The Health Care Repeal Bill Masquerading as a Tax Bill

A wolf in sheep's clothing. That's what the tax reform bill has become. How so?
  • The Senate version will repeal the individual mandate. Politico explains how the Senate version of the tax reform bill became yet another GOP referendum on the ACA, and how it will lead to 13 million fewer insured (5 million of them in Medicaid) and higher premiums.
  • But it may backfire: The Washington Post analyzes how the repeal of the individual mandate could backfire on some middle class people who buy individual insurance and pay full price for their plans. 
  • The tax reform plan cuts alcohol taxes: Vox's German Lopez does the math. Cutting alcohol taxes would be a public health disaster.
  • The medical expense reduction disappears: Although only a relatively small number of people (4.1 million in 2015) use this deduction, it could lead to increases in Medicaid spending when these consumers exhaust their financial resources.
By a vote of 227 - 205, the House yesterday passed its version of the tax bill WITHOUT the  individual  mandate repeal. Now the Senate must take up its own version of the bill, which as described above, includes repeal of the individual mandate. If it passes in the Senate, and that's a big if, now that Sen. Ron Johnson (WI) has raised issues about the corporate tax breaks and Sen. Susan Collins (ME) has expressed concern about the mandate repeal.  The New York Times   provides a useful perspective on the bill's future.
In Other News...
  • IRS Cracks Down on Employers: For the first time, the IRS is enforcing a provision of the ACA that requires employers to offer qualified health plans to their employees. The first round of notices went out to employers with 100 or more employees last week.
  • Health Care of Tomorrow: This article raises some thought-provoking ideas about the move to take care out of the hospitals while citing the importance of addressing social disparities of health. For example, Aetna CEO Mark Bertolini "said it makes sense for payers to be thinking about social determinants of health because that's how diseases can be prevented and savings can be realized. 'Paying for a ramp, an Uber ride, food, fuel assistance is cheaper than one ER visit.'
  • Drug industry exec. tapped to lead HHS: Alex Azar, a former head of US operations for Eli Lilly, who raised prices dramatically. He's opposed government negotiations of drug pricing and drug importation, and suggested during a Fox News appearance that the administration should pressure Europe over its "radical price controls."
  • A note of passing: We mourn the loss of a champion for a more rational health care system, with the passing of noted health care economist Uwe Reinhardt. Ezekiel Emanuel called him, a great moral conscience." His wit and wisdom will be sorely missed.  
Mental Health Parity and Addiction Equity Act

The Legal Action Center ( LAC) and 4 other leading advocacy organizations, have announced the launch of the Parity@10 Compliance CampaignThe campaign is a three year effort that will unite local and national advocates in Maryland and 9 other states to pursue full enforcement of the Federal Parity Act on its 10th anniversary next year. The campaign's goal is to ensure that insurance carriers and State Medicaid programs ensure full parity compliance for substance use and mental health benefits. Ellen Weber, Consumer Health First Board member and LAC Vice President for Health Initiatives and director of the campaign said,

"The campaign is ready to jumpstart parity enforcement...Achieving more robust parity compliance in 10 states over the next three years will not only benefit millions of people living in those states, but will also establish models that can be adopted by other states."

The Parity@10 Compliance Campaign will be launched in 5 states:  Illinois, Maryland, New Jersey, New York and Ohio. An additional 5 states will be added next year.
Open Enrollment Has Record Signup Rates

In the first two weeks of Open Enrollment, Healthcare.gov had more than 1.5 million Americans have signed up for health care, including 23% new sign ups. That's an increase of 47% over the same period last year. These national numbers mirror exchanges not on the national exchange, including Maryland, which also had record sign ups in its first week.

Experts are worried however, that despite the rosy startup, that sign ups could drop off if the repeal of the individual mandate goes through.

A big message, though, is shop around. Kaiser Health News has come up with a handy Cheat Sheet to assist with that process.

Once consumers have done their homework, they should:
  • Visit our website for more Maryland insurance resources on selecting the right plan for you and your family.
Mark Your Calendar
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  • Tuesday, November 28th: Giving Tuesday. Please give generously. We rely on your support. Your contributions on this day will be matched for the first $3,000.
  • Friday, December 15th: Open Enrollment ends! Last day to sign up for health care coverage beginning January 1, 2018.

We Need You!
We simply can't do this work without your financial support.    
  • November 28 is Giving Tuesday,  and we rely on your generosity. Affordable,  accessible  health care is at risk now more than ever, and we need resources to help fight for it. Please give generously on November 28, or donate now!

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