KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: ‘Parade Of Delays’ On Health Law; McConnell On White House ‘Stunts;’ Update On SHOP Exchange

The New York Times: Weak-Kneed On The Health Care Mandate
If the website malfunctions in October and November were infuriating to supporters of health care reform, the continuing parade of delays that followed it have simply been depressing. They have contributed to the impression that the Obama administration is desperately trying to keep the new system from spinning out of control, countering the good news that 1.2 million people have signed up for insurance through the federal and state exchanges. ... Having cracked once on this subject, the White House will be pushed to do so more forcefully by the law’s critics when the policies take effect next month. This should be the last concession (David Firestone, 12/23).

The New York Times: The Legitimacy Problem 
Governing in an age of distrust is different than governing in an age of trust. Government now lacks the legitimacy to impose costs on losers, so politicians face unprecedented pressure to create situations in which everybody looks like winners. ... People like Social Security, but I bet you that Congress could not pass a Social Security law today. ... The erosion of the [individual] mandate won’t kill Obamacare over all. It’ll just make it much more expensive for the government. But the larger lesson is that to sustain a program in this culture, you probably have to rely on policy mechanisms that maximize consumer-style choice, not mandates (David Brooks, 12/23).

Reuters: Obamacare's Endless Exemptions
All the delays, waivers and exemptions in the world aren’t going to solve a problem like this. They only create more confusion for a public that’s looking for results, not spin. And many of the administration’s exemptions could force premiums even higher. Moreover, the White House’s stunts ignore what is fundamentally wrong with Obamacare: The "we know best" attitude that led to it in the first place (Sen. Mitch McConnell, R-Ky., 12/20).

The Fiscal Times: Another Big Flaw In Obamacare – Tort Reform
With all the delays and "fixes," the misnamed Affordable Care Act looks like downtown Aleppo – a mere shell of its former self. ... If cost control were really the ambition, some ideas favored by Republicans, such as limiting the awards available to patients who sue their doctors – i.e., tort reform – would have been adopted. The Obama White House stood in the way of limiting excessive payments to plaintiffs (Liz Peek, 12/23).

The Washington Post: Wonkbook: Obamacare's Newly Uninsured
Pennsylvania's insurance commissioner, Michael Consedine, estimates that about 250,000 people in his state have seen their insurance policies cancelled this year — many of them because of Obamacare. ... Many of the people whose plans were cancelled have gone and bought new insurance through brokers or directly from insurance companies. So the gap between plan cancellations and new plan sign-ups is considerably smaller than these numbers suggest. But it's not at all likely that it's been closed (Ezra Klein and Evan Soltas, 12/23).

The New York Times: Small Businesses Showing Little Interest in State SHOP Exchanges
While the travails of the federally run SHOP exchanges have been widely reported, many of the state-run exchanges — which together could serve about two-fifths of the nation’s small businesses — have faced their own problems in attempting to field a small-business health insurance exchange. ... To be sure, businesses in any state that want to offer health insurance to employees — and no company with fewer than 50 full-time equivalent employees is obliged to provide the coverage — can do so (Robb Mandelbaum, 12/23).

The Washington Post: Obama Has Begun Repealing Obamacare
Obamacare as written is already gone, dismantled by its namesake. Obamacare itself has not, strictly speaking, collapsed of its own weight. Rather, it has been changed from its original, unworkable form first by Chief Justice John Roberts and then by the president into some new, unworkable mishmash. ... The question remains whether the law in some form will remain or whether the 2016 contest will be about what sort of plan replaces Obamacare (Jennifer Rubin, 12/23). 

The Washington Post: How Did Maryland's Health Site Malfunction?
If people's health weren't on the line, it would be darkly funny: For weeks, uninsured Marylanders trying to get coverage through the state’s health exchange have slogged through online forms and technical glitches, only for the system to freeze just before they hit the "enroll" button. The Web site is supposed to facilitate the enrollment of 150,000 Marylanders in private health insurance. As of the middle of the month, it had signed up only 7,435 — and that is after notching its highest-volume days since its Oct. 1 launch (12/23).

Health Policy Solutions (a Colo. news service): Simple Solution – Single Payer
Our fiscally prudent cohorts should want a system of private care or whatever the provider fancies with a low overhead to administer, and one that covers everyone — namely single payer. After all, let’s remember that Medicare was implemented within six months of passage using one’s Social Security number and all the relevant information documented on index cards. No fancy computer system was required with exorbitant expenditures to make it work. Now seniors love their Medicare (Dr. Rochelle Dworet, 12/23).

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