The Biden Administration will have two powerful tools to make health care more affordable and accessible:

The Center for Medicare and Medicaid Innovation.

State waivers under the ACA and Medicaid.

@JAMAHealthForum

jamanetwork.com/channels/healt…
The Trump Administration encouraged states to use ACA and Medicaid waivers to restrict coverage, including Medicaid work requirements.

The Biden Administration could instead encourage states to expand coverage and improve affordability and give them the flexibility to do so.
Even with the new Democratic majority in the Senate, a robust public option will be difficult to pass, and Medicare for all is not in the cards in the near term.

But, with waivers, one or more states could potentially show how it could work.
Democrats will now have an opportunity to pass significant health reforms through Congress.

But, with razor thin majorities in both the House and the Senate, executive actions the Biden administration can take on health care will be just as important.

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More from @larry_levitt

21 Dec 20
Here's a link to the COVID relief bill.

The provisions protecting patients from surprise medical bills starts on page 4,095.

rules.house.gov/sites/democrat…
Congress is finally poised to protect patients from surprise medical bills.

It took a pandemic to overcome a political fight over how much insurers should pay out-of-network doctors and hospitals.
Insurers, employers, and consumers have argued payments to out-of-network providers should be based on a benchmark like in-network negotiated rates.

Providers favored an arbitration process for determining payment.

The bill Congress is poised to pass calls for arbitration.
Read 13 tweets
18 Dec 20
As Congress considers a ban on surprise medical bills, a new KFF survey finds 80% of the public supports such a prohibition.

Few health care ideas have this degree of bipartisan support.

kff.org/coronavirus-co… Image
We've been debating surprise bills for so long, it's easy to lose track of how bonkers these bills are.

For example: You get taken to the nearest ER (because, it's an emergency). Your insurer covers it. But, the hospital or ER doctors send you extra bills, because...they can.
Another example of a surprise medical bill:

You do your research and pick an in-network hospital for your planned procedure. But, an out-of-network anesthesiologist shows up in the operating room and sends you a surprise extra bill over and above what your insurer pays.
Read 4 tweets
7 Nov 20
A lot of President-Elect Biden's sweeping health care plans will be stymied if Republicans maintain control of the Senate, but he can and probably will reverse much of what President Trump has done in health care administratively.
Some Trump actions Biden can reverse:

Short-term plans not covering pre-existing conditions
ACA outreach cuts
Work requirements and funding caps in Medicaid
Gender identity discrimination
Family planning funding restrictions
Immigration limits for those using health benefits
Possibly the most important thing President-Elect Biden can do in health care at this moment in history is approach the pandemic with facts, science, and empathy. None of those things require an act of Congress.
Read 6 tweets
28 Sep 20
Biden's public option proposal has gotten more attention, but his expansion of ACA premium subsidies could be an even bigger deal.

More than 12 million people with employer health insurance could save money. That's a group the ACA largely left out.

kff.org/health-reform/…
Biden's proposal to build on the ACA eliminates the "subsidy cliff," providing help to enrollees who are middle-income, older, and in rural areas.

It also eliminates the "firewall" that prevents people with expensive employer health insurance from accessing ACA subsidies.
If Democrats sweep the November election, Biden's proposal to expand ACA subsidies could attract broad support.

His proposal for a public option has significant public support, but would bring vehement opposition from the health care industry.
Read 6 tweets
19 Sep 20
President Trump and many other candidates opposing the ACA say they support protecting people with pre-existing conditions. Now seems like a good time to ask how they would do that if the ACA gets struck down, which is all of a sudden more likely.
Overturning the ACA is not only about pre-existing condition protections. It's also about the Medicaid expansion, closing the Medicare drug coverage donut hole, preventive services, Medicare payments to hospitals, taxes, and much more.

kff.org/health-reform/…
You can’t just click your heels together three times to get insurance companies to guarantee pre-existing condition protections.

It takes strict regulations, plus government spending to make coverage affordable and encourage people who are currently healthy to enroll, too.
Read 5 tweets
15 Sep 20
New federal data show the the number of people uninsured increased by one million in 2019, before the pandemic and economic crisis hit.

The number of people uninsured has been growing since 2016, reversing historic gains following passage of the ACA.

census.gov/newsroom/press… Image
The number of Americans uninsured increased by 2.3 million from 2016 to 2019, after dropping by 20 million in the years following passage of the Affordable Care Act in 2010.
There was a big increase in the share of Hispanics uninsured in 2019 -- 18.7%, up from 17.9% in 2018. Hispanics are the group most likely to be uninsured, and are being hit particularly hard by COVID-19 right now.
Read 5 tweets

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