Trump Signals Support for Repealing Obamacare Now, Then Replacing It Later

President Donald Trump and conservative senators are embracing a new tactic in their quest to undo the damage of Obamacare: repeal it now, then replace it later.

If the approach sounds familiar, it’s what conservative had planned to do in January until Trump, Sen. Rand Paul, R-Ky., and other Republicans insisted on a replacement at the same time.

Today, however, the repeal-now, replace-later idea is gaining momentum again. Sen. Ben Sasse, R-Neb., is urging lawmakers and Trump to consider the alternate path after Senate Republicans failed to reach agreement on the Better Care Reconciliation Act before their July 4 recess.

“The Senate will next be in legislative session on Monday, July 10,” Sasse wrote in a letter to Trump on Friday. “If we don’t get to agreement on a combined, comprehensive Obamacare repeal and replace plan by that day, I humbly suggest that you publicly call on the Congress to do two things.”

The Nebraska senator said his plan would be to first “immediately repeal as much of Obamacare as is possible under congressional budget reconciliation rules.”

Sasse then said the Senate should “cancel the scheduled August state work period and instead to spend that month working through regular order, six days per week, writing a health reform package with a vote to be scheduled on Labor Day.”

Other lawmakers, including Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus, and Sen. David Perdue, R-Ga., have advocated for canceling the August recess to work on priorities such as repealing and replacing Obamacare.

In a recent op-ed for The Daily Signal, Perdue wrote, “There isn’t time to deal with the issues that demand immediate attention. The only appropriate response is to cancel, or heavily truncate, the annual August recess that turns the United States Capitol into a ghost town.”

Shortly after Sasse outlined his idea, Trump tweeted his support:

Meadows, the House Freedom Caucus chairman, said in a statement provided to The Daily Signal that he would support a move to repeal Obamacare first, and then replace it:

At the very beginning of this process, many of my colleagues and I advocated doing repeal and replace of Obamacare separately on the same timeline so that we can both keep our promise of full repeal to the voters while having an open and honest debate about a better system. I still believe it would be an effective approach. Whether we proceed in this direction or another, I remain committed to that promise: repealing Obamacare and replacing it with market driven principles that lower premiums for American families.

Trump and Sasse’s suggestions come following the announcement Tuesday by Senate Majority Leader Mitch McConnell, R-Ky., that the Senate would delay its vote on the health care bill until after July 4.

“We’re going to continue the discussions within our conference on the differences that we have that we’re continuing to try to litigate,” McConnell said. “Consequently, we will not be on the bill this week, but we’re still working toward getting at least 50 people in a comfortable place.”

Paul, who challenged Trump for the GOP nomination in 2016, also indicated he was open to the repeal-first approach.

Earlier in the year, Republicans opted for a repeal-and-replace strategy in part because of Trump and Paul’s support for simultaneous action.

Dan Holler, a spokesman for Heritage Action for America, told The Daily Signal in an email that any health care legislation going forward “needs to address Obamacare’s burdensome rules and regulations that are driving up costs for hardworking Americans.”

Republicans will need at least 51 votes to pass a health care bill under a procedure known as budget reconciliation, with Vice President Mike Pence enabled to break a tie if two Republicans defect.

Moderates such as Sen. Rob Portman, R-Ohio, have not been supportive of the Senate’s current bill. Sen. Susan Collins, R-Maine, said the bill would need a “fundamental overhaul” to gain her vote.

Meanwhile, conservatives such as Sen. Ted Cruz, R-Texas, have advocated for changes that would give consumers the freedom to choose between more affordable plans that don’t adhere to the standards imposed by Obamacare as long as insurers still provide plans that do.

The post Trump Signals Support for Repealing Obamacare Now, Then Replacing It Later appeared first on The Daily Signal.

Ohio Is Already Rolling Back Parts of Obamacare. How Other States Can Do the Same.

For years, most Americans have looked to Washington for relief from Obamacare.

To be sure, Congress must pass and the president must sign a full repeal of Obamacare so that states and citizens can regain their health care freedom and decision making.

But even while Obamacare remains law, states have the tools to stop and roll back parts of the law in their state. In Ohio, we are doing just that.

In April, I proposed that an enrollment freeze on Obamacare’s Medicaid expansion population be added to Ohio’s budget during House deliberations.

I believed then, as I do today, that this is a necessary step to both free up resources for those who are truly vulnerable and to ensure that our Medicaid program, and state as a whole, are financially sound for the future.

Fortunately, the Ohio General Assembly sent the expansion freeze to Gov. John Kasich’s desk as part of Ohio’s biennial operating budget bill, making Ohio the first state to do so.

Many state legislatures across the country are currently having discussions about how to roll back the Affordable Care Act and cultivate a free market health care system that works for the citizens of their state.

While I hope that Congress eventually reaches a solution to fully and completely repeal Obamacare, it is the duty of the states to do what we can now to begin repairing a health care system broken by federal intrusion.

It is my hope that Ohio will stand as a leader in this effort.

In Ohio, we currently have nearly 60,000 people who qualify for traditional Medicaid and are currently on a waiting list to receive services. These are children and adults with developmental disabilities who need anything from specialized medical equipment to assist them with their daily lives, to therapeutic intervention, to at-home medical services.

Meanwhile, Obamacare’s Medicaid expansion spends billions of dollars each year—more than double its projections—to cover over 725,000 individuals, a large percentage of whom are able-bodied, childless adults.

In other words, the truly vulnerable have been forced to wait for services, while many who have the capacity to provide for themselves have been jumped to the front of the line.

By enacting an enrollment freeze on the expansion, Ohio has reasserted our prerogative as a state and sent a strong message that states do not need to wait around for Congress to act.

Make no mistake, Ohio’s enrollment freeze is the single most impactful action taken by a state to roll back and stop Obamacare since the law passed in 2010.

By freezing enrollment for the Medicaid expansion, states are able to preserve resources for the truly vulnerable, all while allowing those who are currently enrolled to maintain coverage as long as they are eligible.

This allows current enrollees time to improve their situation so that they can obtain better coverage on the individual market or through an employer.

Our vision in Ohio of a healthy and prosperous state includes fewer citizens and families dependent on government, not more.

By pursuing this goal, we support the dignity, worth, and freedom of every human being by reducing government dependency, and putting individuals and families back in charge of their health care choices.

The post Ohio Is Already Rolling Back Parts of Obamacare. How Other States Can Do the Same. appeared first on The Daily Signal.

Ohio Is Already Rolling Back Parts of Obamacare. How Other States Can Do the Same.

For years, most Americans have looked to Washington for relief from Obamacare.

To be sure, Congress must pass and the president must sign a full repeal of Obamacare so that states and citizens can regain their health care freedom and decision making.

But even while Obamacare remains law, states have the tools to stop and roll back parts of the law in their state. In Ohio, we are doing just that.

In April, I proposed that an enrollment freeze on Obamacare’s Medicaid expansion population be added to Ohio’s budget during House deliberations.

I believed then, as I do today, that this is a necessary step to both free up resources for those who are truly vulnerable and to ensure that our Medicaid program, and state as a whole, are financially sound for the future.

Fortunately, the Ohio General Assembly sent the expansion freeze to Gov. John Kasich’s desk as part of Ohio’s biennial operating budget bill, making Ohio the first state to do so.

Many state legislatures across the country are currently having discussions about how to roll back the Affordable Care Act and cultivate a free market health care system that works for the citizens of their state.

While I hope that Congress eventually reaches a solution to fully and completely repeal Obamacare, it is the duty of the states to do what we can now to begin repairing a health care system broken by federal intrusion.

It is my hope that Ohio will stand as a leader in this effort.

In Ohio, we currently have nearly 60,000 people who qualify for traditional Medicaid and are currently on a waiting list to receive services. These are children and adults with developmental disabilities who need anything from specialized medical equipment to assist them with their daily lives, to therapeutic intervention, to at-home medical services.

Meanwhile, Obamacare’s Medicaid expansion spends billions of dollars each year—more than double its projections—to cover over 725,000 individuals, a large percentage of whom are able-bodied, childless adults.

In other words, the truly vulnerable have been forced to wait for services, while many who have the capacity to provide for themselves have been jumped to the front of the line.

By enacting an enrollment freeze on the expansion, Ohio has reasserted our prerogative as a state and sent a strong message that states do not need to wait around for Congress to act.

Make no mistake, Ohio’s enrollment freeze is the single most impactful action taken by a state to roll back and stop Obamacare since the law passed in 2010.

By freezing enrollment for the Medicaid expansion, states are able to preserve resources for the truly vulnerable, all while allowing those who are currently enrolled to maintain coverage as long as they are eligible.

This allows current enrollees time to improve their situation so that they can obtain better coverage on the individual market or through an employer.

Our vision in Ohio of a healthy and prosperous state includes fewer citizens and families dependent on government, not more.

By pursuing this goal, we support the dignity, worth, and freedom of every human being by reducing government dependency, and putting individuals and families back in charge of their health care choices.

The post Ohio Is Already Rolling Back Parts of Obamacare. How Other States Can Do the Same. appeared first on The Daily Signal.

Here Are 3 Reasons the Senate Health Care Bill Should Expand Individual Health Accounts

As Congress works to undo the damage caused by Obamacare, members are looking for ways to maximize their opportunity to address Obamacare’s problems that drove up premium costs for insurance and reduced access to plans.

One innovative idea currently under consideration: expanding the use of health savings accounts. These are tax-advantaged accounts that let individuals save for routine health expenses.

Created in the Medicare Modernization Act of 2003, the use of these accounts has been successful, though limited, due to restrictions placed on them by Congress.

The good news: Provisions for expanding these individualized health savings accounts have been included in both the House and Senate Obamacare repeal bills. Additionally, reports suggest senators are looking for additional ways to expand the accounts.

More needs to be done to promote this innovative reform.

Here are three big reasons for expanding the use of health savings accounts:

1.) Individual Control and Choice

One of the primary benefits of health savings accounts is that their management is put in the hands of individuals, not the government or health insurance providers.

With health savings accounts, more options are available to users to manage how, when, and where money is spent. Consumers have the option of spending money from the account or saving it for the future, depending on their individual needs.

What is also important is that the money is portable, and doesn’t go away if the account holder switches jobs.

This is a big deal.

The American health care system has been built around the employer-based model in which people generally receive a plan from the company they work at.

But Americans in the 21st century move and switch jobs at a much higher pace than previous generations. A 2016 Gallup survey showed that millennials change jobs and are open to changing jobs at a much higher rate than earlier generations.

This is an increasing reality in competitive job markets. It makes sense to have a health care system that matches their behavior.

With a health savings account, a temporary loss or change of employment doesn’t force the individual to start from scratch.

2.) Promoting Saving

It is wise to save money for a rainy day, but the American health care system does little to incentivize this behavior.

Unlike other plans, like so-called flexible savings accounts, health savings accounts permit funds to “roll over” at the end of the year—tax–free—without the money being turned over to the employer.

This means that if an individual or family wants to save their health care savings for the future, those extra funds would be available.

Allowing Americans to build up funds is not just helpful in preparation for a potential catastrophe, it can aid families bracing for expected big expenses down the road, or for purchasing long-term care insurance.

For instance, such a plan can be highly beneficial to couples who are planning to start a family. They could choose to spend less money on themselves for a few years, and then build a bigger financial war chest to meet the inevitable medical expenses when they have children.

This could take a huge burden off of young couples who may be wary of the cost of having children.

3.) Lower Costs for Consumers, and the Country

Health savings accounts come with a generous tax break that is highly beneficial for the account holder. Employee contributions are tax-deductible and employer contributions are tax-free.

Also, money withdrawn from the account to pay for qualified medical expenses—such as dental work or prescription drugs—is also tax-free.

But reduced costs do not just impact the individual consumer. When people experience a direct and positive impact from their financial decisions, both in costs and benefits, they tend to find ways to operate more efficiently.

When more individuals are making choices about their health care and more efficiently address their needs, the entire system will benefit from lower health care costs.

According to a Heritage Foundation analysis of Indiana’s health care reform for state employees, the adoption of health savings accounts had a major impact on individual behavior.

The researchers noted:

Increased responsibility for health spending encouraged consumers to substitute generics for brand drugs, avoid unnecessary emergency room visits, and use primary-care physicians instead of specialists when appropriate. Participants also had lower hospital admissions and shorter lengths of stay when they were admitted.

The study estimated that the savings of this system added up to between “$17 million to $23 million” in 2010.

The impact of moving the whole country toward this type of health insurance would, of course, be far greater.

Some studies have shown that moving Americans toward health savings accounts in large numbers could save tens of billions of dollars annually.

Certainly, Congress can do more to both improve the efficacy of health savings accounts and make them more accessible.

>>> Read The Heritage Foundation report on the Senate health bill: “Better Than the Status Quo, Senate Health Care Bill Still Misses Major Opportunities

Currently, Congress requires people to have high-deductible insurance policies in order to contribute to the accounts.

This could be expanded by allowing the account to be free-standing, regardless of the type of insurance, which would allow people to make contributions while buying any kind of plan, further increasing consumer choice.

Another likely and important addition would be allowing individuals and families to use the savings accounts to pay for monthly health care premiums, which skyrocketed under Obamacare. This could potentially drive down premium costs for everyone.

The U.S. hasn’t really had a federal “free-market” health care system since the passage of the New Deal. Over time, the system has moved even further in the direction of government meddling and involvement.

Obamacare doubled down on this top-down path of government control, and moved the country closer to a single-payer health care system that is common in Europe.

By adopting health savings accounts in higher numbers, our health care system can be moved in a direction that puts it on stronger footing in the future and allows individuals to do what’s best for themselves and their families.

The post Here Are 3 Reasons the Senate Health Care Bill Should Expand Individual Health Accounts appeared first on The Daily Signal.

Asset based long-term care insurance as an alternative to traditional long-term care policies

One thing I hear a select group of senior retirees lament is that they feel they have put “so much money” into their long-term care insurance policies and, as yet, have received little or no benefit. Some wonder, as they continue to pay premiums, whether they will ever see a return for the dollars they …

The post Asset based long-term care insurance as an alternative to traditional long-term care policies appeared first on TedStevenot.com.

What the CBO Score Means for the Senate Health Care Bill

The Congressional Budget Office (CBO) released its score on Monday of the Better Care Reconciliation Act (BCRA) of 2017.

The top line score is very similar to the American Health Care Act (AHCA) that was passed earlier in the House.

This budgetary analysis projects that if passed into law, the BCRA would reduce the number of insured by 22 million, but would decrease the deficit by $321 billion while also reducing federal outlays by $1022 billion and federal revenue by $701 billion.

The BCRA differs from its House counterpart in that it modifies the Obamacare tax credits rather than creating an entirely new tax credit. While it seems that the effects might be similar, the CBO states that average premiums in 2019 would be slightly higher in the BCRA due to larger subsidies for older people.

The CBO also includes the caveat that out-of-pocket costs could increase in states. However, in 2020, average premiums would be about 30 percent lower than under current law, and about 20 percent lower by 2026.

The CBO suggests that few low-income people would purchase plans under this scheme, as they believe higher deductibles and out-of-pocket costs will push people away from gaining coverage.

While total coverage losses work out to be roughly the same as the House bill, it is clear that on the insurance side, the effects of the law may be felt by different people.

One group, for example, are individuals that are not eligible for Medicaid, but under current law are also not eligible for exchange subsidies. The BCRA extends subsidies to this group, meaning they receive assistance when they previously were on the hook for the full cost of their premiums.

This calculation could vary across individuals and states because of the uncertainty when it comes to waivers.

The new CBO score also addresses the effect of allowing states to pursue waivers in order to address their insurance programs.

They find that premiums would likely be lower in states that pursue waivers, and while they provide some illustrative examples, the magnitude of these changes are highly dependent on state-level factors that are very difficult to score.

Once again, one of the main drivers in savings comes from the changes to Medicaid. The BCRA cuts $772 billion from Medicaid by 2026.

While the BCRA saves less than its House counterpart on Medicaid—mostly due to higher spending in the early years—it is clear that the budgetary effects still serve to put Medicaid on a budget.

While this includes rolling back the exclusion, there are also additional savings such as targeting gaming of the Medicaid reimbursement through provider taxes.

Key Takeaways

The CBO’s score of the BCRA has not changed much from the previous scores of the House bills.

While there might be disagreements about the coverage effects of state waivers, it is still clear that there are meaningful premium reductions from allowing states to pursue them.

The CBO still leaves many questions about the effects of this legislation open-ended. There are many difficulties and uncertainties in scoring any piece of health care legislation. When state-level decisions are also included, this becomes an even more difficult task.

Additionally, the CBO was asked to score this legislation with a quick turnaround time. The score likely would have provided more clarity if given extra time.

The CBO has also still failed to walk back its overly optimistic views on the effectiveness of the individual mandate and the performance of Obamacare moving forward.

The post What the CBO Score Means for the Senate Health Care Bill appeared first on The Daily Signal.

Americans Struggling Under Obamacare Tell Pence ‘Real Story’

Marjorie Weer spent six months negotiating with an insurance company just to clear the way for her 3-year-old son Montgomery to travel from South Carolina to see doctors at Boston Children’s Hospital.

“This is the real story of Obamacare in America,” @VP says.

Monty, as the family calls him, has spina bifida, a birth defect that prevents the spinal cord from developing properly. Weer says she had to press his case with the insurer from November into April.

During Monty’s short life, the family has had three health insurance plans—under two different companies—largely because of problems caused by Obamacare, Weer says. Those plans offered the Weers few options for insurers in South Carolina and restricted coverage networks outside that state.

Marjorie Weer, left, shares her story as Trump administration official Seema Verma listens. (Photo: Fred Lucas/The Daily Signal)

“Whenever you tell a special needs mom ‘No,’ there is no point to that,” Weer said Monday, as she had the ears of Vice President Mike Pence and Seema Verma, administrator of the Centers for Medicare & Medicaid Services, which oversees Obamacare.

Weer, whose story was first featured by The Daily Signal in February, traveled to Washington to be part of Pence’s listening session with Americans who spoke on behalf of 10 different families who are “victims of Obamacare.”

“You make us jump through hoops; I have the strongest legs in South Carolina,” Weer said in the meeting at the Eisenhower Executive Office Building, adjacent to the White House. She added:

I’ve jumped through hoops every day for three years. So thankfully they did approve the care, after a long time on the phone, for [Monty] to go to the doctor he wanted to. But he is 3. I have a 17-month-old daughter. I don’t want to be on the phone for hours. I want to pick up Play-Doh off the floor. I want to be a mom to my kids.

>>> One Mom’s Fight for Her Special Needs Son in the Age of Obamacare

It’s ironic, Weer said, that the Democrats who passed Obamacare and staunchly support keeping it in place also tout themselves as “pro-woman” and “pro-choice.”

“I’m a woman. My choice is to take my child to a different doctor than Obamacare will let me,” Weer said, with Monty sitting beside her.

After hearing Weer’s story, Pence said to her: “Monty is truly blessed.”

She is the one who is blessed, his mother responded.

Gathered around a table, Marjorie Weer and other guests tell Obamacare stories to Vice President Mike Pence, in blue tie at right. (Photo: Fred Pence/The Daily Signal)

“This is the real story of Obamacare in America,” Pence said, speaking of all the participants in the listening session.

As Senate Republicans grapple with a health care bill to replace Obamacare, the White House featured the forum for “victims of Obamacare.” Representatives of families talked for more than an hour about skyrocketing premiums, loss of coverage, and a lack of stability when health plans change on an annual basis.

The Congressional Budget Office predicted Monday that 22 million fewer people would have health insurance under the Senate plan than under the Affordable Care Act, popularly known as Obamacare.

However, critics note that too many health insurance plans under Obamacare can’t be used because medical networks are so restricted. And Obamacare mandates that Americans buy insurance even if they don’t want it, or pay a penalty.

Christine McCullough, of Slidell, Louisiana, is among the 6.5 million Americans who chose to pay a penalty and buy their own insurance.

At Pence’s event, McCullough spoke about the outrageous expense of Obamacare plans.

“Move now,” she implored lawmakers. “Don’t wait until this meeting is over. Move now to let us buy insurance plans across state lines.”

Christine Chalkey of Streator, Illinois, talked about her 22-year-old son, Jacob, who has a rare seizure disorder. When Medicaid expanded in Illinois, it led to less coverage for Jacob’s medication, Chalkey said.

“He had tried so many different medicines,” she said.

While on a new medication, he had a major, life-threatening seizure.

“I’m a living miracle,” Jacob said during the forum.

Those around the table applauded him, and he passed written letters about himself to the vice president, including one for President Donald Trump to read.

Pence passed that one along to Kellyanne Conway, counselor to the president, who was at the meeting.

Pence gave a hug to another participant, Connie May of Richmond, Ohio, who talked about what she lost in paying for insurance that that too many doctors won’t accept.

“It’s been ringing in our ears: affordable health insurance for everyone. Well, who is everyone?” May said, tearfully.

The post Americans Struggling Under Obamacare Tell Pence ‘Real Story’ appeared first on The Daily Signal.

The Senate Should Offer a Range of Options to Encourage Continuous Insurance Coverage

As Senate Republicans work on legislation to start reversing Obamacare’s damage to insurance markets, one problem they need to address is the perverse incentive created by two Obamacare mandates.

Those mandates required insurers to accept all applicants and prohibited them from denying coverage for pre-existing conditions.

The problem to address is that the combination of these two Obamacare mandates created a perverse incentive for people to delay obtaining health insurance coverage until they need medical care, and to drop coverage once they have been treated.

Such behavior has occurred, particularly in the subsidized exchange market, with the result that Obamacare has destabilized the market for individual health insurance sold both on and off the exchanges.

Obamacare tried to counter those perverse incentives by offering subsidies to lower-income individuals and imposing a mandate on all Americans to buy coverage.

After three years of experience, it is clear that the mandate approach failed.

Neither the subsidies nor the mandate penalty got enough healthy people to buy overpriced Obamacare coverage, and there is little insurers can do to stop people gaming the system.

The resulting imbalance between premium revenues and claim costs has been one of the two biggest drivers responsible for escalating premiums under Obamacare (as insurers hike rates to avoid operating at a loss), along with the law’s benefit mandates.

Therefore, Congress should provide a range of options for creating incentives to maintain continuous health insurance coverage.

Without such provisions, the bill is likely to cause significant problems in the insurance market, including rising premiums for all, as Obamacare’s perverse incentives for people to wait to buy coverage until they are sick will remain in place.

The House-passed bill’s approach allows states to authorize insurers to impose a one-year premium surcharge on individual market applicants who lack continuous coverage at the time of enrollment, or charge those without continuous coverage risk-rated premiums for a year.

The Senate bill now includes provisions to impose on those without continuous coverage a six-month waiting period before their coverage takes effect (as has been suggested by some insurers).

The Senate should give additional options and give states the flexibility to experiment with different approaches, allowing each state to determine which one works best for its market.

The most effective approach would be to apply the prohibition on pre-existing condition exclusions to only those individuals who can demonstrate continuous coverage during the prior year. This would be the same as the federal rule for employer-group plans that was in place before Obamacare.

Other, somewhat less effective alternatives, have also been proposed, such as imposing on those without continuous coverage a premium surcharge, a risk-rated premium or higher deductibles for one year.

The goal of all these mechanisms is the same: Return to states authority over insurance market regulation that was pre-empted by Obamacare.

This is appropriate because states have over a century of experience regulating insurance. Obamacare’s pre-emption of their authority with new federal benefit mandates and regulations was not only unnecessary, but short-circuited the ability of states to adopt different approaches or to modify rules to accommodate changing circumstances.

The House-passed version of the American Health Care Act attempts to return much of that authority to the states.

The Senate can improve on the House-passed bill’s approach by giving states more options, particularly for addressing the important issue of creating incentives for continuous coverage.

The post The Senate Should Offer a Range of Options to Encourage Continuous Insurance Coverage appeared first on The Daily Signal.

The Senate Should Offer a Range of Options to Encourage Continuous Insurance Coverage

As Senate Republicans work on legislation to start reversing Obamacare’s damage to insurance markets, one problem they need to address is the perverse incentive created by two Obamacare mandates.

Those mandates required insurers to accept all applicants and prohibited them from denying coverage for pre-existing conditions.

The problem to address is that the combination of these two Obamacare mandates created a perverse incentive for people to delay obtaining health insurance coverage until they need medical care, and to drop coverage once they have been treated.

Such behavior has occurred, particularly in the subsidized exchange market, with the result that Obamacare has destabilized the market for individual health insurance sold both on and off the exchanges.

Obamacare tried to counter those perverse incentives by offering subsidies to lower-income individuals and imposing a mandate on all Americans to buy coverage.

After three years of experience, it is clear that the mandate approach failed.

Neither the subsidies nor the mandate penalty got enough healthy people to buy overpriced Obamacare coverage, and there is little insurers can do to stop people gaming the system.

The resulting imbalance between premium revenues and claim costs has been one of the two biggest drivers responsible for escalating premiums under Obamacare (as insurers hike rates to avoid operating at a loss), along with the law’s benefit mandates.

Therefore, Congress should provide a range of options for creating incentives to maintain continuous health insurance coverage.

Without such provisions, the bill is likely to cause significant problems in the insurance market, including rising premiums for all, as Obamacare’s perverse incentives for people to wait to buy coverage until they are sick will remain in place.

The House-passed bill’s approach allows states to authorize insurers to impose a one-year premium surcharge on individual market applicants who lack continuous coverage at the time of enrollment, or charge those without continuous coverage risk-rated premiums for a year.

The Senate bill now includes provisions to impose on those without continuous coverage a six-month waiting period before their coverage takes effect (as has been suggested by some insurers).

The Senate should give additional options and give states the flexibility to experiment with different approaches, allowing each state to determine which one works best for its market.

The most effective approach would be to apply the prohibition on pre-existing condition exclusions to only those individuals who can demonstrate continuous coverage during the prior year. This would be the same as the federal rule for employer-group plans that was in place before Obamacare.

Other, somewhat less effective alternatives, have also been proposed, such as imposing on those without continuous coverage a premium surcharge, a risk-rated premium or higher deductibles for one year.

The goal of all these mechanisms is the same: Return to states authority over insurance market regulation that was pre-empted by Obamacare.

This is appropriate because states have over a century of experience regulating insurance. Obamacare’s pre-emption of their authority with new federal benefit mandates and regulations was not only unnecessary, but short-circuited the ability of states to adopt different approaches or to modify rules to accommodate changing circumstances.

The House-passed version of the American Health Care Act attempts to return much of that authority to the states.

The Senate can improve on the House-passed bill’s approach by giving states more options, particularly for addressing the important issue of creating incentives for continuous coverage.

The post The Senate Should Offer a Range of Options to Encourage Continuous Insurance Coverage appeared first on The Daily Signal.

The Opioid Crisis is Dire. Why We Need a National Conversation About It Separate From Obamacare.

Whatever the merits or demerits of the recently released Senate version of the GOP health care bill, some have suggested that it should put more funding into treating opioid addiction.

Let’s be honest—the opioid crisis in America is huge, it is severe, and it is devastating. But this partisan-fought legislation just isn’t the place to put that funding. And it would likely do little to help stem and reverse the opioid crisis.

First, it’s not as though funding for opioid treatment and recovery has been absent from the federal budget. As recently as last month, Sen. Susan Collins, R-Maine, was touting signed legislation that spent more than $1 billion to fund recovery programs.

This money was authorized separately from the debate over Obamacare in two pieces of legislation known as the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act.

To highlight the importance of the opioid problem, and provide needed moneys to combat it, more and separate attention should be put on it as those two pieces of legislation began to do—it should not be caught up and tucked into the partisan debate over the repeal of Obamacare.

Reversing the opioid epidemic should not and cannot be a partisan political issue, and the debate over Obamacare is more partisan than almost any legislation in Congress.

Second, as the opioid crisis begins attracting more and more national attention—late as it may be—we need to give thorough consideration to how treatment money is being spent and what kinds of outcomes we should expect and demand from recovery treatment programs.

As things stand, the dropout rate for those in recovery programs is well over 50 percent, even after a great deal of time and money has been invested in the programs.

This is not a new problem. Relapse is high among those recovering from substance abuse in almost every program.

In part, that is the nature of addiction and drug abuse, and in part, it is the nature of some programs that work better than others.

But throwing good money after bad only to see high rates of relapse and worsening overdose events by those who do relapse is a waste of money and, in too many cases, life.

Finally, if we plan to get serious about the opioid crisis, we must devote at least half as much—if not more—attention to prevention as we do to treatment and recovery.

Treatment and recovery—while important—are last ditch efforts, after-the-fact solutions, addressing the issues too late. We need to focus on stopping these problems before they start, especially knowing how high the rates of relapse are.

We know that prevention programs have worked in the past, whether they pertain to forest fires or drunk driving or, for that matter, the massive reduction in drug use we witnessed in the late 1980s and early 1990s.

Such a prevention program for the opioid crisis must start with leadership from the White House in leading these conversations and highlighting the devastation of substance abuse initiation.

It requires detailing what is driving the opioid epidemic—namely, illegal fentanyl, heroin, and other illegal drug use and diversion. It requires more law enforcement—from border and customs policies and cracking down on cartels to international initiatives. And it requires messaging to our youth.

Yes, we need better physician training and pain management protocols. That has begun to take place—mostly out of the light of public view, which is fine and necessary.

But the national conversations and public messaging we’ve seen work so well in the past on a range of issues—especially on drug initiation and abuse—has been too muted.

If we want to get serious about the opioid crisis—and we must—partisan politics in repeal and replace debates are not the place to do so.

This crisis deserves its own conversation and, indeed, a new mindset that has, to date, been sorely absent.

The post The Opioid Crisis is Dire. Why We Need a National Conversation About It Separate From Obamacare. appeared first on The Daily Signal.