2 posts tagged “Healthcare policy”

The 2017 healthcare policy roller coaster ride — and what’s around the bend

Posted 10 months ago by

It’s been a year of wild ups and downs related to the proposed U.S. healthcare policy changes and unknowns around the Affordable Care Act (ACA or “Obamacare”), Medicare and CHIP (an insurance program for kids). See a legislative recap and what could be next.

2017 ACA repeal efforts recap

Having trouble keeping track of what happened this year? You’re not alone. Check out this timeline.

In the spring, we shared the results of a May 2017 PatientsLikeMe healthcare poll, which found that nearly 3,000 participants are largely aligned about components of a strong plan for the country. Right when we announced the poll results in mid-June, the Republican majority in Congress was trying to pass the American Health Care Act (AHCA), which would’ve repealed most of the ACA/“Obamacare.” PatientsLikeMe members shared our poll results – showing the largely united patient voice – along with their personal views in messages to their members of Congress through this Take Action page.

Over the summer, the ACA repeal efforts failed to gain enough support in the Senate, despite a few different attempts (including the Better Care Reconciliation Act, and the so-called “repeal only” and “skinny repeal” bills – see a legislation refresher here).

This fall, Congress turned its attention to tax reform (but has lumped in healthcare changes with less fanfare). In early December, the Senate passed a tax bill called the Tax Cuts and Jobs Act that could repeal the individual mandate of the ACA (the part of the healthcare law requiring that all Americans have health insurance).

The nonpartisan Congressional Budget Office projects that without the mandate, the number of uninsured Americans would jump by 4 million in 2019, on up to 13 million by 2027. Some view the healthcare changes in the tax bill as an attempt at the “skinny repeal” all over again and say that without the mandate, the ACA/Obamacare is at risk of collapse unless Congress takes action to “prop up” the health insurance markets.

Now what? The tax bill is not yet final – now the House and Senate are hashing out differences in their versions of the legislation. Many members of Congress in the Republican majority appear to support the repeal of the individual mandate (one of the least popular parts of the ACA). But most Democrats and several vocal groups like the AARP oppose the tax bill and the possible healthcare fallout.

The estimated $1.5 trillion U.S. deficit increase over the next decade and beyond will “inevitably lead to calls for greater spending cuts, which are likely to include dramatic cuts to Medicare, Medicaid, and other important programs serving older Americans,” AARP says, noting that the tax bill would lead to $136 billion in federal funding cuts in fiscal year 2018, $25 billion of which must come from Medicare. “Such sweeping cuts would be detrimental to an already vulnerable population,” AARP says.

CHIP and VA healthcare programs

Two other pieces in the U.S. healthcare puzzle are also facing risks or changes, but they’ve gotten a lot less news coverage.

The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to kids in families that earn too much money to qualify for Medicaid. In the past, the program had bipartisan support in both the House and Senate, but Congress let federal funding for CHIP expire in September and now states are scrambling to sort out a backup plan for the 9 million children enrolled.

The Kaiser Family Foundation made a map illustrating when states could run out of CHIP funding, with 16 states projected to exhaust their funds by the end of January 2018. They say that children in CHIP may be enrolled in Medicaid, which means states will pay more because the federal match rate for Medicaid is lower than it is for CHIP.

The Veterans Affairs (VA) Choice program could also be in limbo if Congress doesn’t act soon to approve emergency funding to the ailing program, which would expand access to care at non-VA facilities in some cases. VA Secretary David Shulkin is reportedly taking steps toward more privatized healthcare for veterans.

What’s your take on U.S. healthcare policy? Join PatientsLikeMe and discuss your views with nearly 30,000 patients who are interested in advocacy. Also, write to your reps in Congress — patient voices matter.

Editor’s note: On December 20, Congress passed the tax bill, including the repeal of the ACA/“Obamacare” individual mandate. The mandate is still in effect for 2018, so those who don’t have health insurance can still face tax fines. The ACA’s private, individual insurance markets will still be around after the mandate goes away in 2019 but could experience “turmoil” because fewer healthy people will be in the markets, as Fortune reports in their article about what the tax bill’s healthcare changes could mean for you.

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Largest Patient Poll on ACA Shows Patients Value Health Care Law More Than the General Population, Are Less Inclined to Want a Repeal

Posted February 7th, 2017 by

Lowering Costs, Coverage for Pre-existing Conditions Remain Top Priorities; If Changes Are Required, Individual Mandate Should Go  

CAMBRIDGE, Mass., February 7, 2017—As Congress and the White House continue to discuss potential changes to the Affordable Care Act (ACA), PatientsLikeMe revealed results from the first large-scale poll to assess patient priorities for the health care law. The poll’s 2,197 respondents are among the estimated 133 million Americans living with chronic conditions.

Sally Okun, PatientsLikeMe’s Vice President of Advocacy, Policy and Patient Safety, said the poll gives voice to those who may be most heavily impacted by changes to the law. “Regardless of your political leaning, the great equalizer is that we’ll all become sick one day. At this time of uncertainty about the future of health care, listening to the voice of patients today will illuminate the path forward for all of us.”

Key findings from the poll show that overall, patients have the same concerns as the general population about health care costs, but see benefits in the law that the healthy may have overlooked:

  • More than half (57%) believe the ACA has been helpful to people living with chronic conditions.
  • Nearly half (46%) feel the ACA needs only minor modifications to improve it.
  • Over the last year, their out-of-pocket expenses for health care have either stayed the same (47%) or increased (43%).
  • Lowering costs is a priority for both patients in the PatientsLikeMe poll and for the general population, which took part in a December 2016 Kaiser Health Tracking Poll. Lowering the amount individuals pay for health care is an important priority for 94% of patients and 93% of the general population. Lowering the cost of prescription drugs is an important priority for 96% of patients and 89% of the general population.
  • Nearly half (46%) of PatientsLikeMe poll respondents felt that a repeal of the 2010 ACA “should not be done,” while one third (31%) of the Kaiser general population felt it “should not be done.”
  • When asked which one component of the ACA they would eliminate if they were forced to choose, PatientsLikeMe respondents were four times more likely to say they would eliminate the individual mandate vs. other components of the ACA.
  • When asked which one component of the ACA they would keep if they were forced to choose, PatientsLikeMe respondents were six times more likely to say they would keep mandatory coverage for pre-existing conditions vs. other components of the ACA.
  • The widest differences in opinion related to questions about a repeal of and government involvement in health care law, and were found between the general population, non-condition specific patients, and those who reported major depressive disorder (MDD) as their primary condition:
  • Of those living with MDD, 59% said that the health care law should not be repealed, vs. 45% of the overall PatientsLikeMe respondents and 31% of the Kaiser general population.
  • 42% of respondents living with MDD said decreasing federal government spending on health care should not be done, vs. 29% of the overall patient population and 18% of the Kaiser general population.
  • As for reducing the federal government’s role in health care, 37% of patients living with MDD said it should not be done, compared to 28% of the overall patient population and 20% of the Kaiser general population.

Okun said that patients living with MDD may have a stronger opinion about healthcare law given the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA), a law passed by Congress in 2008 and codified into rules in 2013 to ensure equal treatment coverage for mental illness and addiction. According to the National Alliance on Mental Illness (NAMI), before the law, “mental health treatment was typically covered at far lower levels in health insurance policies than physical illness.”

Full survey results and graphics are available at http://news.patientslikeme.com.

PatientsLikeMe Poll Methodology
Between January 23-27, 2017, PatientsLikeMe fielded a 19-question poll to a sample of its members in the United States who are living with chronic or progressive degenerative conditions. A total of 2,197 patients completed the poll, which asked both original questions and questions from a December 2016 Kaiser Health Tracking Poll to compare patient and general population responses.

Respondents had a range of chronic or progressive medical conditions and listed their primary condition as multiple sclerosis (13%), fibromyalgia (12%), Parkinson’s disease (6%), major depressive disorder (5%), ALS (5%), type 2 diabetes (3%) and multiple myeloma (3%), among many other conditions. The mean age of respondents was 54.5 years (the range was 18- >89). Of 1,840 respondents who gave information on level of education (83.8% of total), 1.0% had less than a high school diploma, 11.0% had high school diplomas, 38.3% had some college, 27.7% reported a college degree, and 22% reported post-graduate education. About one-third (36%) of patients had health insurance through their employer, one-third (35%) had Medicare; and the rest had a mix of other health care coverage including Medicaid, VA, military, and direct pay insurance, which includes insurance purchased from ACA exchange programs. A very small percentage (2.5%) of respondents said they had no health insurance. Nearly all respondents (95%) are registered voters. Their party affiliation is as follows: 37% say they are Democrats, 19% are Republicans; 15% are Independent; 13% preferred not to say; 11% are unaffiliated and 4% are Libertarian.

About PatientsLikeMe
PatientsLikeMe, the world’s largest personalized health network, helps people find new options for treatments, connect with others, and take action to improve their outcomes. The company has worked with every major pharmaceutical company and a range of government organizations to bring the patient voice to research, development and public policy. With 500,000 members, PatientsLikeMe is a trusted source for real-world disease information and a clinically robust resource that has published more than 100 research studies. Visit us at www.patientslikeme.com or follow us via our blog, Twitter or Facebook.