Pro-Life Advocates Optimistic as One of Their Own Gets Key HHS Job

President Donald Trump’s appointment of a national pro-life leader to serve as the top communicator at the Department of Health and Human Services is great news for the pro-life cause, leaders at associated organizations say.

Charmaine Yoest, longtime head of the group Americans United for Life, will assume the responsibilities of assistant secretary for public affairs at the sprawling federal agency.

Yoest, 52, will be the principal public affairs adviser to HHS Secretary Tom Price, which puts her in charge of speechwriting, strategic planning, and broadcast and digital communications.

“We are going to see a radical transformation occur within HHS,” Kristan Hawkins, president of Students for Life of America, told The Daily Signal in an interview.

“I fully expect us [as a society] to talk about … the consequences of abortion on women,” Hawkins said.

Tony Perkins, president of the Family Research Council, where Yoest worked for seven years, told The Daily Signal in an interview that she will have an important platform in the Trump administration working for Price:

In her capacity in public relations I am not sure exactly how deep she will get in policy directly, but I think indirectly she will have a huge impact making sure policies are consistent with the secretary’s vision, the president’s vision. And her knowing this [pro-life] issue inside and out, again, I think it’s going to have a significant impact.  

From August 2008 to February 2016, Yoest was CEO of Americans United for Life, a group that seeks to advance the legal and policy issues of the pro-life movement. She has extensive experience in working for conservative, pro-life officials and organizations on the national level.

Her start date at HHS is pending.

Yoest’s political experience began when, as a young woman, she was on the staff of the White House personnel office during President Ronald Reagan’s second term. She went on to work as a policy analyst and vice president of communications at the Washington-based Family Research Council. She briefly advised the 2008  presidential campaign of former Arkansas Gov. Mike Huckabee.

Her new role as assistant secretary of public affairs at HHS, which does not require Senate confirmation, includes tasks such as overseeing the agency’s public affairs programming, leading its other public affairs activities, and managing digital communications.

Yoest, who will report directly to Price, also will oversee agency responses under the Freedom of Information and Privacy Acts, which allow individuals to access federal records. And she will direct a division that “leads the planning, development, and implementation of emergency incident communications strategies and activities.”

Yoest joins the administration at an important time, Melanie Israel, a research associate at The Heritage Foundation, told The Daily Signal in an email.

“From respecting rights of conscience for health care entities to administering programs and grants, to establishing important agency regulations, there are many areas in which the Department of Health and Human Services can affirm the inherent dignity and worth of every person, from conception to natural death,” Israel said.

Jeanne Mancini, president of the March for Life Education and Defense Fund, previously worked in the Office of the Secretary at HHS. In an interview, Mancini told The Daily Signal that Yoest will have a significant role to play in the agency’s policy messaging.

“All of the different things that are happening at HHS, whether it’s through the Centers for Disease Control or National Institutes of Health or the Food and Drug Administration or the many other programs that are happening through there, Charmaine will help them with their messaging and she is very gifted at communication both digitally and in person,” Mancini said.

Planned Parenthood Federation of America, the nation’s largest abortion provider, is not supportive of Yoest’s appointment.

“It is unacceptable that someone with a history of promoting myths and false information about women’s health is appointed to a government position whose main responsibility is to provide the public with accurate and factual information,” Dawn Laguens, executive vice president of Planned Parenthood, said in a statement provided to The Daily Signal.  

Yoest, Laguens said, “has spent her whole professional life opposing access to birth control and a woman’s right to a safe, legal abortion.”

Kevin Griffis, Yoest’s predecessor at HHS during the Obama administration, recently joined Planned Parenthood as vice president of communications.

Under Yoest’s leadership, Americans United for Life developed a legislative package called the Women’s Protection Project, designed to provide lawmakers with “specific legislative solutions to the growing concerns regarding the health risks to women from abortion.”

Chuck Donovan, president of the Charlotte Lozier Institute, an organization that seeks to educate society on the importance of protecting life, told The Daily Signal that such attacks on Yoest are are unfounded.

“I think she is terrific,” Donovan said in an interview. “She’ll be the most knowledgeable policy person, my guess would be, to ever hold a position like that,” adding:

She’s not only a great communicator with experience [in] the media, print and broadcast, but she has written extensive policy documents. She knows the issues inside and out.

The post Pro-Life Advocates Optimistic as One of Their Own Gets Key HHS Job appeared first on The Daily Signal.

As Senate Mulls Obamacare Repeal, Insurers in 2 States Ask Double-Digit Premium Hikes

Consumers in at least two states face the prospect of double-digit increases in health insurance rates next year, as insurers attempt to price premiums amid uncertainty, including from Congress and President Donald Trump on the fate of Obamacare.

Also driving rate increases is the fact that the millions of Americans enrolled on Obamacare’s exchanges are sicker than the general population.

Insurance companies selling plans in Maryland and Connecticut have submitted their rate requests for 2018, as other insurers decide whether they’ll continue to offer coverage on Obamacare’s state-run and federal exchanges.

Already, Tennessee and Iowa have seen an exodus of major insurers. Consumers in parts of those states are in jeopardy of having no insurers to choose from on the exchange next year.

Humana announced in February that it no longer would sell Obamacare coverage in Tennessee, leaving residents of 16 counties in the eastern part of the state at risk of having no plans available to them.

But BlueCross BlueShield of Tennessee stepped in Tuesday, notifying the state’s insurance commissioner in a letter that it would sell coverage on the Obamacare exchange in those areas.

That coverage, though, may come with a steep price, the insurer warned.

“Given the potential negative effects of federal legislation and/or regulatory changes, we believe it will be necessary to price-in those downside risks, even at the prospect of a higher-than-average margin for the short term, or until stability can be achieved,” J.D. Hickey, president of BlueCross BlueShield of Tennessee, wrote.

In Iowa, Wellmark Blue Cross and Blue Shield and Aetna already said this year they no longer would sell plans in the individual market next year. That leaves just one insurer, Medica, as the only choice for Iowans living in 94 of the state’s 99 counties.

But Medica indicated last week that it would leave Iowa’s individual insurance market.

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today,” the company said in a statement to The Des Moines Register.

Higher Premiums

Alongside potential exits from Obamacare’s exchanges, insurers in Maryland, Connecticut, and Virginia have begun to submit proposed premium increases for 2018.

Chris Sloan, a senior manager at Avalere, stressed that the figures coming from insurers are only proposed rates, and those rates typically decrease as insurance companies negotiate with state insurance departments and their commissioners.

Still, the preliminary figures from insurance companies indicate that uncertainty about the future of the health insurance market, and the enrollment population from years past, could lead to double-digit premium increases next year.

“This is a market that continues to have underlying issues with the risk,” Sloan told The Daily Signal. “Last year, a lot of people looked at 2017 as a market correction, which is why we had such big increases [in premiums], but then going into 2018 and nothing has changed in most of these markets.”

In Connecticut, just two insurers will sell health coverage on Obamacare’s exchange next year, according to the state.

There, Anthem requested an average rate increase of 34 percent for plans sold in the individual market. ConnectiCare requested an average rate increase of 15 percent for individual health plans.

In documents filed with the state, ConnectiCare said that despite “uncertainties” in the market, the company based its pricing on “weakened” enforcement of Obamacare’s individual mandate and continuation of cost-sharing reduction payments, which are taxpayer-funded subsidies that lower the cost of deductibles and copayments for exchange customers.

Anthem also attributed its request for a 34 percent rate increase to the continuation of the subsidies that lessen the amount low-income Americans pay in deductibles and copayments. But the company also warned it has continued to enroll patients who are sicker and require more expensive care.

In Maryland, consumers purchasing coverage on Obamacare’s exchange could see substantially higher premiums next year.

There, CareFirst BlueCross BlueShield asked to raise rates by more than 50 percent.

“What we’re seeing is greater sickness levels,” Chet Burrell, CareFirst’s chief executive, told The Washington Post. “The pool of beneficiaries is becoming sicker, in part because healthier people are not coming in at the same level we hoped.”

Cigna and Evergreen Health asked to raise rates by an average of 37 percent and 28 percent, respectively.

Maryland reminded consumers, though, that the requests from insurers are preliminary.

“It’s important to remember that these rates are what companies have requested and not necessarily what will be approved,” Insurance Commissioner Al Redmer said. “There will be a thorough review of all the filings. As in years past, we may require changes.”

Uncertainties

In addition to the continuation of subsidies to reduce deductibles and copayments, some insurers attributed their requested rate hikes to the federal government’s weakened enforcement of the Obamacare mandate that all individuals have health insurance.

The health care bill passed by House Republicans last week eliminates the mandate altogether. And earlier this year, the IRS signaled it would continue accepting tax returns from taxpayers who didn’t indicate whether they had insurance for 2016.

But Sloan, of Avalere, said there wasn’t necessarily a significant shift in enforcement of the individual mandate from the Obama administration to the Trump administration.

“The secret in Washington is that the mandate hasn’t been enforced anyway,” he said. “The Obama administration gave a ton of exemptions, and the vast majority of people who were uninsured didn’t pay this penalty. It’s not as if we’re going from heavy enforcement to suddenly none. We’re going from lax enforcement to potentially more lax enforcement.”

Where Sloan does agree with insurers, though, is in the uncertainties looming as companies plot their rates for 2018.

“What [insurers] may have gained in understanding the exchange population, they’re losing in uncertainty of what the market will look like,” he said.

Those uncertainties include whether Trump will continue funding—and whether Congress will appropriate the money for—Obamacare’s cost-sharing subsidies, and how the House GOP’s health care bill will affect the insurance market.

The House-passed bill to repeal parts of Obamacare is called the American Health Care Act, or AHCA. Republican leaders in the Senate have said they will draft their own bill in coming weeks.

“With Congress, obviously if there was certainty on what the market will look like when talking about the AHCA, that would help,” Sloan said. “It would help if they committed or de-committed either way to funding or not funding the cost-sharing reductions.”

Sloan added:

There’s uncertainty around how many other carriers are going to be participating in the market, whether they’re going to have to bear all the bad risk in the market, uncertainty around what happens with the AHCA and whether subsidies will change or changes to the mandate. There’s a lot of stuff swirling around these plans. You’re going to see that in their requests going forward.

Still, the potential for double-digit rate hikes has provided fodder for congressional Republicans and the Trump administration, as both work to fulfill a campaign promise of repealing and replacing Obamacare.

“Last year alone, 83 insurers left the Obamacare marketplace and Americans living in one-third of our nation’s counties had only one choice for coverage,” Alleigh Marre, spokeswoman for the Department of Health and Human Services, said in an email to The Daily Signal. “The fact remains, insurers are fleeing because the law is fundamentally flawed.”

“Repealing and replacing Obamacare remains the best option,” Marre said.

In an interview Tuesday on “Fox & Friends,” House Speaker Paul Ryan pointed to the rate hike proposals in Maryland, as well as Medica’s decision to leave Iowa, as reasons why Obamacare has to be repealed.

“Here’s the problem: This law is collapsing. This law is failing fast,” Ryan, R-Wis., said. “And so what we’re doing is a rescue operation, which is getting rid of this law, which is collapsing.”

The post As Senate Mulls Obamacare Repeal, Insurers in 2 States Ask Double-Digit Premium Hikes appeared first on The Daily Signal.

As Senate Mulls Obamacare Repeal, Insurers in 2 States Ask Double-Digit Premium Hikes

Consumers in at least two states face the prospect of double-digit increases in health insurance rates next year, as insurers attempt to price premiums amid uncertainty, including from Congress and President Donald Trump on the fate of Obamacare.

Also driving rate increases is the fact that the millions of Americans enrolled on Obamacare’s exchanges are sicker than the general population.

Insurance companies selling plans in Maryland and Connecticut have submitted their rate requests for 2018, as other insurers decide whether they’ll continue to offer coverage on Obamacare’s state-run and federal exchanges.

Already, Tennessee and Iowa have seen an exodus of major insurers. Consumers in parts of those states are in jeopardy of having no insurers to choose from on the exchange next year.

Humana announced in February that it no longer would sell Obamacare coverage in Tennessee, leaving residents of 16 counties in the eastern part of the state at risk of having no plans available to them.

But BlueCross BlueShield of Tennessee stepped in Tuesday, notifying the state’s insurance commissioner in a letter that it would sell coverage on the Obamacare exchange in those areas.

That coverage, though, may come with a steep price, the insurer warned.

“Given the potential negative effects of federal legislation and/or regulatory changes, we believe it will be necessary to price-in those downside risks, even at the prospect of a higher-than-average margin for the short term, or until stability can be achieved,” J.D. Hickey, president of BlueCross BlueShield of Tennessee, wrote.

In Iowa, Wellmark Blue Cross and Blue Shield and Aetna already said this year they no longer would sell plans in the individual market next year. That leaves just one insurer, Medica, as the only choice for Iowans living in 94 of the state’s 99 counties.

But Medica indicated last week that it would leave Iowa’s individual insurance market.

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today,” the company said in a statement to The Des Moines Register.

Higher Premiums

Alongside potential exits from Obamacare’s exchanges, insurers in Maryland, Connecticut, and Virginia have begun to submit proposed premium increases for 2018.

Chris Sloan, a senior manager at Avalere, stressed that the figures coming from insurers are only proposed rates, and those rates typically decrease as insurance companies negotiate with state insurance departments and their commissioners.

Still, the preliminary figures from insurance companies indicate that uncertainty about the future of the health insurance market, and the enrollment population from years past, could lead to double-digit premium increases next year.

“This is a market that continues to have underlying issues with the risk,” Sloan told The Daily Signal. “Last year, a lot of people looked at 2017 as a market correction, which is why we had such big increases [in premiums], but then going into 2018 and nothing has changed in most of these markets.”

In Connecticut, just two insurers will sell health coverage on Obamacare’s exchange next year, according to the state.

There, Anthem requested an average rate increase of 34 percent for plans sold in the individual market. ConnectiCare requested an average rate increase of 15 percent for individual health plans.

In documents filed with the state, ConnectiCare said that despite “uncertainties” in the market, the company based its pricing on “weakened” enforcement of Obamacare’s individual mandate and continuation of cost-sharing reduction payments, which are taxpayer-funded subsidies that lower the cost of deductibles and copayments for exchange customers.

Anthem also attributed its request for a 34 percent rate increase to the continuation of the subsidies that lessen the amount low-income Americans pay in deductibles and copayments. But the company also warned it has continued to enroll patients who are sicker and require more expensive care.

In Maryland, consumers purchasing coverage on Obamacare’s exchange could see substantially higher premiums next year.

There, CareFirst BlueCross BlueShield asked to raise rates by more than 50 percent.

“What we’re seeing is greater sickness levels,” Chet Burrell, CareFirst’s chief executive, told The Washington Post. “The pool of beneficiaries is becoming sicker, in part because healthier people are not coming in at the same level we hoped.”

Cigna and Evergreen Health asked to raise rates by an average of 37 percent and 28 percent, respectively.

Maryland reminded consumers, though, that the requests from insurers are preliminary.

“It’s important to remember that these rates are what companies have requested and not necessarily what will be approved,” Insurance Commissioner Al Redmer said. “There will be a thorough review of all the filings. As in years past, we may require changes.”

Uncertainties

In addition to the continuation of subsidies to reduce deductibles and copayments, some insurers attributed their requested rate hikes to the federal government’s weakened enforcement of the Obamacare mandate that all individuals have health insurance.

The health care bill passed by House Republicans last week eliminates the mandate altogether. And earlier this year, the IRS signaled it would continue accepting tax returns from taxpayers who didn’t indicate whether they had insurance for 2016.

But Sloan, of Avalere, said there wasn’t necessarily a significant shift in enforcement of the individual mandate from the Obama administration to the Trump administration.

“The secret in Washington is that the mandate hasn’t been enforced anyway,” he said. “The Obama administration gave a ton of exemptions, and the vast majority of people who were uninsured didn’t pay this penalty. It’s not as if we’re going from heavy enforcement to suddenly none. We’re going from lax enforcement to potentially more lax enforcement.”

Where Sloan does agree with insurers, though, is in the uncertainties looming as companies plot their rates for 2018.

“What [insurers] may have gained in understanding the exchange population, they’re losing in uncertainty of what the market will look like,” he said.

Those uncertainties include whether Trump will continue funding—and whether Congress will appropriate the money for—Obamacare’s cost-sharing subsidies, and how the House GOP’s health care bill will affect the insurance market.

The House-passed bill to repeal parts of Obamacare is called the American Health Care Act, or AHCA. Republican leaders in the Senate have said they will draft their own bill in coming weeks.

“With Congress, obviously if there was certainty on what the market will look like when talking about the AHCA, that would help,” Sloan said. “It would help if they committed or de-committed either way to funding or not funding the cost-sharing reductions.”

Sloan added:

There’s uncertainty around how many other carriers are going to be participating in the market, whether they’re going to have to bear all the bad risk in the market, uncertainty around what happens with the AHCA and whether subsidies will change or changes to the mandate. There’s a lot of stuff swirling around these plans. You’re going to see that in their requests going forward.

Still, the potential for double-digit rate hikes has provided fodder for congressional Republicans and the Trump administration, as both work to fulfill a campaign promise of repealing and replacing Obamacare.

“Last year alone, 83 insurers left the Obamacare marketplace and Americans living in one-third of our nation’s counties had only one choice for coverage,” Alleigh Marre, spokeswoman for the Department of Health and Human Services, said in an email to The Daily Signal. “The fact remains, insurers are fleeing because the law is fundamentally flawed.”

“Repealing and replacing Obamacare remains the best option,” Marre said.

In an interview Tuesday on “Fox & Friends,” House Speaker Paul Ryan pointed to the rate hike proposals in Maryland, as well as Medica’s decision to leave Iowa, as reasons why Obamacare has to be repealed.

“Here’s the problem: This law is collapsing. This law is failing fast,” Ryan, R-Wis., said. “And so what we’re doing is a rescue operation, which is getting rid of this law, which is collapsing.”

The post As Senate Mulls Obamacare Repeal, Insurers in 2 States Ask Double-Digit Premium Hikes appeared first on The Daily Signal.

Here Are the Challenges Facing the Senate After House Passes Obamacare Replacement Bill

Republicans cleared a major hurdle on Wednesday in advancing their proposal repealing and replacing Obamacare. But the House GOP’s health care bill is likely to see major changes in the Senate, where Republicans must contend with strict budget rules and slim margins to pass the legislation.

The House passed the American Health Care Act, 217 to 213, Thursday afternoon, capping off weeks of negotiations that sought to satisfy conservative and centrist Republicans.

The bill repeals a number of Obamacare’s major provisions, including the individual and employer mandates, and replaces the law’s tax credits with age-based, refundable tax credits.

House leaders and the White House worked for weeks to get the health care bill through the lower chamber after conservatives and centrist Republicans came out against the original proposal.

The legislation that passed Thursday included amendments to address the concerns of both factions of the Republican party.

But though the health care plan was narrowly approved by the House, the bill could undergo a major makeover in the Senate.

There, a 12-member group of senators is drafting the Senate’s own proposal repealing and replacing Obamacare, which will include parts of the plan that passed the House.

“The safest thing to say is there will be a Senate bill, but it will look at what the House has done and see how much of that we can incorporate in a product that works for us in reconciliation,” Sen. Roy Blunt, R-Mo., said.

Republicans are using a budget tool called reconciliation to fast-track their Obamacare replacement plan through the Senate, where it will need 51 votes to pass.

Republicans hold 52 seats.

Margins for Senate Majority Leader Mitch McConnell are slim, and already, several GOP senators have been skeptical of the House’s Obamacare repeal plan.

Sen. Susan Collins, R-Maine, criticized the bill in March and opposes efforts to defund Planned Parenthood. The legislation strips the organization of its federal funding for one year.

Additionally, four other Republican senators—Rob Portman of Ohio, Cory Gardner of Colorado, Lisa Murkowski of Alaska, and Shelley Moore Capito of West Virginia—expressed concerns about the bill’s plan for phasing out Obamacare’s Medicaid expansion in March.

Portman reaffirmed his opposition to the legislation Thursday.

“I’ve already made clear that I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse,” the Ohio Republican said in a statement.

Conservatives, too, have their own concerns with the House’s Obamacare repeal plan.

Sen. Ted Cruz, R-Texas, emboldened his colleagues to “continue to improve the bill.”

“For many weeks, I have been working closely with my Senate colleagues, from across the ideological spectrum, on consensus reforms to make health insurance more affordable,” Sen. Ted Cruz, R-Texas, said in a statement. “We must deliver on that promise.

Conservative members of the Freedom Caucus are holding out hope that the upper chamber repeals more of Obamacare.

“Let’s be honest, when we sent an Obamacare repeal legislation to the Senate, it got better because we had folks like Mike Lee and Sen. [Ted] Cruz and Sen. [Marco] Rubio and Sen. [Rand] Paul and all these conservative senators who pushed the so-called reconciliation rules, who pushed the envelope and made it a slightly better piece of legislation,” Rep. Jim Jordan, R-Ohio, told The Daily Signal. “So we’re hoping that’ll happen again.”

In addition to addressing the concerns of Senate Republicans, GOP senators crafting their own bill must adhere to strict rules that govern the reconciliation process. Those rules ensure the tool is used only on bills that change taxes, spending, or the deficit.

Senators can challenge a provision of legislation by raising a point of order against “extraneous matter” included in the bill if he or she believes it violates the Byrd rule, named for the long-serving Democratic senator from West Virginia, Robert Byrd.

The Byrd rule outlines six tests to determine what constitutes “extraneous matter,” and some tests hold more weight than others.

If a senator objects to a part of a reconciliation bill, the Senate parliamentarian advises members on whether it meets the requirements or not. If the parliamentarian says a provision violates the Byrd rule, it may be removed from the bill, or it may be deemed fatal to the legislation.

House Speaker Paul Ryan said the House GOP’s health care bill was crafted to adhere to the rules of reconciliation.

But health policy experts warn that some provisions of that legislation could pose problems for Republicans in the Senate.

“I think the bill is ultimately going to have to be significantly rewritten to answer some of those concerns and hopefully takes it more toward something approaching an actual repeal of Obamacare,” Chris Jacobs, a senior health care policy expert at the Texas Public Policy Foundation and founder of Juniper Research Group, told The Daily Signal.

Jacobs has previously warned about pro-life protections included in the tax credits, which prevent the use of federal dollars to pay for most abortions, and the Senate parliamentarian has ruled in the past that those pro-life provisions violate the Byrd rule.

“There’s past precedent to suggest that this is ultimately a policy change and may not be permitted under the Byrd rule,” he said. “A policy change with an incidental budgetary impact. Therefore, it’s essentially not permitted under the Byrd rule.”

But removing the pro-life provisions for the tax credits could pose further problems for Republicans in both chambers.

“It raises the entire question of whether or not the tax credits remain politically viable because it will be taxpayer funding for plans to cover abortion, just like Obamacare,” Jacobs said.

Jacobs and other experts raised concerns about the fate of the House GOP’s original bill in the Senate several weeks ago. But since then, Republican leaders have added several amendments to the legislation, including one that allows states to pursue waivers to opt out of some Obamacare regulations and another that allocates money to states to set up programs to protect people with pre-existing conditions.

The Senate parliamentarian hasn’t yet ruled whether those amendments will pass muster in the upper chamber, but Jacobs said an analysis from the Congressional Budget Office would’ve provided some clarity.

Reconciliation bills can’t increase the deficit, and Jacobs said a “score” from the nonpartisan agency will detail the provision’s fiscal impact.

The House voted without an analysis from the Congressional Budget Office, which estimates how many people will lose or gain coverage and what the costs of the bill will be.

Though it’s unclear whether the waiver scheme created by the House GOP’s bill will withstand what’s called a “Byrd bath,” Jacobs said it would’ve been better for Republicans to repeal the regulations outright.

“I think a better solution is to repeal the regulations rather than having this waiver option of if you like your Obamacare, you can keep it,” he said.

The post Here Are the Challenges Facing the Senate After House Passes Obamacare Replacement Bill appeared first on The Daily Signal.

House Passes Obamacare Replacement by Razor-Thin Margin

The House of Representatives voted 217-213 to pass Republicans’ revised Obamacare replacement bill and move it to the Senate, where more changes are expected.

House Speaker Paul Ryan needed 216 votes to pass the legislation, and 20 GOP members voted no.

Immediately after the 2:30 p.m. vote, House Republicans began boarding buses to head to a celebratory event at the White House.

The legislation, called the American Health Care Act, has been a point of contention on Capitol Hill since  Ryan, R-Wis., pulled the bill March 24 when it became clear Republicans did not have enough votes to pass it.

The House Freedom Caucus, a group of conservative lawmakers, originally opposed the bill but now supports it with the addition of the so-called MacArthur amendment negotiated by Freedom Caucus Chairman Mark Meadows, R-N.C., and Tuesday Group Co-chairman Tom MacArthur, R-N.J.

“The MacArthur amendment will grant states the ability to repeal cost-driving aspects of Obamacare left in place under the original [American Health Care Act],” the Freedom Caucus said in a formal statement. “While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health care costs.”

The revisions also include a provision on coverage for Americans with preexisting conditions.

Reps. Fred Upton, R-Mich., and Billy Long, R-Mo., worked with President Donald Trump on Wednesday to secure a new amendment that provides $8 billion more in federal funding over five years to help cover individuals with preexisting conditions.

The Wall Street Journal tweeted the names of the 20 Republicans who voted no:

“While it’s not full repeal, I’ve said this many times, it’s what we believe is the best piece of legislation we can get out of the House at this moment,” Rep. Jim Jordan, R-Ohio, told reporters Wednesday at Conversations With Conservatives, a monthly gathering on Capitol Hill.

The bill includes provisions to repeal Obamacare subsidies and replace them with age-based, refundable tax credits to help consumers get coverage in the individual market, and to  repeal the Obamacare mandate that forced consumers to get health insurance or pay a penalty.

The legislation allows states to choose waivers to bypass Obamacare’s community-rating rules, which block insurers from charging sick consumers more than healthy consumers.  States that do so may charge sick customers more only if they don’t maintain continuous coverage.

Before the vote, House Minority Leader Nancy Pelosi, D-Calif., railed on the House floor against the “moral monstrosity” she called Trumpcare. Ryan, when he spoke, depicted the legislation as beginning to keep a promise to voters.

Senate Minority Leader Chuck Schumer, D-N.Y., tweeted his opposition shortly before the House vote.

Melanie Israel, a research associate at The Heritage Foundation, praised the bill’s pro-life provisions, one of which ensures that tax dollars will not go to the abortion industry and also defunds Planned Parenthood for one year.

“The American Health Care Act addresses pro-life concerns regarding Planned Parenthood funding and abortion coverage in health plans,” Israel told The Daily Signal in an email, adding:

These important restrictions would protect tax dollars from entanglement with the abortion industry and help allow individuals and families to choose health care that meets their needs without violating their beliefs or subsidizing life-ending drugs and procedures.

Melissa Quinn and Ken McIntyre contributed to this report.

The post House Passes Obamacare Replacement by Razor-Thin Margin appeared first on The Daily Signal.

The House Acts on Obamacare. Time for the Senate to Follow Suit.

By passing the American Health Care Act by a vote of 217-213, the U.S. House of Representatives has taken a major step in the process of repealing and replacing Obamacare.

It’s now time for the Senate to act.

In paving the way for successful House floor action, the House Rules Committee adopted an amendment enabling states to reverse the upward trajectory of premiums in their health insurance markets.

As Heritage analysts have argued, the right policy is to liberate states from Obamacare’s insurance mandates. This is a step in that direction.

New Jersey Rep. Tom MacArthur’s amendment would give the secretary of health and human services the authority to grant a waiver to states that wanted an exemption from costly Obamacare rating rules and benefit mandates.

In order to secure a waiver from these federal insurance rules, the amendment specifies that states must establish a high-risk pool for persons with pre-existing conditions, a program to stabilize the those premiums, or participate in a new federal risk-sharing program designed to secure continuing coverage and market stability.

As drafted, the waiver from these federal regulations would be virtually automatic. In short, the states would make the key regulatory decisions over benefits and rating rules.

A second amendment, offered by Rep. Fred Upton (R-MI) and Rep. Billy Long (R-MO) adds $8 billion over 2018-2023 to the bill’s $130 billion Patient and State Stability Fund (making the total around $138 billion).

It specifies that those additional funds are to be used by states that have received a waiver from federal insurance rules (under the MacArthur Amendment) to assist individuals with increased healthcare costs.

A Good Foundation

The House’s action should be understood as part of a continuing process of national health reform.

As amended, the House bill rightly focuses on costly health insurance rules, makes historic changes in Medicaid—transforming Medicaid from an open-ended entitlement to a budgeted program—and repeals the national health law’s mandate penalties and its slew of taxes.

In fact, the House bill provides for one of the largest tax reductions on record.

Up Next: The Senate

While the House bill is a major improvement over current law, the Senate can do even better.

First, the Senate should start the reform of the federal tax treatment of health insurance.

The House has failed to repeal the so-called “Cadillac Tax” on “high value” group health plans—a 40 percent excise tax (effective in 2020) on all group health plans with a value that exceeds $10,800 for single coverage and $29,100 for family coverage.

The House bill merely delays the tax implementation until 2026. The Senate should instead repeal the tax and replace it with a simple cap on the tax exclusion for group insurance.

This would not force employers to alter their plans, but merely limit the amount of health benefits that are tax-free, just as current law limits all other pre-tax employment compensation.

Economists, regardless, of their political perspectives, have generally agreed that such a move would drive down health costs throughout the entire system.

Second, the Senate should address the Medicaid provisions. The Senate should speed up the reversal of Obamacare’s Medicaid expansion, and provide an alternative to the House bill’s block grant provision.

The best alternative is a robust premium support program for the able-bodied Medicaid population, enabling them to enroll in private plans and secure the same access to doctors and quality care that their fellow citizens enjoy.

Finally, the Senate should reconsider the continuing coverage provisions of the House bill.

For the individual market, the best option would be for the Senate to adopt the rules that currently govern group insurance, and link the prohibition on pre-existing condition exclusions to a requirement that persons maintain continuous coverage. The group rules work.

The health care sector of America’s economy is approximately $3.2 trillion. It is huge, complex, and rapidly growing. No single bill can or will accomplish comprehensive reform—it is an ongoing process.

The House of Representatives has made a strong start. Now, it’s time for the Senate to do its job.

The post The House Acts on Obamacare. Time for the Senate to Follow Suit. appeared first on The Daily Signal.

Conservatives Back Newest Changes to Health Care Bill as House Moves Closer to Obamacare Repeal

House Republicans are inching closer to a vote on the GOP’s revised health care bill following the addition of an amendment that gained the support of two prominent Republicans, and maintained the backing of conservatives.

Reps. Fred Upton, R-Mich., and Billy Long, R-Mo., negotiated the terms of the amendment with President Donald Trump during a meeting at the White House on Wednesday. The new measure would add $8 billion in federal funding over five years to help consumers with pre-existing conditions.

The pair came out in opposition to the bill repealing and replacing Obamacare earlier this week following the addition of an amendment, revealed last week, that would allow states to opt out of Obamacare’s regulations.

That proposal, negotiated by Tuesday Group Co-chairman Tom MacArthur, R-N.J., and House Freedom Caucus Chairman Mark Meadows, R-N.C., earned the backing of the conservative Freedom Caucus.

The White House has been pushing House GOP leaders to bring the revised bill, called the American Health Care Act, before members for a vote. But top Republicans have struggled to find a delicate balance between appeasing conservatives and centrist Republicans, who opposed the original plan for different reasons.

The amendment from Long and Upton, though, appears to have succeeded in striking that balance, and conservatives said Wednesday they would continue to back the repeal bill barring any changes to its policy.

“While it’s not full repeal, I’ve said this many times, it’s what we believe is the best piece of legislation we can get out of the House at this moment,” Rep. Jim Jordan, R-Ohio, told reporters at a monthly gathering on Capitol Hill.

The text of the amendment hasn’t been released yet, but Rep. Raúl Labrador, R-Idaho, said that he would continue to support the revised plan as long as it only added additional money to help sick consumers.

“If they’re changing any of the policies that we have been able to advocate for and get included in the bill, then that’s going to cause a tremendous problem for conservatives,” Labrador said.

Conservative lawmakers, who negotiated with the White House and Republican leaders for several weeks, announced their support for the health care bill, with the addition of the MacArthur amendment, last week.

The MacArthur Amendment allows states to seek waivers from the federal government to opt out of two of Obamacare’s regulations. One of those regulations, the community rating rules, prohibits insurers from charging sick patients more than they charge healthy patients.

The proposal’s backers said people with pre-existing conditions would be protected from being charged expensive premiums, since the provision requires states to set up high-risk pools, which subsidize coverage for sick people.

But the plan sparked significant skepticism from centrist Republicans who worried the legislation would make it more difficult for Americans with pre-existing conditions to gain affordable coverage.

The future of the House GOP’s health care bill was put into jeopardy—despite the endorsement from the Freedom Caucus—after Upton, former chairman of the Energy and Commerce Committee, came out in opposition to the legislation.

He was joined by Long, who also worried the revised bill wouldn’t protect people with pre-existing conditions.

“I have always stated that one of the few good things about Obamacare is that people with pre-existing conditions would be covered,” Long said in a statement. “The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable.”

Still, the addition of the new amendment appeared to quell their concerns.

“I think [the bill] is likely now to pass in the House,” Upton told reporters Wednesday at the White House.

Republicans could vote on the legislation as early as Thursday, but they’ll be voting on the plan without an analysis from the nonpartisan Congressional Budget Office, which estimates how much premiums will change and how many people will lose or gain coverage.

Still, conservatives are hopeful the revised bill, with the addition of the MacArthur amendment, will help lower the price of health insurance premiums for consumers.

“We’re going to have a CBO score with other amendments that are offered in the Senate,” Meadows said, “so before we vote for final passages, we’ll obviously have a CBO score.”

The post Conservatives Back Newest Changes to Health Care Bill as House Moves Closer to Obamacare Repeal appeared first on The Daily Signal.

What You Need to Know About the Obamacare Subsidies At the Center of the Health Care Debate

While Republicans and Democrats negotiated a government spending bill this week, another form of financial assistance that aims to help low-income Americans under Obamacare has been at the center of a debate involving insurance companies, consumers, and President Donald Trump.

These subsidies aren’t the tax credits implemented under the health care law, which lower the cost of premiums for eligible consumers, but are called cost-sharing reductions.

They’ve been the subject of much scrutiny lately, and a source of concern for insurance companies, congressional Democrats, doctors, hospitals, and the U.S. Chamber of Commerce.

So what are the cost-sharing reductions, how do they work, and why have they been thrust to the center of debate?

What Are the Cost-Sharing Reductions?

The cost-sharing reductions are subsidies designed to reduce out-of-pocket costs for low-income patients who purchase silver-level plans through Obamacare’s exchanges. The subsidies are only available to marketplace customers with an income between 100 percent and 250 percent of the federal poverty line ($12,000 to $30,000 for an individual).

In 2017, 7 million people—58 percent of marketplace enrollees—qualified for cost-sharing reductions, according to the Department of Health and Human Services.

How Do the Cost-Sharing Reductions Work?

While Obamacare’s tax credits and cost-sharing reductions are both intended to help lower the cost of coverage for low-income Americans, both serve different functions.

The tax credits are paid directly to consumers and lower the cost of premiums. But the government pays cost-sharing reductions directly to insurers.

Insurance companies then offer plans with reduced deductibles, copayments, and out-of-pocket limits to eligible patients.

In 2016, the government reimbursed insurers roughly $7 billion for cost-sharing reductions.

Why Are They in the News?

The cost-sharing reductions were the subject of much scrutiny in 2014, and now they’re back in the news again.

In 2014, the Republican-led House of Representatives filed a lawsuit against the Department of Health and Human Services, then led by Secretary Sylvia Mathews Burwell, over the subsidies.

Republican lawmakers argued that the Obama administration made payments to insurers without an appropriation from Congress, which they said was unconstitutional. But the Obama administration said they intended for lawmakers to fund the cost-sharing reductions alongside Obamacare’s tax credits.

In 2016, a federal district court judge in the District of Columbia sided with House Republicans and ruled that because Congress never appropriated money for the cost-sharing reductions, the Obama administration violated the Constitution.

Obama’s Department of Justice quickly appealed, and the judge’s order has been halted since then.

Now, the Trump administration has to decide whether it will continue the Obama administration’s fight, and the next court date is scheduled for May 22.

What Does the Trump Administration Want to Do?

At this stage, no one is entirely sure what Trump and his officials plan to do about the cost-sharing reductions.

Both the White House and the Department of Health and Human Services, now led by Secretary Tom Price, have sent mixed signals on whether they intend to continue funding the subsidies.

In a statement to The New York Times last month, the Department of Health and Human Services said the agency would continue to make payments to insurance companies.

But Trump floated the idea of using the cost-sharing reductions as leverage to bring Democrats to the negotiating table over a bill replacing Obamacare.

“Obamacare is dead next month if it doesn’t get that money,” Trump said of the subsidies in an interview with the Wall Street Journal last month. “I haven’t made my viewpoint clear yet. I don’t want people to get hurt … What I think should happen and will is the Democrats will start calling me and negotiating.”

Even more recently, though, White House budget director Mick Mulvaney told reporters Tuesday the administration hadn’t yet decided whether it will make cost-sharing reduction payments for May.

What Options Does Trump Have?

The Trump administration could drop the Obama administration’s lawsuit, and the Department of Health and Human Services would stop making payments to insurers.

But if the White House decided to continue funding the subsidies, they could move forward with the lawsuit that originated with the Obama administration.

Trump could also urge Congress to appropriate the money in future appropriations bills.

Democrats pushed the president and congressional Republicans to allocate money for cost-sharing reductions in a stopgap government spending bill that passed Congress this week. But money for the subsidies was ultimately left out of the legislation.

That spending bill keeps the government running until September.

While it remains unclear how the Trump administration wants to proceed—and whether Congress will appropriate money for cost-sharing reductions—the subsidies could be eliminated entirely.

The House GOP’s health care bill, called the American Health Care Act, gets rid of cost-sharing reductions.

What Happens if The Cost-Sharing Reductions Stop?

If the Trump administration decided to halt subsidies, insurance companies would lose the money they’re reimbursed for offering reduced deductibles, co-pays, and out-of-pocket limits to consumers.

To compensate for the lost money, insurers could raise premiums for all of their customers. The Kaiser Family Foundation estimates that if that were to happen, health insurance premiums would increase an average of 19 percent.

Insurance companies could also decide to leave the marketplace by canceling contracts with state and federal regulators, and end coverage for consumers mid-year, according to the Commonwealth Fund.

However, the Commonwealth Fund said leaving the marketplace would be complicated.

Where Do Republicans and Democrats Stand?

For Democrats, the answer to the question on what to do with the cost-sharing reductions is easy: they want Congress to appropriate the money to fund the subsidies.

They’re joined by a coalition of insurance companies, physicians, hospitals, and the U.S. Chamber of Commerce, which collectively sent a letter to congressional leaders last month urging them to fund the cost-sharing reductions.

Though the Republican-led Congress didn’t appropriate money for the subsidies in this week’s spending bill, top GOP lawmakers are also in favor of continuing the cost-sharing reductions.

Rep. Tom Cole, R-Okla., told The New York Times he believes Congress should provide the money to fund the subsidies.

He was joined by House Energy and Commerce Chairman Greg Walden, R-Ore., who said lawmakers had an obligation to insurers and consumers to make sure the government’s payments to insurance companies were made.

“We cannot leave them high and dry,” he told The New York Times.

The post What You Need to Know About the Obamacare Subsidies At the Center of the Health Care Debate appeared first on The Daily Signal.