Harold Pollack – ACA and AHCA Update

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This week we are joined a few days early by Harold Pollack to bring you a timely update on the Affordable Care Act (ACA) repeal and American Health Care Act (AHCA) legislation that is moving quickly through congress.

Harold has published widely at the interface between poverty policy and public health including the effects of health reform and the ACA. Today we talk about the current state of the repeal and replace effort in the Senate and what effects their bill would have in terms of individuals who would lose coverage or find it much more expensive should the bill pass. We also discussed the very dramatic changes the bill would likely make to Medicaid and how that might affect the poor and vulnerable people that the program serves, and in particular how it might impact the raging opiate epidemic. Lastly, we talk about what a bipartisan solution to many of the very real problems of the ACA might look like, and what impact individuals can have on policy by calling congress. You can find more information about the unusual legislative process here, and the lack of information available on the bill here. Read about the effects that changes to Medicaid might make for disabled individuals here, and listen to Matt Broaddus of the Center on Budget and Policy Priorities discuss block granting and per capita caps on Medicaid here. If you would like to reach out to your Senator to talk with him or her about the legislation and how it might affect you or your patients, you can find your Senator’s contact information here.

Harold is the Helen Ross Professor at the School of Social Service Administration, an Affiliate Professor in the Biological Sciences Collegiate Division and the Department of Public Health Sciences and Co-Director of The University of Chicago Crime Lab and a committee member of the Center for Health Administration Studies (CHAS) at the University of Chicago. He tweets @haroldpollack.

If you like the show, please rate and review us on itunes or stitcher, which makes the show easier for others to find; and share us on social media. We tweet at @rospodcast and are on facebook at www.facebook.com/reviewofsystems.  Please drop us a line at contact@rospod.org. We’d love to hear from you.

Emma Sandoe – Update on the AHCA & ACA

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This week, we are publishing the show a few days early to bring you a timely AHCA and ACA update. We are joined once again by Emma Sandoe, a PhD candidate in Health Policy & Political Analysis at Harvard University, for a discussion of the AHCA, the most recent attempt to repeal the ACA. You can find our prior episode with Emma, about the ACA, here. Prior to starting her PhD program, Emma spent six years in Washington, DC working on the passage and implementation of the ACA. She served as the spokesperson for Medicaid and HealthCare.gov at the Centers for Medicare & Medicaid Services and worked on ACA coordination at the HHS Budget Office.

We start with a summary of what happened this week and what were key factors in the ACHA’s demise (2:45), in particular the key Essential Health Benefits (9:00), talk about the future of the ACA (14:05), and ways that opponents of the law may try to sabotage it’s success over the next few years (15:25), and finally how lawmakers might address some of the very real problems with the law (16:57).

It turns out that healthcare reform is complicated, and advocacy does work as this Washington Post article shows. Listen to a show all about block grants and per capita caps on Medicaid featuring Matt Broaddus of the Center on Budget and Priorities here.

If you like the show, please rate and review us on itunes or stitcher, which makes the show easier for others to find; and share us on social media. We tweet at @rospodcast and are on facebook at www.facebook.com/reviewofsystems.  Please drop us a line at contact@rospod.org. We’d love to hear from you.

Matt Broaddus: What are Medicaid Block Grants?

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This week we are joined by Matt Broaddus to talk about block granting Medicaid, which is a major health policy change that the Trump administration plans to pursue in the coming months. Matt is a Research Analyst in the Health Division at The Center on Budget and Policy Priorities, a non-partisan research and policy institute in Washington DC. His policy, research, and analytical work is conducted in the areas of Medicaid and the State Child Health Insurance Programs.

We start with an overview of the Medicaid program, the largest insurance program in the US. We touch on the possible benefits of block granting (19:00), and how it may affect other industry stakeholders such as health systems, hospitals, community health centers, and insurers that offer Medicaid managed care products (23:20). Lastly we discuss another block granted program, CHIP and why many see it as a successful block grant program (29:00), and one other suggestion that has been made for Medicaid reform, per-capita funding (32:45).

You can find the article we mentioned by Sara Rosenbaum here, as well as some additional resources on block grants from Kaiser Health News and The Commonwealth Fund.

If you like the show, please rate and review us on itunes or stitcher, which makes the show easier for others to find; and share us on social media. We tweet at @rospodcast and are on facebook at www.facebook.com/reviewofsystems.  Please drop us a line at contact@rospod.org. We’d love to hear from you.

Photo: President Lyndon B Johnson surrounded by supporters and advisors signing Medicare into law.

Emma Sandoe: Affordable Care Act Repeal Update

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Emma Sandoe, a PhD student in Health Policy Political Analysis at Harvard University, joins us for a discussion of the Affordable Care Act. Prior to starting her PhD program, Emma spent six years in Washington, DC working on the passage and implementation of the ACA. She served as the spokesperson for Medicaid and HealthCare.gov at the Centers for Medicare & Medicaid Services and worked on ACA coordination at the HHS Budget Office.

We start with an overview of the ACA and then review key players in the repeal and replace efforts thus far (5:25); the recent CBO report and the possibility of an insurance premium death spiral (15:00); the likelihood of Trump’s ability to keep his promise to retain the popular provisions of the ACA and what a replacement law might look like (18:00); the ACA’s flaws and some historic context for them (24:12); and give some well-hedged predictions for the coming weeks (32:05).

We discuss a report released last week by the Congressional Budget Office projecting what might happen if the ACA is repealed without a replacement, and two articles from healthcare reporter Sarah Kliff looking at potential ACA replacement plans and a story about discontent with the ACA among beneficiaries. Here is a helpful article from New York Times reporter Margot Sanger-Katz looking at what President Trump’s executive order against the ACA might mean. You can find the resources for getting involved Emma mentioned here.

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