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States and Rebates

If you run a small business in Florida, are self-employed in Texas, or work for a large corporation in New Jersey ( see an update below ), then your state insurance regulators probably haven't been working for you. The news that 15.8 million people can expect $1.3 billion in rebates from insurers this year because of the Affordable Care Act (ACA) underscores how weak health insurance regulation has been in states across the country.  It may come as no surprise that Florida and Texas, two leaders in the fight against ACA, have been exposed as anti-consumer.  But they are not the only states with an anti-consumer bias. First, the good news: last week, the federal government announced that three-quarters of us will get letters beginning on July 1 telling us that our insurance plans paid out at least 80 to 85 cents in benefits for every premium dollar they collected. This means that under ACA they met the minimum standard for a reasonable benefit payout (which i...

Trump, DC Homelessness, and the National Guard

Claiming that D.C. crime is out of control, President Trump has brought in the National Guard. Never mind that crime rates are down in the District. The optics are compelling. Trump blames homeless people. As Fox News reported , he is giving them two choices – jail or homeless shelters to treat mental health and substance use disorders. If these choices seem reasonable, they aren’t. Sending someone to jail who hasn’t committed a crime is a bad, even unconstitutional, idea. Like our new South Florida gulag, this notion offends many of us. And many, if not most, of the people who are chronically homeless have seriously undertreated mental health conditions. Jails and shelters don’t have the money or resources to provide that treatment. What this boils down to is comfort. Seeing homeless people congregating makes some people uncomfortable. President Trump is suggesting that the freedom to congregate peacefully is a freedom reserved only to some of us – not everyone. There’s bigotry t...

Why the Republicans Have No Health Care Plan

There's a simple reason why (after more than a decade) Donald Trump and the Republicans have no plan to replace Obamacare. I'll explain in a few minutes. But first, some background. When the Affordable Care Act (or Obamacare) was passed in 2010, it was an effort to expand health care coverage to a lot of people who needed it, while controlling their costs. It had certain key provisions, not the least of which were that people couldn't be denied coverage for pre-existing conditions, that all chronic diseases needed to be covered fairly, and lifetime coverage caps had to be lifted. The problem was that if you left matters to insurers to set insurance premiums based on what this would cost, the price of insurance would rise dramatically. So the government took a look at three different programs and ultimately put them together into one system. For people whose income was so low that they couldn't afford any real cost-sharing, the government expanded Medicaid. For elders...