Checking Up On Health: July 5, 2016

Health Policy News and Views
Compiled by Benita M. Dodd

Mixed Reviews



If you ever wondered why, six years later, it remains difficult to overturn ObamaCare, consider the mixed reviews of the nation’s experts to the white paper Republicans released last month about their planned health insurance reforms.

Michael Cannon of the Cato Institute is not impressed .Writing in Forbes, Cannon makes nine points of where he believes Republicans fall short, and prefaces that with this disclaimer: “Don’t get me wrong. The plan is not all bad. Where it matters most, however, House Republicans would repeal ObamaCare only to replace it with slightly modified versions of that law’s worst provisions.”

The Reason Foundation’s Peter Suderman echoes that sentiment: “Although the plan starts by repealing the health care law in its entirety, it ends up replacing many of its central components with similar provisions.”

One of Cannon’s main concerns is the proposed refundable health insurance tax credit.  

As I have tried to warn Republicans before, these and all health-insurance tax credits are indistinguishable from an individual mandate. Under either a tax credit or a mandate, the government requires you to buy health insurance or to pay more money to the IRS. John Goodman, the dean of conservative health policy wonks, supports health-insurance tax credits and calls them “a financial mandate.” Supporters protest that a mandate is a tax increase while credits – or at least, the non-refundable portion – are a tax cut. But that’s illusory. True, the credit may reduce the recipient’s tax liability. But it does nothing to reduce the overall tax burden imposed by the federal government, which is determined by how much the government spends. And wouldn’t you know, the refundable portion of the credit increases the overall tax burden because it increases government spending, which Congress ultimately must finance with additional taxes. So refundable tax credits do increase taxes, just like a mandate.

His other concerns are they would retain guaranteed issue and the millennial mandate and retain and modify, rather than repeal, ObamaCare’s community-rating price.

Cannon concludes, “Health care reform should make health care better, more affordable, and more secure, particularly for the most vulnerable. ObamaCare does the opposite, and Republicans are right to oppose it.If they really care for patients, Republicans need to go back to the drawing board until they find a better way.”

Also in Forbes, Grace-Marie Turner of the Galen Institute, praises the GOP plan: “The biggest push-back from the right on this is that they instinctively prefer a tax deduction rather than a credit.  But a tax deduction is worth little or nothing to the people who are most likely to be uninsured and who most need help in purchasing insurance.  They may make too little to even pay taxes, but even if they do, their tax bracket is so low that the deduction may reduce the price of a policy for them by only 10%. The task force wisely opted for the credit approach.”

Forbes staffer Avik Roy also likes the plan: “No proposal is perfect … but, all in all, we would have a far better health care system with the [Paul] Ryan plan than we do today,” he writes.

Heritage Foundation health policy director Nina Owcharenko said the agenda has key core reforms that are needed for any patient-centered health reform plan: “There are areas where the task force could be more robust but on the whole the proposal is a good first start,”

It’s a white paper, an outline, a starting point. It’s the furthest along the long, tough road ahead that congressional Republicans have gone. The GOP, libertarian and conservative health care experts and those organizations already benefiting from ObamaCare will still struggle to reach agreement. Will it involve horse trading? Of course it will; it’s the nature of politics. On the bright side, however, there is an opportunity to begin constructing policy based on the areas where there is agreement on the plan.

Going down: Last Thursday the Centers for Medicare and Medicaid Services (CMS) announced the latest ObamaCare enrollment numbers (March): 11,081,330, and about 85 percent of those are getting premium assistance through advance payment of the premium tax credit – at an average of $291 per month. That number was 89.4 percent in Georgia. Interestingly, CMS predicts that enrollment will drop to 10 million by the end of the year. The administration reported 12.7 million signed up by the Jan. 31 deadline. If only 11.1 million were still paying premiums at the end of March, that’s a 13 percent enrollment decrease in two months.

Foundation Board Member Frank Barron of Rome, Ga., chats with Dr. Leonard Reeves and Barbara Earle of Rome's Faith and Deeds Community Health Free Clinic. See this weeks commentary, "Rome's Free Clinic: Community Taking Charge."

Georgia Public Policy Foundation Board Member Frank Barron of Rome, Ga., chats with Dr. Leonard Reeves and Barbara Earle of Rome’s Faith and Deeds Community Health Free Clinic. Read my commentary, “Rome’s Free Clinic: Community Taking Charge,”  here.

ICYMI: Two recent related commentaries consider ways to address Georgians’ health care needs.

  • I visited a free clinic in Rome, Georgia last month and wrote a commentary about the inspiring individuals behind the volunteer effort and the people served by Faith and Deeds Community Health. They save lives, and they do it with the cost-effectiveness of an organization committed to being responsible stewards of their donors’ dollars: For every dollar contributed, Faith and Deeds provides $7 of health care.  
  • Foundation President Kelly McCutchen had an op-ed published in The Atlanta Journal-Constitution that explained why Medicaid expansion is a bad, bad idea for Georgia and Georgians: “At the very least, Georgia could expand the scope of practice for nurse practitioners to help address an influx of patients without exacerbating access issues for existing Medicaid recipients. Unfortunately, Georgia has some of the nation’s most restrictive regulations for nurse practitioners.”

In Brief:

Shear amazement: You may know that it’s been 20 years since Dolly the sheep was cloned, but do you know why it was named Dolly? According to the journal Scientific American, researchers led by the University of Edinburgh’s Ian Wilmut cloned the sheep using DNA from an adult sheep’s mammary gland and named it after country singer Dolly Parton. Source:

An education on telemedicine: Georgia Magazine, the statewide distributed magazine of the Georgia EMCs, has an informative article on telehealth in the state. It reports that 96 schools in 25 counties have telemedicine capabilities. The approach is also making strides in emergency stroke care, ambulance services and home-based health care, Georgia Magazine reports. Not only is it providing a cost-effective option by reducing unnecessary trips to the emergency room (EMTs evaluate on-site), it’s also improving response times (early treatment of strokes) and reducing time-consuming trips to the hospital for ailing home-bound individuals. Read the article here.

Vanity is thy pain: The Washington Post reminds us how we once bemoaned “Blackberry thumb.” Now we have “selfie elbow,” the repetitive stress injury caused by people taking so many photographs of themselves! The condition was “discovered” after NBC journalist Hoda Kotb developed a pain in her elbow and visited the doctors to investigate, according to news reports. No more Blackberry worries, though: Blackberry has announced it is ceasing manufacture of its Blackberry Classic smartphone, which was based on the original that led the smartphone world before Samsung and Apple took over.