Health Affairs: ACA’s Section 1332, Escape Hatch Or Straightjacket For Reform?

June 1, 2016June 1, 2016 / Nic Horton / Leave a comment

In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act (ACA): Section 1332. According to some proponents, these waivers will “turbocharge state innovation” and will provide states with an “exit strategy” from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested?

As policy practitioners who work daily with state policymakers around the country, we have seen proponents be overly dismissive—or perhaps even unaware—of the large practical and political challenges surrounding the implementation of these waivers. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers. Continue reading →

Townhall: Where Are All The ObamaCare Jobs?

March 20, 2016March 20, 2016 / Nic Horton / Leave a comment

For years, hospital lobbyists have promised that Obamacare’s Medicaid expansion would kick start states’ economies and produce thousands of new jobs. (Expanding welfare always stimulates the economy, right?)

This piece of their Obamacare sales pitch is critical because, according to their calculations, these new jobs will generate the necessary revenue to pay for states’ share of the Obamacare expansion costs. The Arkansas Hospital Association, for example, made a similar guarantee, promising that most of the state’s share would be covered by new tax revenue generated by new jobs.

But now that expansion has been up-and-running for more than two years, the data is starting to paint a clearer picture of the real economic impact. And, believe it or not, Obamacare expansion isn’t living up to the hype. Continue reading →

Forbes: NE’s Medicaid Expansion Plan Puts Truly Needy In Danger

March 20, 2016 / Nic Horton / Leave a comment

Co-authored by Nic Horton, Jonathan Ingram, and Josh Archambault

Nebraska legislators are currently considering another plan to bring Obamacare’s Medicaid expansion to the Cornhusker state. The proposal would create a new welfare program, dubbed the “Transitional Health Insurance Program,” for more than 130,000 able-bodied adults, costing taxpayers nearly $15 billion over the next ten years.

Nebraska policymakers have rejected all previous attempts to expand Medicaid under Obamacare. With expansion costs exploding in other states and federal funding now on the chopping block, it’s clear that their decision was the right one. And nothing in this new proposal should give them reason to reconsider. In fact, the latest plan, modeled after Arkansas’ “Private Option,” is Nebraska’s worst expansion proposal yet.

This model has failed to deliver on its promises everywhere it has been tried and would cost taxpayers billions of dollars more than a traditional expansion. In fact, Iowa has already scrapped its own version of this model and Arkansas’ expansion is scheduled by law to terminate later this year. Worse yet, the plan would also prioritize welfare for this new class of able-bodied adults over services for the truly needy. Continue reading →

Forbes: UT Proposes Sick Tax To Pay For ObamaCare

September 29, 2015 / Nic Horton / Leave a comment

By Nic Horton, Jonathan Ingram, and Josh Archambault— Mr. Horton is a Policy Impact Specialist, Mr. Ingram Research Director, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability

After the legislature blocked his Obamacare Medicaid expansion plans in 2014 and 2015, Utah Governor Gary Herbert (R) began working with legislative leaders to negotiate some kind of “compromise” to expand the program to more than 100,000 able-bodied adults. Although the deal is being negotiated in secret, some details have been leaked to the public.

According to the few specifics made public, the biggest component of the negotiated framework is to levy a new “assessment” on medical providers in Utah to help pay for the state’s share of expansion. But the so-called assessment is simply a new Obamacare tax on the sick that will not only raise health care costs for all Utahns, but add significantly to the national debt. Continue reading →

Forbes: AR’s ‘Health Independence Accounts’ Are Making Obamacare Worse

July 13, 2015 / Nic Horton / Leave a comment

By Jonathan Ingram, Nic Horton and Josh Archambault— Mr. Ingram is Research Director, Mr. Horton a Policy Impact Specialist, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability

Arkansas’s Obamacare Medicaid expansion has been a costly misadventure. The expansion has been so misguided in fact, that lawmakers voted earlier this year to end it, effective December 31, 2016.

That hasn’t stopped state bureaucrats from scurrying to institute a new component of expansion that makes the program even worse. Under this plan, some enrollees are asked to contribute nominal amounts to new “Health Independence Accounts,” or HIAs, which were supposed to mirror health savings accounts.

But these new HIAs are nothing like real health savings accounts and were destined to fail from the beginning. Now that the program is up and running, the evidence is mounting: so-called “independence” accounts are actually reducing enrollees’ “skin in the game,” and costing even more money for taxpayers.

Arkansas legislators meet in the House chamber at the Arkansas state Capitol in Little Rock, Ark. (AP Photo/Danny Johnston, File)

Health Independence Accounts Are Nothing Like Health Savings Accounts

Under this new Obamacare Medicaid expansion tweak, enrollees above the federal poverty line are “required” to make monthly contributions to HIAs. But the truth is that this “requirement” is more like a mere suggestion. If enrollees refuse to contribute to their accounts, they aren’t removed from the program.

These suggested contributions start at just $10 per month. But unlike real health savings accounts, Private Option enrollees will not use funds in their HIAs to pay for their own medical care. Instead, the money will simply sit in enrollees’ accounts until they leave the program. At that point, they can take the money with them and use it toward other health care costs. Continue reading →

FGA: What Exchange Enrollees Want, After King v. Burwell

June 17, 2015 / Nic Horton / Leave a comment

A new, one-of-a-kind poll released yesterday by the the Foundation for Government Accountability takes a look at what ObamaCare exchange enrollees want in the wake of the King v. Burwell ruling. The poll surveyed exchange enrollees in only the 34 states that have not set up ObamaCare exchanges. Many of these enrollees would be personally impacted by a pro-King ruling.

Here’s a snapshot:

Continue reading →

FGA: States Can’t Trust Washington To Fund ObamaCare Expansion

April 9, 2015 / Nic Horton / Leave a comment

A new report from the Foundation for Government Accountability highlights a string of broken funding promises by the federal government:

Examples of broken promises and unfunded mandates pushed on states by the federal government are virtually limitless. The Obama administration withheld $111 million in mineral royalties that had been promised to states. The Federal Highway Administration has cut back the transportation funding it had previously promised states. The Centers for Disease Control and Prevention has reduced or cancelled promised grants to state and local governments. The Department of Commerce revoked funding for a large-scale broadband project, designed to bring online access to schools and health care facilities in Louisiana. The Federal Emergency Management Agency suddenly revoked more than half a million in funds for a small Minnesota township, leaving it vulnerable to significant financial and legal liability. Stories of broken federal promises like these can be found all over the country.

The report, authored by Jonathan Ingram and Nic Horton of FGA, is available here.

Forbes: New Poll Confirms Voters Don’t Want State Obamacare Exchanges

April 3, 2015 / Nic Horton / Leave a comment

By Jonathan Ingram, Nic Horton and Josh Archambault – Mr. Ingram is Research Director, Mr. Horton is Policy Impact Specialist, and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.

Last week, the Foundation for Government Accountability released a groundbreaking poll of voters in federal exchange states that provides valuable insight into how voters want policymakers to respond to the pending King v. Burwell Supreme Court ruling.

In short, voters don’t want their state legislators to rescue Obamacare should the Supreme Court rule that health insurance subsidies cannot flow through HealthCare.gov. They blame Congress for a poorly written law and don’t want or expect states to clean up Washington’s mess. In fact, they’re prepared to vote against state lawmakers who try to set up Obamacare exchanges.

Voters Don’t Want To Live in An Obamacare State

If the Supreme Court strikes down subsidies in federal exchange states, voters don’t want their state legislators to rescue Obamacare. They see the issues presented in the King v. Burwell case as a problem created by Congress and the IRS; they don’t think states should bail them out.
Continue reading →

Forbes: Latest Florida Proposal Is Still Obamacare

March 27, 2015 / Nic Horton / Leave a comment

By Nic Horton, Jonathan Ingram, and Josh Archambault— Mr. Horton is a Policy Impact Specialist, Mr. Ingram is Research Director, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability.

The Florida hospital lobby is persistent, to say the least. Barely two years after the Florida Legislature defeated Obamacare Medicaid welfare expansion, the hospital lobbyists are back at it, rolling out yet another Obamacare expansion plan, this time with the help of local chambers of commerce and other groups. The hospitals’ new coalition even has a clever name for itself: “A Healthy Florida Works.”

These actions have prompted some speculation that Florida lawmakers may flip flop on their principled opposition to this massive expansion of Medicaid welfare. Insiders are also reporting that the hospitals are preparing to dump even more money and resources into lobbying for Obamacare expansion—on top of the more than 250 lobbyists hospitals already deploy to Tallahassee every year.

In the past, lawmakers have taken a thoughtful, careful approach to the Medicaid expansion question. After setting up a special committee to study every aspect of the issue and gathering all the facts, they rightly rejected every effort to implement it – even when that meant standing up to a wavering Republican governor, the chairman of the Democratic National Committee, and the full force of the Obamacare lobby. Continue reading →

Forbes: AR’s Private Option Architect Hopes To Revive The State’s Failed Obamacare Medicaid Experiment

March 23, 2015 / Nic Horton / Leave a comment

By Nic Horton, Jonathan Ingram and Josh Archambault. Mr. Horton is a policy impact specialist, Mr. Ingram is research director, and Mr. Archambault a senior fellow at the Foundation for Government Accountability.

Earlier this session, Arkansas lawmakers took an important first step in rolling back its disastrous Obamacare expansion. The legislature passed Act 46, which requires the Arkansas Department of Human Services to eliminate the Obamacare expansion by December 31, 2016. But a new bill proposed by one of the chief legislative architects of the failed Private Option experiment would reverse that progress and cement Obamacare into state law forever.

Days until the Private option is scheduled to end.

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