The new Senate health care bill

The following researchers have conducted extensive research on the pros and cons of the Affordable Care Act, Medicare and Medicaid, the insurance market and drug prices. Much of their research is accessible at the USC Schaeffer Center blog Evidence Base and the Schaeffer Initiative for Innovation in Health Policy, a partnership between the Brookings Institution and the USC Schaeffer Center.

Contact: Emily Gersema at (213) 361-5730 or gersema@usc.edu

Why insurers struggle in the ACA marketplace

“In recent weeks, some health insurers have announced that they will not offer individual market coverage in 2018, while others have requested sizable premium increases. In response to this news, President Donald Trump has pronounced the individual market structure created by the Affordable Care Act (ACA) ‘dead.’ Similarly, House Speaker Paul Ryan (R-WI) has claimed that the market is experiencing a ‘death spiral’ reflecting fundamental flaws in the ACA’s design. These claims misdiagnose the situation. The ACA’s individual market structure — though not perfect — is sound and has succeeded in greatly expanding coverage. As 2017 began, the market was poised to leave behind the growing pains of the past few years. Then the President and Congress acted to create needless turmoil.”

Paul B. Ginsburg was among a group of experts at the Brookings Institution who co-wrote this commentary and analysis recently for the New England Journal of Medicine. He can discuss how the Senate bill would affect Americans and insurers, as well as comment on current oversight and management of the ACA. Ginsburg leads the Schaeffer Initiative for Innovation in Health Policy. He is director of public policy at Schaeffer Center and a professor. He is based in Washington, D.C.

Contact: (202) 797-6268 or pginsbur@usc.edu

Alternatives to improve U.S. health care, aid the economy 
“Healthcare costs are a threat to the entire economy, not just to business. Left to current market forces, those costs will result in higher government deficits, increased borrowing, and eventually higher taxes on everyone, both personal and corporate. By 2040, the government projects healthcare will consume one-quarter of the economy.

“The connection between healthcare spending and the national deficit is rarely made in congressional debate. That is not a good thing. Healthcare costs are rapidly overwhelming both state and federal budgets, while raising costs for businesses that provide health insurance to their employees.”

Dana Goldman wrote this in a recent op-ed with USC Trustee Leonard D. Schaeffer, founder and CEO of WellPoint, that was published by The Hill. In a separate op-ed published by The Sacramento Bee, Goldman and Schaeffer suggested that policymakers should look to California’s health insurance system as a model. Goldman can comment on the Senate bill, discuss model health care systems such as California’s, and explain how the ACA compares to congressional proposals. Goldman is the director and chair of the Schaeffer Center, as well as a distinguished professor of pharmacy, policy and health economics.

Contact: (213) 740-0548 or dpgoldma@usc.edu

Uncertainty for ACA subsidies destabilizes the exchanges

“The ACA requires insurers to cover cost-sharing subsidies to help low-income exchange enrollees pay out-of-pocket costs like deductibles and copays, with the understanding that they will be reimbursed by the federal government. However, these payments to insurers are currently subject to legal challenges, and the administration has been unclear regarding whether it intends to continue to fund them (or ask Congress to do so legislatively). Similarly, it is highly unclear whether the administration plans to enforce the law’s individual mandate, or whether they will actively support the marketing of policies during open enrollment.

“In contrast to the indicated intention to promote market stability with the recent rule, this lack of clarity surrounding the future of the ACA’s cost-sharing subsidies and individual mandate instead injects a considerable degree of uncertainty regarding the short and long-term future of the exchanges.”

Erin Trish co-wrote this commentary published by the Schaeffer Initiative for Innovation in Health Policy earlier this year. Trish can comment on details about the new Senate bill and the Affordable Care Act. Trish is an assistant research professor at the USC Schaeffer Center and USC Price School.

Contact: (213) 821-6178 or etrish@healthpolicy.usc.edu

Medicaid cuts would burden families with special-needs kids

“Children with chronic health conditions require a significant amount of care, and hiring a home health aide can be prohibitively expensive for a family. To maintain their child’s care, families often incur financial and emotional stress from reduced earnings.””

John Romley can comment on the possible effect of health care policy changes on families with children who have special health needs. Romley recently conducted a study with Boston Children’s Hospital and Rand Corp., published by the journal Pediatrics, which calculated the value of medical care provided by family members at home for their special-needs children. Romley is a visiting associate professor of public policy at the USC Price School, and he is a visiting associate professor of pharmaceutical and health economics at the USC School of Pharmacy.

Contact: (213) 821-7965 or romley@healthpolicy.usc.edu

Medicaid needs revamping but not reductions

“State control of Medicaid was designed to foster experimentation and competition among states to provide efficient, high-quality care for the poor. And, the AHCA relies heavily on the logic that Medicaid will run better when states have greater financial responsibility and control.

“However, rising inequality between rich and poor areas of the country has undercut this rationale. As poorer states fall farther behind, they become ever less capable of mustering the resources needed to protect the growing ranks of vulnerable children, adults and seniors among their constituents.

“From this standpoint, further cuts to Medicaid — as envisioned by the AHCA — make little sense. Why make an underfunded program even more underfunded? Replacing Medicaid with an adequately funded alternative would make more sense than retaining the program and rendering it even less capable of aid to the poor.”

Darius Lakdawalla co-wrote these statements in an op-ed published by The Conversation in May. Lakdawlla can comment on the newly released Senate bill. He is a professor who holds the Quintiles Chair for Pharmaceutical Development and Regulatory Innovation at USC School of Pharmacy and the USC Schaeffer Center.

Contact: (213) 740-6012 or dlakdawa@usc.edu

GOP’s approach to health care would end the mandate

“Among Obamacare’s many provisions, none was more galling to Republicans than the individual mandate, which required Americans above a certain income to buy insurance. It was the subject of a lawsuit that went to the U.S. Supreme Court — and survived.

“Republican proposals to reform Obamacare have centered on repealing the mandate and thus the penalty on people who don’t buy comprehensive insurance coverage.”

Geoffrey Joyce wrote this in a column published by The Conversation in March. Joyce can comment on the new Senate health care bill and the Affordable Care Act. Joyce is director of health policy at the USC Schaeffer Center and an associate professor at the USC School of Pharmacy.

Contact: (323) 442-1371, (213) 821-7958 or gjoyce@usc.edu

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