is ridiculous, of course. It’s covering more than 20 million people at a lower cost than originally projected, and by any fair appraisal it’s been hugely successful.

But that’s not to say it has no problems. The Obamacare insurance pool is skewed toward the old and sick, and this has made it hard for insurers to turn a profit. Several smallish insurers have already left the market, and there are hundreds of counties in the US with only one insurer left on the exchanges. This is probably not fatal—CBO says the Obamacare market is stable—and it’s a problem that could be addressed fairly easily and inexpensively. Still, it does put the Obamacare market in modestly perilous shape.

But what now? Even if the godawful Republican repeal effort fails, there’s every reason to think that Congress will try again. What’s more, it’s clear that they’ll do everything they can to undermine Obamacare along the way. In a few months, insurance companies have to decide whether they want to participate in the exchange market in 2018, and I wonder what they’ll decide? The uncertainty is sky high now, and that means they have little incentive to continue. Remember, most insurers swallowed big losses early on in hopes of building a stable, profitable market later. But what’s the point of absorbing losses if it looks like—at best—years and years of chaos ahead?

It may be that 2018 is safe. The exchanges are pretty close to profitable now, and it’s probably worth it for most insurers to stay on board for at least another year to see what happens. Still, I wonder. Merely by upending everything and making it clear just how dedicated they are to cutting taxes on the rich and cutting health coverage for the poor, have Republicans already managed to effectively repeal Obamacare without passing a single page of legislation?

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Is Obamacare Already Dead?

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Republicans Finally Have a Plan to Replace Obamacare. But They Won’t Let Anyone See it.

Mother Jones

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Congressional lawmakers are scrambling to get their hands on the latest draft legislation to repeal and replace the Affordable Care Act, after top Republicans moved to keep the new proposal out of sight and “under lock and key” in the basement of Congress.

Bloomberg reports the draft legislation will likely be reviewed by only members of the House Energy and Commerce panel Thursday, but physical copies of it will not be distributed for other lawmakers or the general public.

The extraordinary effort to conceal the contents of the latest replacement plan comes amid intense debate within the GOP over the extent to which the healthcare law should be changed: some favor a full repeal, while others in the party advocate keeping certain parts of the law intact. The current secrecy is also likely a response to last Friday’s leak of a now outdated version of the proposal.

Sen. Rand Paul (R-Ky.) joined several other lawmakers on Thursday for the frantic search to find the draft bill:

Rep. Steny Hoyer (D-Md.) was even spotted lamenting to a bust of President Abraham Lincoln during the hunt:

The spectacle on Thursday follows a wave of rowdy town halls across the country, where thousands of protesters packed into public meeting spaces to complain to Republican lawmakers about dismantling Obamacare. Several Republican lawmakers have since voiced serious concern over repeal efforts, and the potential fallout such a repeal could have on their political futures.

The secretive, hurried process to repeal and replace Obamacare also has its ironies; Republicans were furious with Democrats for what they saw as a rushed effort starting in 2009 to pass the healthcare law without any GOP input.

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Republicans Finally Have a Plan to Replace Obamacare. But They Won’t Let Anyone See it.

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It’s Official: The Trump Administration Will Soon Solicit Bids for a New Border Wall

Mother Jones

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The Department of Homeland Security announced Friday that it will soon begin soliciting bids “for the design and build of several prototype wall structures in the vicinity of the United States border with Mexico.” Bidding begins March 6. The official posting says the administration will select the companies to potentially build the new structure sometime in April.

The solicitation appears to correspond to President Trump’s highly publicized pledge to build a new border wall along the US-Mexico border. “We’re going to build a wall, don’t worry about it,” Trump said at the Conservative Political Action Conference on Friday. “We’re building the wall. We’re building the wall. In fact, it’s going to start soon. Way ahead of schedule, way ahead of schedule.”

The official post soliciting bids for the border wall is available online here.

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It’s Official: The Trump Administration Will Soon Solicit Bids for a New Border Wall

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Congress Just Got a Lot Closer to Defunding Planned Parenthood

Mother Jones

On Thursday afternoon, the House voted to approve a resolution that is widely seen by advocates as a step towards defunding Planned Parenthood. Should it become law, the measure would weaken contraceptive access across the country.

The bill, HJ Resolution 43, allows states to withhold Title X family planning funds—about $300 million distributed to states annually—from providers who also offer abortion care, a group that includes Planned Parenthood affiliates. In December, Obama’s Department of Health and Human Services finalized a rule that anticipated this sort of effort by prohibiting states from withholding Title X family planning money from Planned Parenthood and other providers. This House resolution proposed overturning that HHS rule via the 1996 Congressional Review Act, which allows Congress to repeal new regulations within 60 days of their passage. A version of this bill is also moving through the Senate.

At a House committee hearing earlier this week, Rep. Louise Slaughter (D-N.Y.) called this bill “the most serious threat women have faced so far this Congress.” Rep. Jim McGovern (D-Mass.) called this the Republicans’ “first salvo” in defunding Planned Parenthood.

This development comes on the heels of several actions by the Trump administration and Congress that threaten women’s health care. They include Congressional efforts to repeal the Affordable Care Act’s mandate requiring insurance coverage for contraception; the approval by the House of a bill to codify the Hyde Amendment, which prevents the use of federal funds for most abortions; and Trump’s expansion of the global gag order, which prohibits health providers overseas from receiving any US funding if they so much as mention abortion as an option for patients.

In the last Congress, a broader bill to deny federal funds to Planned Parenthood passed both chambers, but was vetoed by then-President Barack Obama. In contrast, Trump’s campaign said often that defunding Planned Parenthood would be a top priority for his administration.

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Congress Just Got a Lot Closer to Defunding Planned Parenthood

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Slavitt: Obamacare Should Be Profitable This Year if Republicans Don’t Blow It Up

Mother Jones

Andy Slavitt ran the Centers for Medicare and Medicaid Services under President Obama, which included responsibility for Obamacare. Here’s a tweetstorm he posted today:

I talked today/last night to 5 health plan CEOs. Won’t use names but: 1 Blues, 1 integrated w hospital, 2 non-profit, 1 VC backed. All 5 health plan CEOs believe they priced 2017 #ACA business & should at least breakeven. Several of the plans beat their ACA membership projections.

Of the 5 plans, w/ current uncertainty none can yet commit 2 participate in 2018. All seemed aware that new #ACA stability reg is coming. One plan said with all the work to be profitable in the #ACA (they hadn’t been), ironic to question participation now.

….They didn’t say, but I will: if there is ambiguity, they will raise prices if they participate. One CEO who has an actuarial background said he would be at single digit rate increases but for all the uncertainty. It sounds like the plans will submit #ACA rates for 2018 high to hold place in line. Big increases all from repeal & mandate uncertainty.

It is a shame. Not sure if representative, but single digit if we would wipe uncertainty off table. Still can. But needs to be fast….I think people are so weary of the unpredictability of politics. It zaps energy from their real jobs.

We don’t yet have final enrollment figures for 2017, but it appears that even with double-digit rate increases, uncertainty over Republican repeal plans, and deliberate sabotage from the new Trump administration, signups will be only 2-3 percent lower than last year. That’s a pretty stable market, and probably a profitable—or at least breakeven—one. Fairly modest changes could fix a lot of Obamacare’s existing problems, and higher funding could fix the rest of them.

Instead, we have massive uncertainty in an industry that felt like things had finally settled down after years of work. Slavitt is right: it’s a shame. We can only hope that Republicans will wake up and decide that repairing Obamacare and then taking credit for its success is a better path than blowing up the entire individual health insurance market.

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Slavitt: Obamacare Should Be Profitable This Year if Republicans Don’t Blow It Up

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