| OPINIONS, EDITORIALS, PERSPECTIVESWashington Post
11) The Politics of Delaying Obamacare
from Washington Post by Sarah Kliff
By delaying a requirement that all large employers provide health insurance, the Obama administration heads off the unseemly spectacle of companies vowing to cut jobs or workers’ hours to avoid the costly mandate. But the late Tuesday action is not a free pass: It contributes to critics’ claims that the White House does not have the ability to launch its biggest legislative accomplishment on schedule.
12) Obamacare’s Employer Mandate Shouldn’t Be Delayed. It Should Be Repealed.
from Washington Post by Ezra Klein
Delaying Obamacare’s employer mandate is the right thing to do. Frankly, eliminating it – or at least utterly overhauling it – is probably the right thing to do. But the administration executing a regulatory end-run around Congress is not the right way to do it. It’s a bad bit of policy.This is a regulatory end-run of the legislative process. The law says the mandate goes into effect in 2014, but the administration has decided to give it until 2015 by simply refusing to enforce the penalties. The regulatory solution reflects the fact that the legislative process around the health-care law is completely broken. Republicans won’t pass any legislation that makes the law work better. Improving the law, they fear, will weaken the arguments for repeal. But Democrats, of course, won’t permit repeal. So Congress is at a standstill, with no viable process for reforming or repairing the Affordable Care Act as problems arise. And so the White House is acting on its own.
Health Affairs
13) Implementing Health Reform: A One-Year Employer Mandate Delay
from Health Affairs by Timothy Jost
One has to hope, however, that the Administration has thought through the ramifications of this delay for the other provisions of the ACA. The statements say that implementation of the rest of the ACA, including the availability of premium tax credits, is going forward on schedule. From all appearances this is true. But tax credits are only available to employed individuals who are either not offered health coverage by their employers or are only offered employer coverage that costs more than 9.5 percent of household income or that fails to offer “minimum value”- covering 60 percent of health care costs. Also, taxpayers are subject to the individual mandate penalty if they fail to accept coverage from their employer that meets the minimum value requirement and costs 8 percent or less of household income.
If employers have no obligation to report coverage, how will the exchanges or the IRS verify claims that coverage is unaffordable or inadequate? Currently proposed rules allow the exchanges to rely on the attestation of the applicant as to these claims if verification is not needed or cannot be obtained. Will the lack of an employer mandate mean that many more individuals will become eligible for premium tax credits, either because their employers drop or do not expand coverage, or fail to respond to requests to verify coverage? If employers fail to expand coverage to employee’s children, as they would have had to under the mandate, more children may end up on CHIP or Medicaid, or become eligible for premium tax credits.
14) Competitive Bidding in Medicare: A Response to the Bipartisan Policy Center’s Proposals
from Health Affairs by Robert Coulam, Roger Feldman, and Bryan Dowd
Competitive bidding thus is a proven method for bringing efficient prices to Medicare. Unfortunately, the BPC’s proposals for competitive bidding are critically flawed. Most important, the BPC proposal proposes a limited form of competitive bidding, restricted to Medicare Advantage plans only – the traditional Medicare fee-for-service (FFS) plan is not one of the bidders. For reasons detailed below, that is a serious flaw. There are other important flaws as well in the BPC proposal. We propose a bidding arrangement for all Medicare plans, MA plans and the traditional FFS Plan. In this post, we explain why. We first review the BPC proposals and then describe the problems that would result from the particular form of competitive bidding BPC has proposed, and why a more comprehensive bidding arrangement would be a far more important reform for Medicare.
Bloomberg
15) Fix Doctors’ Pay and Improve Health, Too
from Bloomberg by Lanhee Chen
Aside from the instability created by the SGR overrides, the formula also cuts pay indiscriminately, failing to distinguish between specialties or physicians. Worse, the regular reprieves set up even steeper future cuts in physician reimbursements — and potentially in access to health care — under the Medicare program. The SGR is set to impose a 24.4 percent cut in physician payments in 2014. The formula also fails to tie payment to quality. Outside of Medicare, private insurers have started using physician compensation to encourage providers to employ resources more effectively and efficiently. Fixing the SGR is an opportunity to embrace some of those changes in Medicare.
16) Retirees’ Medical Bills are Brining Down Detroit
from Bloomberg by Stephen Eide
The emergency manager in charge of keeping Detroit afloat says the city’s $20 billion debt load can’t be reduced to manageable levels without “shared sacrifice” from all stakeholders, including retirees. Pension and retiree-health-care obligations make up the bulk of the city’s unsecured debt, and their costs are rising rapidly. The emergency manager, Kevyn Orr, is right that Detroit must reduce its retirement-related debt to secure its future, but he has to be more specific about his target. Cutting retiree health care — also referred to as “other post-employment benefits,” or OPEBs — should take priority over pensions.
New York Times
17) A Chance for Pro Sports to Help on Health Care
from New York Times by Editorial Board
It would be nice to imagine that sports officials would ignore this entirely self-serving pressure tactic. Given its struggle with on-field injuries, for example, the N.F.L. would do well to help 25 million people receive the health insurance to which they are now legally entitled. So far, though, it seems the intimidation is working. The N.F.L. said last week it has no plans to help out, and the other leagues have yet to sign on. Apparently, when confronted with bullying and misinformation, a bunch of professional tough guys are nothing but pushovers. |
