Republicans may have the votes pass a reconciliation bill that will hollow out the ACA in a few years. They pinkie swear that, at that point, they’ll pass some kind of replacement. But for that to work, they’ll need Democratic support. Chuck Schumer is already saying they won’t get it: “We’re not going to do […]
Shortly after his nomination as Treasury Secretary was announced, Steven Mnuchin went on television to offer some tax-reform principles that would guide the new administration: Any reductions we have in upper income taxes will be offset by less deductions so that there will be no absolute tax cut for the upper class. There will be […]
The big risk of repeal-and-delay (well, one big risk) is that the individual insurance market will unravel before the Affordable Care Act’s repeal takes effect. As one expert has tartly noted, “Republicans are being awfully naïve. They seem to be ignoring the risks in the transition period, particularly because they need insurance companies to provide insurance […]
$8.3 billion and counting. (For background, see here.) The risk corridor program runs from 2014 through this year, and the balance for the 2016 plan year won’t be calculated until next fall. But the federal government has just released figures for 2015, and they’re eye-popping. Insurers are owed $5.9 billion (h/t Charles Gaba) on top […]
I’m getting a lot of head-scratching questions about the lawsuit, which is now pending at the D.C. Circuit. (For background, see here.) Let me see if I can help. As I see it, there are two distinct questions in play: Does President Trump want to stop making cost-sharing payments on Day One, leading to the […]
It got lost in the election news last week, but a judge on the Court of Federal Claims has dismissed one of the risk corridor lawsuits. (Background on these lawsuits, which seek several billions of dollars from the U.S. government, is here.) The opinion in Land of Lincoln v. United States is long and complicated, […]
With the caveat that this is a bad week for predictions, I’d like to offer my thoughts on what might happen next to the Affordable Care Act. I suspect there’s a pretty relentless political logic that’s about to take hold. For starters, I doubt that Republicans will be able to coalesce around an alternative to Obamacare. […]
When it comes to the ACA, the first major question facing an incoming President Trump will be whether to terminate cost-sharing payments to health plans. Already, prominent voices are calling on him to immediately cut off payments. What effect would that have? And what are his options? Under the ACA, health plans are required to […]
I write about law for a living. Over the past five years or so, I’ve committed my time and my pen to saying what the law does and doesn’t allow the president to do, even when that’s made me unpopular with my friends. I’ve pored over statutes, parsed Federal Register notices, dredged the case law, […]
Ashish Jha has a new post on antitrust problems in the health-care industry: A robust literature on the benefits of competition in the health care marketplace shows that when health care markets are competitive, prices tend to be lower, quality tends to be higher, and people have more choices for care. Competition is a remarkably powerful tool […]
Although it’s been eclipsed by the presidential election, the fight over the risk corridor lawsuits continues to simmer. Last Friday, the House of Representatives moved to file an amicus brief objecting to the administration’s willingness to open settlement negotiations: The law is clear that insurance companies operating on the health exchanges established pursuant to the […]
Last week, the Washington Post reported that settlement negotiations with insurers over risk corridor payments are well underway. “One health plan executive, whose attorney has spoken with Justice officials, said the department is trying to reach an agreement with suing insurers in the next two weeks on what percentage of the remaining $2.5 billion would […]
Congressional Republicans will have to confront at least three tough strategic questions as they move to shut off risk corridor payments. (Prior coverage is here.) First, the courts will entertain congressional objections to any risk corridor settlements only if the House has standing to intervene in the litigation. But the question of whether the House […]
From the Wall Street Journal: Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress. I get what the Republicans are doing here. […]
The Obama administration made news on Friday afternoon when it announced that it was open to discussing settlements with health plans that have sued the administration over risk corridor payments: As in any lawsuit, the Department of Justice is vigorously defending those claims on behalf of the United States. However, as in all cases where […]