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What The Debt Deal Means For Health Reform

10:40 AM ET, 08/04/2011

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For a law regularly at the center of controversy, there was surprisingly little talk of the health care reform law during the debt ceiling debate. It certainly factored into some discussions — House Speaker John Boehner (R-Ohio) reportedly pushed for the individual mandate’s repeal as a trigger — but the issue never emerged as a deal breaker. That’s a big difference from the budget debate in April, where Republicans demanded a defunding vote as one of their must-have items.

Health policy analysts are still digging through the 74-page debt deal, and are starting to come to a few important conclusions about how it would effect the health care law. The general takeaway: if the trigger goes off, the law comes out a little bruised, but relatively unscathed. But no one knows what the Supercommittee will do.

Legislators have not shied away from using reform funds as an offset: they financed the last doc-fix, for example, by shaving off some funds to the health insurance tax credit. The Gang of Six would have repealed health reform’s longterm health insurance plan, the CLASS Act, to save $86 billion; Republicans have repeatedly voted to defund the health reform law’s $15 billion Preventive Health Fund. It’s changes like these, on the table heading into the next round of the deficit debate, that have the most potential for a serious impact on the Affordable Care Act’s future.

If the Supercommittee does not come up with enough savings, and the trigger cuts go into effect, the Affordable Care Act comes out in relatively decent shape. Medicaid, which will expand up to 133 percent of the Federal Poverty Line in 2014, is shielded from the trigger. So are most of the provisions to cover the cost of insurance premiums for lower -income Americans. Since the funds are provided as refundable income tax credits, they also can’t be touched. Continue reading

Increasing The Medicare Eligibility Age: A Smaller Bargain

From Politico:

By JENNIFER HABERKORN | 7/28/11 12:41 PM EDT

President Barack Obama and House Speaker John Boehner failed to strike a “grand bargain” on the nation’s deficit, but they may have pulled off another trick: revolutionizing the debate over Medicare.

When they both accepted the idea of increasing the Medicare eligibility age to 67, they gave a controversial idea more legitimacy and high-profile support than it’s ever gotten before.

The White House’s Fiscal Commission, led by Erskine Bowles and Alan Simpson, listed the idea of raising the eligibility age with the likes of such dramatic structural changes as the public option, block grants or an all-payer system. Alice Rivlin and former Sen. Pete Domenici didn’t even bring up the idea in their deficit report. And the top Democrats in both the House and Senate brushed aside the concept just last month.

But now the idea of raising the eligibility age has gotten the support of Obama and Boehner. While the age change is not expected to be part of the latest debt ceiling compromises, the idea is now likely to be a permanent fixture in the Medicare debate and, someday, to become a reality.

The idea has been loosely supported by Republicans in the past. Continue reading

Hypocrisy Alert: The GOP’s Jilted Individual Mandate

By Noam N. Levey

Washington Bureau

May 28, 2011

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Former Massachusetts Gov. Mitt Romney has renounced it. Former House Speaker Newt Gingrich says he doesn’t believe in it anymore. Former Utah Gov. Jon Huntsman has brushed off suggestions he even considered it.

As the three have discovered, there is hardly a bigger black mark against a Republican presidential candidate today than the hint of past support for requiring Americans to get health insurance — as President Obama‘s new healthcare law mandates.

But Republicans were not always so hostile. Until the healthcare law passed last year, requiring medical insurance had a long history as a mainstream GOP idea.

It was promoted by conservative policy experts at places like the Heritage Foundation more than 20 years ago. In the 1990s, the concept was championed by Republicans on Capitol Hill.

And it was ultimately implemented by Romney in Massachusetts; in 2006 he became the first elected official from either party to sign a mandate into law.

“I still don’t see what the objection is to the idea that people should not be allowed to run around without at least some basic health insurance,” said Mark Pauly, a conservative health economist at the University of Pennsylvania‘s Wharton School.

Emphasizing personal responsibility, Pauly and other conservatives have argued that the uninsured incur medical bills as other Americans do; the tab is just picked up by someone else. Continue reading

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