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January 13, 2018
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Kentucky on Friday became the first state to make use of Thursday's guidelines from the Centers for Medicare and Medicaid Services permitting states to test work requirements for Medicaid recipients. Kentucky applied for permission to do this in 2016, and Kentucky Gov. Matt Bevin (R) said the "community engagement and employment initiative" will be gradually phased in later this year.

The rules require able-bodied adult Medicaid recipients ages 19-64 to engage in at least 80 hours of "employment activities" each month, a category including jobs, community service, education, and training. Some exemptions tied to health, family commitments, and personal history will apply; for example, pregnant women and people who are the primary caregiver of a dependent will be exempt.

"Kentucky will now lead on this issue," Bevin said Friday, arguing that Medicaid recipients "want the dignity associated with being able to earn and have engagement in the very things they're receiving." Bonnie Kristian

October 22, 2017
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Senate Majority Leader Mitch McConnell (R-Ky.) said on CNN Sunday he is prepared to call a vote on the bipartisan health-care proposal negotiated by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) if President Trump is prepared to sign it.

The proposal has the support of all 48 Senate Democrats plus 12 Republicans, Senate Minority Leader Chuck Schumer (D-N.Y.) said on NBC Sunday. "This is a good compromise," Schumer argued. "It took months to work out. It has a majority."

The Murray-Alexander bill would appropriate funds for two years of the insurance subsidies Trump recently ended while loosening some ObamaCare rules, including allowing "insurance companies to sell less comprehensive plans to all customers, not just those under age 29 as is the case under current law."

Trump has sent mixed signals about the plan, calling it both "a good start" and "a short-term fix." Bonnie Kristian

October 14, 2017

President Trump tweeted Friday night and Saturday morning to defend his decision to end ObamaCare subsidy payments to insurance companies:

Trump is correct that stocks for several insurers and hospital operating companies dropped Friday after the subsidy announcement. He is also right that insurance companies have been in what The New York Times labeled a "profit spiral" since the Affordable Care Act (ACA) took effect. Insurers in the ObamaCare marketplaces had their most profitable first quarter ever in 2017 and posted a 29 percent increase in second-quarter profits as compared to last year.

The decision to nix the payments, which subsidized low-cost policies mandated by the ACA, has already come under legal challenge from 18 states. Bonnie Kristian

August 31, 2017
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During a town hall in Oakland on Wednesday night, Sen. Kamala Harris (D-Calif.) announced she will co-sponsor Sen. Bernie Sanders' (I-Vt.) single-payer health-care bill when it is introduced next month.

Harris said she intends to co-sponsor "the Medicare-for-all bill because it's just the right thing to do." Health care "should be a right, not a privilege," she continued. "And it's also about being smart. It is so much better that people have meaningful access to affordable health care at every stage of life, from birth on. Because the alternative is that we as taxpayers otherwise are paying huge amounts of money for them to get their health care in an emergency room. So it's not only about what is morally and ethically right, it also makes sense from a fiscal standpoint, or if you want to talk about it as a return on investment for taxpayers."

Sanders responded on Twitter with a thank you to Harris, adding, "Let's make health care a right, not a privilege." Two other Democrats announced this summer that they support single-payer health insurance — Sen. Elizabeth Warren (Mass.) and Sen. Kirsten Gillibrand (N.Y.). Catherine Garcia

July 18, 2017

President Trump was "blindsided" by the defection of Sens. Jerry Moran (R-Kan.) and Mike Lee (R-Utah) from the GOP health-care bill on Monday, a move that effectively killed the "replace" part of repeal and replace for now, Politico reports. But even as Trump has privately warned "we're in trouble" if Republicans don't offer up a health-care solution, even the leadership's last-ditch efforts look grim.

As it stands, Trump might be in for more surprises. Although Senate Majority Leader Mitch McConnell (R-Ky.) has vowed to repeal ObamaCare with a two-year window to come up with a replacement, many experts don't see the move as having much of a chance. "This is leadership saying: 'If you're not going to come around on a 'replace' bill, [forget] you,'" explained Axios' Jonathan Swan. "'We'll do repeal without replace — which you voted for before, when Obama was president, and you knew it wouldn't take effect. What was that, a fake vote?'"

As Axios' Mike Allen adds, the bill will "probably lose. But this is McConnell trying to get the issue fully off his plate so he can move on to tax reform, while showing the base he tried everything he could."

In the words of one person briefed on Trump's Monday meeting, though, the president has stressed "we have the Senate, House, and White House and we have to do it or we're going to look terrible."

Or as one White House aide put it to Politico, Trump will be happy with anything so long "as something gets done." Jeva Lange

July 13, 2017

With the threat of President Trump's ire hanging over the heads of Republicans, Senate Majority Leader Mitch McConnell (R-Ky.) is desperately attempting to rustle up enough votes to pass a revised version of the GOP's health-care bill. To do so, McConnell will need to sell a handful of deeply concerned moderate Republicans on the bill's proposed Medicaid cuts, and The Washington Post reports he is doing so by suggesting the cuts will never actually happen:

Under the current version of the Senate health-care bill, federal Medicaid spending would drop by 26 percent starting in 2026, pegged to the Urban Consumer Price Index. That's still eight-and-a-half years away — long past senators' next election. And cutting Medicaid is so unpopular, with so much resistance from the health-care industry, that it's likely Congress would find a way to avoid the cuts when the time comes. After all, that's what Congress did for years by enacting the so-called "Doc Fix" to a Medicare doctors' payment formula. [The Washington Post]

McConnell is "trying to sell the pragmatists like [Ohio Sen. Rob Portman], like [West Virginia Sen. Shelley Moore Capito], on 'the CPI-U will never happen,'" a GOP lobbyist added to the Post.

Still, it could take a lot of convincing. In a closed-door meeting Wednesday, centrist Sens. Lisa Murkowski (R-Alaska) and John Hoeven (R-N.D.) put their collective foot down about the ambitious Medicaid cuts, which would snip $772 billion over 10 years and lead to 15 million fewer people enrolled, Politico reports. "The [Affordable Care Act] allowed for Medicaid expansion. The ACA didn't address traditional Medicaid," Murkowski said. "Why do we not focus on the urgency of the concerns with the ACA? Let's deal with the urgency of the issue. Let's set Medicaid off to the side." Jeva Lange

July 10, 2017
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A chief criticism of the GOP's various plans to repeal and replace ObamaCare is how many Americans lawmakers could leave unwillingly uninsured — but a new survey finds uninsurance rates are edging up even under ObamaCare.

Results of the Gallup-Sharecare Well-Being Index were released Monday, showing some 2 million U.S. adults lost insurance coverage this year alone. The uninsurance rate grew from 10.9 percent at the end of 2016 to 11.7 percent in the second quarter of 2017, a change analysts determined is statistically significant despite its small size. This decline comes after five years of coverage increases stalled within the last 12 months.

Lack of coverage primarily increased among young adults and those who buy their insurance in the ObamaCare marketplaces instead of receiving an employer plan, The Associated Press reports. A now-familiar litany of problems is in play: Premiums are spiking ever upward and many insurance markets offer consumers little to no choice of what plan to purchase. Bonnie Kristian

July 5, 2017
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A measure now heading to the desk of Oregon Gov. Kate Brown (D) requires insurers in the state to cover abortions and other reproductive health services for all patients at no cost.

The bill, which passed in the Oregon state Senate 17-13, ensures that women are not denied access due to income, citizenship status, or gender identity, and does have some religious exemptions. Additionally, over the next two years, the measure would allocate nearly $500,000 to expand reproductive health coverage for immigrants who are not eligible for Medicaid, The Associated Press reports.

Oregon does not have tight abortion restrictions like some states, and there are no waiting periods or spending limits on using taxpayer money. The measure was introduced in early March as Republicans in Washington began to move forward with their attempt to repeal ObamaCare. Catherine Garcia

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