Part 2: Healthcare Destabilization Day

Thursday, October 12, should now be known as “Healthcare Destabilization Day.” On the same day President Trump declared that Cost Sharing Subsidies (CSS) to insurance companies would no longer be funded, he also signed an Executive Order to expand the use of Health Reimbursement Arrangements (HRAs). We all now know that healthcare is complicated, but this combination is one for the record books. Destabilization #1 — The CSS are a mathematical manipulation created in the original Affordable Care … [Read more...]

Part 1: Trump Tackles the ACA Alone!

After multiple congressional efforts to repeal/replace/modify the Affordable Care Act (ACA) have failed due to partisan and inter-party disagreements, President Trump issued an Executive Order and then announced an end to Cost Sharing Subsidies (CSS) to force change. The order, titled “Promoting Healthcare Choice and Competition Across the United States,” directs regulatory agencies to focus on three areas with the goal of facilitating the purchase of insurance across state lines and providing … [Read more...]

What’s ‘Fair’ Anymore?

It’s State Fair time in Texas. That means corn dogs, car shows, and Texas vs. Oklahoma football. Although it may also include clowns and carnival rides, this blog is about actually about healthcare (and what’s “fair”) and not the State Fair. Politically-motivated news, AKA fake news, makes it virtually impossible to make meaningful legislative progress on major healthcare items like Medicaid. Here’s an example using the recent Graham-Cassidy Bill. Please understand, I’m not stating any opinion … [Read more...]

Healthcare Sanctuary City

The term “sanctuary city” does not have a consistent definition, but it does provoke a wide range of emotional (and political) responses. I will define a sanctuary city as a jurisdiction where local authorities have made a conscious and declared decision to not enforce certain federal immigration laws. These local authorities lack the power to change the laws, so they simply don’t enforce them. President Trump effectively created a healthcare sanctuary city on his first day in office. His … [Read more...]

Healthcare Sanctuary City

The term “sanctuary city” does not have a consistent definition, but it does provoke a wide range of emotional (and political) responses. I will define a sanctuary city as a jurisdiction where local authorities have made a conscious and declared decision to not enforce certain federal immigration laws. These local authorities lack the power to change the laws, so they simply don’t enforce them. President Trump effectively created a healthcare sanctuary city on his first day in office. His … [Read more...]

Same Old, Same Old

My wife and I eat at our favorite Thai food restaurant on a regular basis. It’s a small, family run restaurant, and Kim waits the tables. I always ask Kim how she’s doing. Inevitably, her answer is, “Same old, same old.” Same old, same old is great for a Thai restaurant with great Thai food. I want the same old, same old. That’s what I expect. The year 2016 ended with the same old, same old. One of the major insurers resolved a pricing dispute with a major hospital system in the 11th hour. The … [Read more...]

What do Hurricanes and High Deductible Health Plans Have in Common?

The recent destruction and flooding caused by Hurricane Matthew caused me to think about the different way we view homeowner’s insurance and health insurance. Seems like an odd comparison, but stay with me on this. Many individuals shy away from high deductible health plans and opt for a more expensive preferred provider organization (PPO) plan even though their maximum exposure is identical under both types of plans. Yet, the same individual has a high deductible homeowner’s policy for their … [Read more...]

ColoradoCare Part 4: “Health Price Discrimination in Colorado”

Whether Colorado voters decide to socialize healthcare financing in the state (ColoradoCare AKA Amendment 69) or maintain the current hybrid of public and private financing, the issue of discrimination in healthcare — and what to do about it — remains. Price discrimination in healthcare is real, and it’s measurable. My questions deal with what level of price discrimination is acceptable, what level is unethical, what level might be illegal, and what role, if any, should the government play? So … [Read more...]

ColoradoCare Part 3: “Why it will Fail”

Combine the technology rollout of the Affordable Care Act (ACA) website, the customer service of the Internal Revenue Service (IRS), the healthcare wait times of the VA hospitals, and the actuarial wizardry of the ACA-created healthcare co-ops and you get a picture of what some believe would happen to healthcare in Colorado if ColoradoCare (Amendment 69) were to pass. Healthcare in Colorado is expensive, and the requested rate increases in the individual marketplace are about to get even more … [Read more...]

ColoradoCare Part 2: “Why it will Pass”

The winds of healthcare change are blowing in Colorado. The clouds are gathering, but will there actually be rain? The following factors could simultaneously converge to create an overhaul in how healthcare is funded in the state through the passage of Amendment 69, or ColoradoCare (to view what ColoradoCare is, check out my previous post: ColoradoCare Part 1: The Basics). Health Care Is a Right Proponents of universal healthcare argue that healthcare is a right and not a privilege or … [Read more...]