Clinton proposes expansion of ACA for doctor ‘sick visits’ and tax credit for …

23 Sep 2015 | Author: | No comments yet »

Clinton Promises Health Insurance Merger Scrutiny in Policy Plan.

Hillary Rodham Clinton proposed Wednesday to guarantee Americans three doctor visits annually that would not count against a patient’s insurance plan “deductible,” the threshold amount patients must pay out of pocket before some insurance plans kick in.Hillary Clinton said she would give close scrutiny to health-insurance industry mergers like those proposed this year by Anthem Inc. and Aetna Inc., part of the Democratic presidential candidate’s latest policy plans.Hillary Clinton released more proposals Wednesday for limiting what people with insurance pay for their health care, amid an effort to show she is seeking to improve the 2010 federal health law with provisions aimed squarely at consumers’ cost concerns.On Tuesday, Hillary Clinton issued her defense of the Affordable Care Act and proposals to change the landmark health law, signaling the next battle in a war with all the signs of a political stalemate.

Americans are basically evenly split in their assessments of the law and sharply divided along partisan lines; Republican presidential candidates want to scrap the law, while Democrats support keeping it (Clinton) or expanding it (Bernie Sanders). The credit would be available for those who spend in excess of 5 percent of their income on health care, and would be paid for by “demanding rebates from drug manufacturers and asking the most fortunate to pay their fair share,” her campaign said. Clinton’s drug cost proposal caused a slide in health-care stocks on Monday, sending the Nasdaq Biotechnology Index down 4.4 percent after she said on Twitter that she would release a plan. “When Americans get sick, high costs shouldn’t prevent them from getting better,” Clinton said in a statement. “With deductibles rising so much faster than incomes, we must act to reduce the out-of-pocket costs families face. My plan would take a number of steps to ease the burden of medical expenses and protect health care consumers.” Each idea is geared toward addressing gripes that have grown louder in recent years among people who have insurance, either as a result of the health law and their own or an employer’s plan.

Among the biggest complaints are so-called high-deductible plans, which offer relatively low monthly premiums but require people to pay several thousand dollars before coverage kicks in. Clinton’s campaign also promised to “vigorously enforce antitrust laws to scrutinize mergers and ensure they do not harm consumers,” mentioning insurers as well as doctors and hospitals that sell them services. Morgan and Minhyoung Kang found the ACA’s passage caused a sharp drop in support for health-care spending across party lines and might have ushered in a broader conservative “cold front” when it comes to other issues. Although Clinton says the law “is here to stay,” she also predicted in an interview with the Des Moines Register on Tuesday that Democrats may be able to retake control of the Senate in 2016 but not the House.

The percentage of Americans saying the country spends “too little” on health dropped from the years before and after its passage (comparing surveys from 2004-2008 to 2010-2014*). Anthem’s and Aetna’s chief executive officers told lawmakers Tuesday that the deals would benefit consumers and are necessary to succeed in a changing health-care landscape. Clinton would also create a process for states that don’t have the authority to block or modify health insurance premium increases to stop what the campaign called “unreasonable” rises in rates. The three “sick visits” would ensure that people who take ill could see a doctor for treatment they might otherwise skip for fear of running up a bill, the campaign said. Consumer costs are becoming the focus of the campaign’s proposals, prompted in part by changes that have companies asking workers to pay a greater share of the cost of coverage.

The public could be reacting to something else, such as the stimulus policies enacted after the Great Recession or to government spending more generally. More and more health plans require significant deductibles – hundreds or even thousands of dollars in some cases – for such unplanned doctor visits. “No one should have to worry about paying large out-of-pocket costs when they get sick and need a checkup during the year, whether it’s a common cold or a more harmful illness,” Clinton’s campaign said. The deductibles patients pay before insurance kicks in climbed about 9 percent this year, and workers now pay an average of $1,077 a year in up-front medical costs for a single-person plan, according to the Kaiser report. Now, she has to simultaneously defend a law that Democrats see as a major achievement of Barack Obama’s presidency and explain how she would change that law. Republicans criticize the law for disrupting the health system for too little benefit, and her chief rival for the Democratic nomination, Bernie Sanders, criticizes it for not disrupting the health system enough.

The “cold front” idea was first proposed in the 1970s, when the public took a conservative turn on spending priorities after a long run trending toward liberalization. Morgan described it broadly: “As government expands, people become less enthusiastic about government expanding.” Here’s how University of Texas’s Christopher Wlezien described it in a 1995 paper: We observe that the signals the public sends to policymakers, in the form of preferences for “more” or “less” spending, react to changes in policy. … [T]here is negative feedback of spending decisions on the public’s relative preferences, whereby the public adjusts its preferences for more spending downward when appropriations increase, and vice versa. What’s striking is that with the ACA, even Democrats behaved like thermostats, withdrawing support for increased health spending after the Democratic-sponsored law was passed. I’m not going to let them tear up that law, kick 16 million people off their health coverage, and force this country to start the health-care debate all over again.” Sanders doubled down on expanding health coverage, reiterating his support for a single-payer health care system this summer.

But the bigger lesson is Americans tend to turn in the opposite direction of policy; Democrats won big in passing health-care reform, but the public’s appetite for more ambitious action has shrunk.

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