Author Archives: Nicholas Bagley

“The tradeoff here is both simple and brutal.”

by Nicholas Bagley — Thursday, Nov. 16, 2017

“Republicans want to pay for a permanent corporate tax by taking insurance from millions of people. Is that who we are as a nation?” That’s the end of my latest op-ed in the Washington Post. Here’s the beginning. To finesse the tricky politics and brutal math of tax reform, Senate Republicans now say that they want to […]

This entry was tagged .

Trump and the Essential Health Benefits

by Nicholas Bagley — Monday, Oct. 30, 2017

On Friday, HHS released a proposed rule that would make a number of adjustments to the rules governing insurance exchanges for 2019. The rule is long and detailed; there’s a lot to digest. Among the most noteworthy changes, however, are those relating to the essential health benefits. They’re significant, and I’m not convinced they’re legal. […]

This entry was tagged .

The Lawsuit to Restore the Cost-Sharing Payments

by Nicholas Bagley — Thursday, Oct. 19, 2017

Yesterday, a group of 19 states asked a California district court to stop the Trump administration from cutting off the cost-sharing payments. To prevail, the states will have to convince the court that they face irreparable injury if the payments are terminated and that they’ve got a substantial likelihood of eventually winning their lawsuit. To […]

This entry was tagged .

Waiver changes

by Nicholas Bagley — Wednesday, Oct. 18, 2017

In broad strokes, the bipartisan deal from Senators Alexander and Murray would restore cost-sharing payments through 2019 in exchange for some amendments to the rules governing ACA waivers. Now that we have the bill text, we can start to wrap our hands around the practical effects of those waiver changes. Most importantly, the bill would […]

This entry was tagged .

Trump has declared open war on the ACA

by Nicholas Bagley — Monday, Oct. 16, 2017

That’s the headline for an op-ed of mine that ran this weekend in the Los Angeles Times. Back in 2013, the Obama administration asked Congress to appropriate the money for the cost-sharing payments. The Republican-controlled Congress refused. Concerned for the fate of its healthcare bill, the Obama administration then adopted a dubious legal theory that allowed […]

This entry was tagged .

Ending the cost-sharing payments.

by Nicholas Bagley — Friday, Oct. 13, 2017

Politico just broke the news that the Trump administration will terminate the Affordable Care Act’s cost-sharing payments, further destabilizing the already-fragile exchanges on the eve of open enrollment. Although state regulators and insurers have taken steps to protect themselves (see this great explainer from David Anderson, Charles Gaba, Louise Norris, and Andrew Sprung), the abrupt […]

This entry was tagged .

The Trump Administration and Contraception Coverage

by Nicholas Bagley — Friday, Oct. 6, 2017

This morning, HHS released two rules that will allow many more employers to exclude contraception from the insurance plans they offer to their employees. The first expands an existing religious exemption; the second allows employers to exempt themselves by invoking a freestanding “moral objection.” As I explained when a draft of the rules first leaked, […]

This entry was tagged .

Faux Federalism

by Nicholas Bagley — Thursday, Sept. 28, 2017

The following is an op-ed that I was shopping around for publication prior to the demise of Graham-Cassidy. It’s obviously less urgent now, but I wanted to put it out there as a time-capsule in case the bill is revived. The op-ed relates to the penultimate version of the bill, not the one that finally […]

This entry was tagged .

The amended version of Graham-Cassidy is a mess

by Nicholas Bagley — Monday, Sept. 25, 2017

The revised bill was leaked last night and will apparently be unveiled today. The reporting has suggested that it’s worse than before. Not only is Graham-Cassidy now full of bribes and giveaways to lure hesitant senators, but it also makes it much easier for states to avoid the application of the ACA’s insurance regulations. That’s […]

This entry was tagged .

Can the courts stop ACA waivers from taking effect?

by Nicholas Bagley — Thursday, Sept. 14, 2017

Iowa has submitted a waiver proposal under section 1332 of the Affordable Care Act that, if granted, would radically reshape its individual insurance market; Oklahoma may soon do the same. Both states have been accused of relying on some magical numbers, and Iowa’s waiver appears to violate the ACA’s guardrails, which require states to assure […]

This entry was tagged .