I was interviewed about the Senate healthcare bill this morning by i24, an English-language channel in Israel. I will post the video as soon as I get the link. For now, I can’t help but think of the Monty Python-ness of the moment. My latest take, “I’m not dead yet,” is here.
My interview on KTLA re: the latest from the Senate. And, for Majority Leader McConnell, third time’s not a charm. Click here to read my recap (published on LinkedIn) of where healthcare reform stands after today.
Last week was a big one. On Thursday, the 7th anniversary of the Affordable Care Act vote, ABC7’s Elex Michaelson invited me to comment on winners and losers on the Republican American Health Care Act (AHCA), just as Speaker Ryan postponed the vote because he didn’t have the votes to pass it: Then, on Friday, Speaker Ryan decided to pull the AHCA indefinitely, an embarrassment for both Ryan and President Trump. What’s ahead? 1. Slow Bleed on the ACA: The ACA is still unraveling despite the non-vote and failure of “Repeal-and-Replace”. The main reason is that, on his first day… Learn More
As we enter 2016, the sheer volume of changes underway in healthcare is staggering. I’ve discussed the issue of conflicting perspectives as an impediment to even describing the changes, but I’ve tried to organize these healthcare transformations into a few meaningful categories, which we’ll return to in the future to delve in more deeply. I’ll start with some broad strokes about four categories where changes are most rampant: (1) evolving patient demands; (2) new financial pressures; (3) realignment; and (4) shifting care delivery models. Evolving Patient Demands: Consumer-Driven | Digital | Underinsured | Aging Patient behavior today is undergoing a… Learn More
Medicare and Medicaid, the two giant federal health programs enacted in 1965, turned 50 years old this year. Their distinctive histories and evolution offer some insight into the challenges ahead for our healthcare system. In many respects, we are still playing out the same political disagreements that began way back when. What Medicare and Medicaid have in common is that President Lyndon Johnson signed them into law in 1965 as part of the Great Society initiatives. Both grew out of growing public attention in the 1960s to the limitations of an employer-based system in providing access to care, and specifically… Learn More
Although I started blogging in order to offer some ideas looking forward about the future of our healthcare system, it’s useful to use the recent past as a starting point. Personally, I am less interested in the argument about whether the ACA was a good idea or a bad idea (or a directionally reasonable idea that’s been implemented badly), and more interested in examining its consequences and implications moving forward. On March 10, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, which was originally given the clunky acronym “PPACA”, which was subsequently shortened to… Learn More
Discussions about our healthcare system have a tendency to sound like the parable about people groping their way around an elephant in the dark: each one grips a different part—one touching a trunk, another a tusk, and a third, the rear end—and when they compare notes, they describe radically different experiences. Similarly, everyone who provides, utilizes, pays for, or invests in healthcare services, products, and technologies has their own perspective. For example, among patients who had reasonably good insurance coverage through their jobs before the Affordable Care Act, the period prior to the ACA is starting to look more… Learn More
Understanding Affordable Care Act Risk Corridors and the Shortfall that Caught Some Health Plans by Surprise and Put Others Out of Business
In early October 2015, health plans around the country received terrible news: the U.S. Department of Health and Human Services expected roughly a $2.4 billion shortfall in connection with Affordable Care Act (ACA) risk corridor program that was intended to subsidize their losses caring for expensive new patients brought in by the ACA. In the wake of an 87% shortfall from the promised subsidies, several health cooperatives around the country promptly announced folded. Others are threatening to follow suit. Before we address what went wrong, a little background may be useful as to what was supposed to happen. The ACA… Learn More
When I mentioned to some friends that I was thinking of launching a blog outside of the law firm and other business ventures in which I’ve been involved, their reactions gave me the sense that they regard me as a crazy person. Between leading our firm, advising clients, supervising and working with colleagues on an array of law firm matters, and taking part in the other ventures in which I play a part, didn’t I already have enough on my plate? I am already all too often an absentee father. Haven’t I already spread myself thin enough? It’s true that… Learn More
In the past few months, I’ve been invited to speak several times on the Supreme Court’s decision in King v Burwell and its implications. My presentation focused on the extent to which this decision and the previous Supreme Court decisions on the Affordable Care Act have been the consequence of a “messy” reconciliation process that missed out on some of the typical legislative clean-up. This was surprising given that the ACA was the most significant legislation for the American healthcare system in a half-century. The larger point I highlighted as that, no matter where you stand on healthcare reform, the… Learn More