The text of a draft bill to repeal and replace Obamacare leaked on Friday. Because the draft hews to principles that Republicans have outlined before, its basic contours aren’t that surprising. As I explained to Greg Sargent at the Washington Post: The emerging GOP replacement would repeal tax hikes on the very rich and, instead, […]

In yesterday’s post on my new draft essay, Federalism and the End of Obamacare, I emphasized the benefits of returning more regulatory authority to the states. Today, I’d like to draw out a different point: the need for the federal government to take the lead when it comes to financing health reform. The states face […]

That’s the title of my new essay, which the Yale Law Journal Forum has published in draft form. Here’s the abstract. Federalism has become a watchword in the acrimonious debate over a possible replacement for the Affordable Care Act (ACA). Missing from that debate, however, is a theoretically grounded and empirically informed understanding of how […]

In response to a scathing report by Kaiser Health News, Senator Charles Grassley has announced an inquiry into the exorbitant prices for orphan drugs. Now seems like a good time to highlight my series, published at The Incidental Economist, on how to think straight about orphan drugs: Background on orphan drugs and the Orphan Drug […]

A judge on the Court of Federal Claims has entered a $214 million judgment against the United States in favor of Moda Health, an Oregon insurer. Moda sued to recover money owed to it under the risk corridor program, a three-year program that was supposed to protect insurers from excessive losses on the exchanges. In […]

Apparently Trump’s HHS doesn’t think so. From Jonathan Cohn at the Huffington Post: HHS has already submitted a proposal of new rules to OMB. [Under the proposal,] insurers would have more leeway to vary prices by age, so that premiums for the oldest customers could be 3.49 times as large as those for younger customers. […]

I’ve got an article up at Vox on the possibility that Donald Trump might suspend enforcement of the ACA’s individual mandate. Would that be legal? The short answer is no. The longer answer is more complicated, but it’s also instructive. At key points, President Barack Obama delayed aspects of the ACA in an effort to […]

This post was coauthored by Nicholas Bagley and Adrianna McIntyre.  The executive order President Trump signed on Friday does not have any immediate policy effect, but it does call attention to the wide range of administrative actions that a Trump administration could take to change the Affordable Care Act—all without legislation from Congress. We’ve compiled […]

There are some misconceptions floating around about what the executive order does and doesn’t do. Let me try to clarify. As I explained in a post last week, “[a]uthority to implement the ACA … is vested in the Secretaries of HHS, Treasury, and Labor—not the President. In the context of the ACA, an executive order […]

Kevin Outterson and I have an op-ed in the New York Times today on combating antimicrobial resistance. Here’s a snippet: [W]e will miss antibiotics when they’re gone. Minor scrapes and routine infections could become life threatening. Common surgeries would start looking like Russian roulette. Gonorrhea and other sexually transmitted infections might become untreatable. Diseases that […]

Three years ago, and without notice, data about patients with substance use disorders began to disappear from Medicare and Medicaid files widely used in health services research. Because researchers had been afforded access to those data for decades, the change was mystifying. Austin Frakt raised an alarm, and he and I began to look into […]

According to Vice-President-elect Pence, “We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for ObamaCare.” This talk about using executive orders to assure an “orderly transition” is a bit confusing. An E.O. has legal force “only if […]

There’s been a lot of talk about the executive actions that President Trump might take to reshape the Affordable Care Act. Here’s one I haven’t heard discussed: undoing the Hill fix. Prior to the ACA, members of Congress and their staffers got health coverage through their jobs, just like most Americans. But Congress wanted to […]

Per a rule released last week, CMS will now require qualified health plans to count the cost sharing paid by the enrollee for an essential health benefit provided by an out-of-network ancillary provider at an in-network setting towards the enrollee’s in-network annual limitation on cost sharing for QHPs in certain circumstances. Let’s say you go […]

When it comes to repealing the ACA, one of the trickiest questions concerns timing. Congressional Republicans don’t want to pitch 20 million people off of their insurance right away. Nor do they want the midterm elections to be fought amidst the collapse of the individual market. At the same time, they’re committed to repeal. To […]