Progress Reducing Uninsured Rate Comes To A Halt

WASHINGTON (AP) — Five years of progress reducing the number of Americans without health insurance has come to a halt, according to a government report out Tuesday. More than a factoid, it shows the stakes in the Republican drive to roll back the Affordable Care Act.

The report from the Centers for Disease Control and Prevention estimates that 28.6 million people were uninsured in 2016, unchanged from 2015. It was the first year since passage of the health care overhaul in 2010 that the number of uninsured did not budge.

The uninsured rate for 2016 was 9 percent, an insignificant difference from 9.1 percent the previous year. When former President Barack Obama signed the ACA in 2010, the uninsured rate had been 16 percent.

Tuesday's report suggests that the ACA was running low on gas in Obama's final year as president. Premiums for private insurance were about to jump, and 19 states continued to refuse the law's Medicaid expansion.

Now, the number of uninsured could start climbing again under policies being considered by President Donald Trump and congressional Republicans.

The politically unpopular GOP bill passed narrowly by the House would limit Medicaid financing and curtail subsidies for many consumers buying their own private policies. Republicans also would repeal the requirement that most Americans carry health insurance or risk fines, a much-disliked nudge to get healthy people covered.

The legislation would lead to an estimated increase of 24 million uninsured people within 10 years, according to congressional analysts. Under "Obamacare," there are 20 million fewer uninsured since 2010.

"It's disappointing that it's stalled out," said health economist Gail Wilensky, a Republican. "The real question is, will we be able to keep the gains that we have made?" Critical of the ACA and co-author of an alternative plan by GOP policy experts, Wilensky nonetheless supports the goal of expanding coverage. She's concerned about the impact of the House bill on Medicaid, the federal-state program for low-income and disabled people.

The new numbers come from CDC's National Health Interview Survey, which is considered an authoritative source, and publishes findings earlier than the Census Bureau. Estimates for 2016 were based on data for nearly 97,500 people.

"It looks like we are kind of sticking a landing and holding on to the gains," said Katherine Hempstead, who directs research on health insurance at the nonpartisan Robert Wood Johnson Foundation. "To increase coverage, you would have to see more states take up the Medicaid expansion, and some reforms to increase take-up in the individual (private) market."

Could the number of uninsured start rising again? Absolutely, say both Wilensky and Hempstead.

"This release is really timely because it just helps everybody focus on what's at stake," said Hempstead.

The report found a significant increase in the percentage of people under age 65 covered last year through government-sponsored insurance markets like HealthCare.gov. About 11.6 million (4.3 percent) had marketplace insurance in the last three months of 2016, compared with 9.1 million (3.4 percent) in the same period the previous year.

States that expanded Medicaid were more effective at reducing the number of uninsured. Of the 16 states with adult uninsured rates significantly lower than the nation as a whole, 15 expanded Medicaid. In that group, only Wisconsin had not extended coverage for low-income people.

Conversely, of the nine states that had significantly higher uninsured rates, only New Mexico expanded Medicaid.

The CDC numbers do not reflect any changes directly attributable to Trump, who took office this year on Jan. 20.

During the campaign and since, the president has made some big promises about health insurance, talking of coverage for everybody and much more affordable premiums and deductibles. But Trump has also embraced a GOP bill that would make more people uninsured, even if it delivers on his campaign pledge to repeal "Obamacare." And he's threatened to stop paying subsidies that reduce out-of-pocket costs such as deductibles for people with modest incomes.

Hillary Clinton, whom Trump defeated, had promised to increase government assistance for private insurance costs, and also work to convince holdout states to expand their Medicaid programs.

"This is really pre-election activity" reflected in the CDC survey, said Wilensky. "It's news because people need to know we seem to have reached a plateau." What that will look like a year from now is unclear, she added.

Senate Likely To Slow Repeal Of Obamacare, May Write New Bill

BY THE WASHINGTON POST

Passage of the House's health-care bill gives the Obamacare repeal effort new life after months of wrangling, but key Republican senators are already pushing it aside to write their own bill with no clear timetable to act.

The narrowly passed House measure can't get anywhere near the 51 votes needed as is, even though Republican senators insist they're united on delivering on their seven-year vow to repeal and replace the Affordable Care Act. Instead, they want to write their own bill.

Lamar Alexander of Tennessee, who chairs the Senate health committee, Rob Portman of Ohio, and Roy Blunt of Missouri, a member of GOP leadership, described the plan even as the House was celebrating passing its repeal after weeks of back-and-forth.

"We'll write our own bill," Alexander said in an interview, although he said senators would consider pieces of the House bill. "Where they've solved problems we agree with, that makes it a lot easier for us."

The decision will delay the prospect of any repeal bill reaching President Donald Trump's desk. Before the failure of the House bill in March, Senate Majority Leader Mitch McConnell had talked of taking it up and passing it in a week.

A senior White House official said the administration is ready for a slower, more deliberative debate in the Senate, where the main sticking point is expected to be how to address Obamacare's expansion of Medicaid.

AHIP Issues Statement as the American Health Care Act Heads To The Senate

WASHINGTON, D.C. – Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP), offered the following statements upon the passage of the American Health Care Act (AHCA) by the House of Representatives:

“AHIP believes that every American deserves coverage and care that is affordable and accessible, including those with pre-existing conditions. The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage. We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.

“Immediate challenges exist in the individual market today, and the bill includes key provisions to stabilize the market in 2018 and 2019. We need certainty now about funding for cost-sharing reductions that lower copayments for patients so they can better afford to get care from their doctor. The tax credit should be enhanced to reduce premiums and better meet the needs of people with low and modest incomes, are older, or live in areas with high health care costs.

“We want to work with the Senate to ensure the continued strength of the Medicaid program, which delivers real value to more than 70 million Americans.  States need adequate resources to administer an efficient, effective program that helps beneficiaries improve their health. If changes are made to criteria for who is covered by Medicaid, we need to give people more time to adjust – and more time for the individual market to stabilize.

“More than 80 million Americans rely on the Medicaid and individual market, and they deserve affordable coverage and access to quality care. AHIP believes that by working together, we can create good private market solutions that improve the health and financial stability of all people.”

About AHIP

America’s Health Insurance Plans (AHIP) is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access and well-being for consumers. Visit www.ahip.org  Learn more about health insurance and how it works at myhealthplan.guide

New 8 Billion For Those With Preexisting Conditions Appears to Boost AHCA Critics Say Amount Is To Low

On May 3, 2017, the House of Representatives may have broken the gridlock that has prevented its passage of Republican changes to the Affordable Care Act. Representative Fred Upton (R MI) and six other moderate Republicans offered what they viewed as a corrective amendment (summary) to the MacArthur-Meadows amendment to the American Health Care Act (AHCA). MacArthur-Meadows, offered to secure the votes of conservative Republican members of the House Freedom Caucus, authorized states to obtain waivers to permit their insurers to charge higher rates based on health status to individuals with preexisting conditions for a period of about a year if those individuals let their insurance coverage lapse for a period of at least 63 days.

The House appears set to vote on the AHCA on May 4, without waiting for a new score from the Congressional Budget Office.

The Upton amendment would create a fund of $8 billion for the years 2018 to 2023. The money would go to states that permit insurers to charge higher health-underwritten premiums to such individuals; the funds would be used to provide “assistance to reduce premiums or other out-of-pocket costs of individuals who are subject to an increase in the monthly premium rate for health insurance coverage as a result of such waiver.” The funds would be apportioned to the states taking into account other stabilization fund grants.

The amendment has been described as funding state high-risk pools. A state could certainly use its share of the $8 billion to fund risk pools as one approach to making coverage affordable to persons subject to high premiums because of their health status. But the money could also be used to directly subsidize the premiums or cost-sharing that high-cost consumers might have to pay for commercial insurance.

Others have commented that $8 billion falls well short of the amount needed to adequately ensure coverage to high-risk consumers and have additionally noted the problems that have plagued high-risk pools in the past. There is also the question of a strategy that allows insurers to up-rate people who do not maintain continuous coverage, purportedly to discourage breaks in coverage, but then seeks to cover the cost of the penalty when the consumer seeks insurance again after the coverage break.

In any event, the Upton amendment is likely to be added to the AHCA as it currently exists on May 4 and may bring in enough votes to secure passage in the House of the bill. The fate of the AHCA in the Senate, however, is a whole another matter, as the Senate operates on different procedural rules that may well block a number of parts of the AHCA and with a much smaller, and quite diverse, Republican majority.

Trump, GOP Lawmakers Planning Obamacare Repeal

Vice President-elect Mike Pence visited with House GOP lawmakers on Wednesday morning to discuss President-elect Donald Trump’s first moves in the Oval Office, including a plan to repeal ObamaCare by Feb. 20.

The date was put forth by incoming House Budget Committee Chairman Diane Black (R-Tenn.). Pence announced during a press conference Wednesday morning that the Trump Administration’s first order of business will be to follow through on the important campaign promise of repealing and replacing the Affordable Care Act, also known as ObamaCare.

Through both executive action and legislation, Trump and GOP lawmakers aim to dismantle the healthcare law and replace it with a free-market based system. Pence offered scant details of what a replacement system would look like, however he ensured that any GOP sponsored fix would be less problematic for Americans than ObamaCare itself.

Pence noted that he and Trump are in “the promise-keeping business” on repealing the law, jabbing at President Barack Obama for the many empty promises surrounding his crowning achievement. Obama and Democratic lawmakers often shared the falsehood that Americans could keep their current doctors, healthcare plans and providers once ObamaCare went into effect, which turned out to be untrue.

Pence added that the American people spoke in November when they elected Trump, who made healthcare a focal point of his campaign. Pence said the election results show Americans want a “better future for healthcare in this country,” and alluded to a Department of Health and Human Services report that shows health care premiums for those enrolled in ObamaCare are expected to increase on average by 25 percent in the coming year.

Women's Health Coverage -How ACA Repeal Will Affect You !

AFFORDABLE CARE ACT REPEAL THREATENS THE HEALTH AND ECONOMIC SECURITY OF 7.8 MILLION WOMEN WHO RECENTLY GAINED INSURANCE COVERAGE

Health care is key to women’s well-being and economic stability. Thanks to the Affordable Care Act (ACA, also known as “Obamacare”), insurance is easier to get and afford, and plans can no longer refuse to cover women. Each year, millions of women enroll in insurance plans under the ACA, but the law is under constant threat. Any repeal of the ACA or changes to the Medicaid program threaten the important gains women have made in obtaining quality, affordable health coverage that allows them to stay healthy and economically secure. Recent Census data show that if the ACA is repealed or changes are made to the Medicaid program, women have a lot to lose. LOSING GAINS IN HEALTH COVERAGE NATIONWIDE: • More than 88.5 million women ages 18–64 across the United States now have health insurance through an employer, the ACA marketplaces, state Medicaid programs, or another source. This means almost 9 in 10 women ages 18–64 now have health coverage. • Between 2013–2015, more than 7.8 million women ages 18–64 gained health insurance coverage, a growth rate of 10 percent nationally.1 Repealing the ACA or changing the Medicaid program puts these millions of women in jeopardy of losing their health coverage. REVERSING GAINS IN EVERY STATE: • Five states and D.C. have achieved nearly universal health coverage (95 percent or greater) of women ages 18–64, and in the majority of states, more than 90 percent of non-elderly women now have health insurance coverage. Before the ACA, only one state (Massachusetts) had nearly universal coverage of women ages 18–64. • The ten states with the greatest increase in health coverage between 2013–2015 for women ages 18–64 are Nevada, California, Kentucky, Florida, Oregon, Arkansas, West Virginia, Washington, Arizona, and Texas, where more than half of the 7.8 million women ages 18–64 who gained health coverage reside. ACA repeal or changes to the Medicaid program could mean women lose the health coverage they have gained in every state across the country. SPECIFICALLY THREATENING GAINS IN STATES THAT HAVE EXPANDED MEDICAID: • States expanding Medicaid have seen the largest increases in insurance coverage of women ages 18–64 between 2013–2015. The vast majority—about 5 million—of women ages 18–64 who have gained health coverage live in a state that expanded Medicaid. • Non-expansion states have the lowest proportions of women ages 18–64 with health coverage. The states with the lowest are Mississippi, Florida, Oklahoma, Georgia, and Texas. In Texas, more than 1 in 5women ages 18–64 remains uninsured. These data indicate that expanding Medicaid produces large gains in health insurance for women across the board. Repealing the ACA, and in particular repealing Medicaid expansion, would put these gains at risk. 11 DUPONT CIRCLE, NW, #800, WASHINGTON, DC 20036 P: (202) 588 5180 WWW.NWLC.ORG HEALTH | PAGE 2 Find information on the gains made in coverage for women ages 18–64 in your state, and how many women stand to lose coverage, below. Health Insurance Coverage of Women 18-64 Source: NWLC calculations based on American Community Survey (IPUMS-USA), 2013 and 2015 ACS 1-year estimates available at https://usa.ipums.org/usa/index.shtml. 1 NWLC calculations based on American Community Survey (IPUMS-USA), 2013 and 2015 ACS 1-year estimates available at https://usa.ipums. org/usa/index.shtml. Gains made in health insurance coverage of women 18–64, from 2013–2015 is calculated as the difference between the number of women with health insurance in 2013 and number of women with health insurance in 2015. Our analysis compares 2013 and 2015 health insurance coverage of women 18-64 as a representation of pre- and post-Affordable Care Act (ACA) trends. While some reforms of the ACA went into effect in 2010, the marketplaces did not become operational until 2014, and many of the major reforms aimed at expanding health coverage to more Americans—such as prohibitions on denying coverage for prior medical conditions, requirements that individuals have health insurance coverage, expansion of Medicaid to all adults making up to 133% of Federal Poverty Level, and availability of tax credits.

Pre-existing conditions: How 130 million Americans maybe affected by the Obamacare Repeal

The U.S. House of Representatives passed by a 217-213 margin on Thursday a revised version of the American Health Care Act -- a bill that rolls back federal protections for those with pre-existing conditions and sets the stage for loss of coverage for some 24 million Americans. If signed into law, this could mean health care cost increases for an estimated 130 million Americans.

In the pre-Obamacare era, insurers were able to deny coverage outright to people with pre-existing conditions. The Affordable Care Act banned individual states from allowing insurers to charge people with pre-existing conditions at a higher cost.

Under the American Health Care Act, states can opt to allow individual insurers the discretion of deciding what does and not count as a pre-existing condition. While people with those pre-existing condition can't be denied coverage, they can potentially be charged more. These states would also receive $138 billion over a 10-year period to help subsidize.

The idea behind this provision is that it would make health insurance cheaper for people who are relatively healthy, while sick people would be in their own, subsidized risk pool. As they debated on the House floor Thursday, Republican members consistently assured their audience that their bill would still protect preexisting conditions."

Varying policy perspectives abound, but the greatest fear for opponents of the legislation is that the $138 billion fund to set up a "high-risk pool" simply won't be enough.

While individual insurers have the right to choose what is defined as a "pre-existing condition," these are the conditions that were previously listed as deniable in the market, before the ACA was passed:

- AIDS

- HIV

- Lupus

- Alcohol abuse

- Drug abuse with recent treatment

- Mental disorders (severe, e.g. bipolar, eating disorder)

- Alzheimer's/dementiaMultiple sclerosis

- Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease

- Muscular dystrophy

- Cancer within some period of time (e.g. 10 years, often other than basal skin cancer)

- Obesity, severe

- Cerebral palsy

- Organ transplant

- Congestive heart failure

- Paraplegia

- Coronary artery/heart disease, bypass surgery

- Paralysis

- Crohn's disease/ ulcerative colitis

- Parkinson's disease

- Chronic obstructive pulmonary disease (COPD)/emphysema

- Pending surgery or hospitalization

- Diabetes mellitusPneumocystic pneumonia

- Epilepsy

- Pregnancy or expectant parent

- Hemophilia

- Sleep apnea

- Hepatitis (Hep C)

- Stroke

- Kidney disease, renal failure