Employers are failing to insure the working class – Medicaid cuts will leave them even more vulnerable

  The Congressional Budget Office estimates that 7.8 million Americans across the U.S. will lose their coverage through Medicaid – the public program that provides health insurance to low-income families and individuals – under the multitrillion-dollar domestic policy package that President Donald Trump signed into law on July 4, 2025.

  That includes 247,000 to 412,000 of my fellow residents of Michigan.

  Many of these people are working Americans who will lose Medicaid because of the onerous paperwork involved with the proposed work requirements.

Americans’ rage at insurers goes beyond health coverage – the author of ‘Delay, Deny, Defend’ points to 3 reforms that could help

  My book “Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It” was thrust into the spotlight recently, after UnitedHealthcare CEO Brian Thompson was shot and killed in what authorities say was a targeted attack outside the company’s annual investors conference. Investigators at the scene found bullet casings inscribed with the words “delay,” “deny” and “depose.”

  The unsettling echo of the book’s title struck me and many others.

Can health insurance companies charge the unvaccinated higher premiums? What about life insurers? 5 questions answered

  The current COVID-19 wave in the U.S. is mostly affecting unvaccinated Americans, who represent more than 95% of current cases of hospitalization and death.

  Given the average cost of a COVID-19 hospitalization in 2020 ran about US$42,200 per patient, will the unvaccinated be asked to bear more of the cost of treatment, in terms of insurance, as well?

Four myths about the public option

  The idea of a public option for health insurance has become increasingly politicized. Insurance companies, the pharmaceutical industry, and powerful hospital systems—all groups that profit from the status quo—are attempting to stir up fears about a plan that would actually help American families. In reality, a public option would lower costs, save American families money, and allow private insurance plans to continue to compete. The public option also remains a popular path for reform with growing support: A recent survey shows that 2 in 3 voters support a public option. In this column, the Center for American Progress sets the record straight on what a public option would do and discusses four common misconceptions about the plan.

Poor U.S. pandemic response will reverberate in health care politics for years, health scholars warn

  Much has been written about the U.S. coronavirus response. Media accounts frequently turn to experts for their insights – commonly, epidemiologists or physicians. Countless surveys have also queried Americans and individuals from around the world about how the pandemic has affected them and their attitudes and opinions.

  Yet little is known about the views of a group of people particularly well qualified to render judgment on the U.S.‘s response and offer policy solutions: academic health policy and politics researchers. These researchers, like the two of us, come from a diverse set of disciplines, including public health and public policy. Their research focuses on the intricate linkages between politics, the U.S. health system, and health policy. They are trained to combine applied and academic knowledge, take broader views, and be fluent across multiple disciplines.

How states are combating Trump’s ACA sabotage

  Following his failure to legislatively repeal the Affordable Care Act (ACA), President Donald Trump and his administration have waged a campaign to undermine and sabotage the landmark health care law. The administration has employed numerous strategies, including expanding access to short-term junk plans; eliminating cost-saving reinsurance programs; and cutting enrollment outreach funding. The Center for American Progress Action Fund (CAPAF) has been tracking these efforts to undermine enrollment, force coverage loses, and increase the cost of care for millions of Americans.

  The Trump administration and congressional Republicans delivered a blow to the ACA in its repeal of the act’s individual coverage mandate, which was included in the 2017 Tax Cuts and Jobs Act. With that provision of the law repealed, Texas Attorney General Ken Paxton, along with 19 other Republican state attorneys general, sued the federal government, arguing that the remainder of the law would now be unconstitutional. In 2018, a federal district court judge sided with the plaintiffs, ruling the ACA unconstitutional in a decision that is now being appealed to the 5th U.S. Circuit Court of Appeals. The fate of the ACA remains uncertain the near future, as the case is likely to reach the U.S. Supreme Court regardless of the 5th Circuit’s decision.

Meaningful protection from surprise medical bills

  Many Americans purchase health insurance under the impression that doing so will protect them from exorbitant, one-time costs associated with medical care. Insured patients pay premiums every month rather than having to worry about paying a large medical expense at once. In some instances, however, insured patients visit their doctors and receive a costly, unexpected bill. This is a consequence of the current structure of health insurance and provider networks, wherein insurers and health care providers negotiate to accept discounted payments as payments in full for services in exchange for sending patients to those providers. When patients visit out-of-network providers—those who haven’t agreed to these discounts—they can lose the benefit of their insurance. The provider may charge them the entire, non-discounted price for a service—and insurance may not cover any of the bill.

Your ultrasound isn’t a car. Why are you told to shop like it is?

  When my doctor suggested an ultrasound for the pelvic pain I was experiencing, my first question was “How much will that cost?” I am one of the many Americans with a high-deductible health care plan — $10,000 to be exact. I often scoff that my health insurance is a “get-in-a-doctor’s-door-plan,” because I pay cash for basically everything anyway.

  My doctor, recalling my poor insurance, asked, “Do you ever get to the other side of the state?” I looked at her quizzically. “Because there’s an imaging service over there that offers ultrasounds for …” She paused and searched her computer. “Let’s see … $137, maybe closer to $300 if they think you need both abdominal and transvaginal. But it’s like a two-hour drive.”

Conservatives are using the courts to attack health care for all Americans

  Conservative state officials, in conjunction with the Trump administration, have launched an all-out attack on health care in the United States. They have brought a suit to overturn the entirety of the Affordable Care Act (ACA), which would have serious consequences for nearly every American who has health coverage, whether through their employer, the individual market, Medicare, or Medicaid. And they found a partisan judge who proved willing to ignore the rule of law and help them advance their political agenda through the courts.

Conservative myths about Medicaid

  Access to health insurance in the United States is one of the most hotly debated issues in the national discourse. Prior to the implementation of the Affordable Care Act (ACA), 44 million Americans lacked health insurance, including many low-income nonelderly adults who did not fall within traditionally covered Medicaid eligibility groups, including pregnant women, disabled adults, and low-income children. Since the ACA went into effect in 2013, 11.9 million newly eligible people have gained coverage through Medicaid in states that chose to expand their programs. In addition to producing better health outcomes, Medicaid expansion has resulted in new enrollees having access to quality care without the threat of financial turmoil.

Sam Berger: Three ways that states can stop ongoing health care sabotage

  This past year has seen a sustained federal attack on state insurance markets. Congress repeatedly sought to repeal the Affordable Care Act (ACA) and significantly cut funding for Medicaid. While these efforts proved unsuccessful, President Donald Trump and his allies in Congress were able to repeal the individual mandate in the regressive tax bill they passed at the end of 2017. And the Trump administration has taken a number of steps to drive up costs and drive down coverage, including by halting billions of dollars in federal payments that help keep people’s deductibles and co-pays low and by directing agencies to seek ways to increase the number of substandard plans in the insurance marketplace without adequate consumer protections.

The Trump premium tax will increase premiums up to $2,500 next year

  Since he entered office, President Donald Trump has taken numerous steps to sabotage the Affordable Care Act (ACA) by driving up costs and driving out insurers. With the failure of ACA repeal in the U.S. Senate, Trump has threatened to accelerate his efforts. In particular, by undermining enforcement of the ACA’s individual coverage mandate and threatening to stop billions of dollars in cost-sharing reduction (CSR) payments that help lower consumers’ deductibles and copayments, Trump will significantly increase 2018 premiums.

For many rural Southerners, no health care to lose

  Last week, the Senate took a series of votes aimed at repealing parts or all of the Affordable Care Act. Under any of the plans put forth by Republicans – all voted down thus far – millions of Americans would lose their health care coverage, according to the Congressional Budget Office.

  But in places like southwestern Virginia, many simply have no health insurance — or access to medical care — to lose.

  Last weekend, more than 2,000 people in Wise, Virginia, waited in long lines and sweltering heat for basic health services from the Remote Area Medical Expedition. At a county fairground over a period of three days, volunteer doctors pulled teeth, performed chest X-rays, tested insulin levels, and handed out eyeglasses to people too poor or too sick to get health care any other way.

Senate repeal bill will increase average costs for exchange enrollees by $2,294

  Now that the Congressional Budget Office (CBO) has released its score of the Senate’s Better Care Reconciliation Act (BCRA), it is clear why the Senate majority worked so hard to keep the text of the bill a secret. The truth is now out: an estimated 22 million people would lose coverage under the BCRA compared to the ACA.

  But the people who would lose coverage are not the only ones who would be worse off. Many Americans who kept their insurance would still face higher costs under the BCRA. For the average marketplace enrollee in 2026, the BCRA would raise their total costs, including net premiums plus cost-sharing, by $2,294.

Cassidy-Collins ACA ‘replacement’ plan forces states to choose from three bad options

  When Sen. Bill Cassidy (R-LA) promoted his ACA “replacement” proposal, introduced this week with Sen. Susan Collins (R-ME), he said, “Republicans think that if you like your insurance, you should keep it.” Yet a review of the Cassidy-Collins legislative text shows that the bill falls short on that promise.

  Under the proposal, the Patient Freedom Act of 2017, states must choose from one of three options: (1) to continue implementing the Affordable Care Act, or ACA, albeit with reduced funding for the financial assistance that makes coverage affordable for lower- and moderate-income individuals; (2) to opt for the legislation’s preferred State Alternative Option; or (3) to reject any federal funding, though the state would still have to follow some ACA provisions.

Republican ACA repeal bill would unravel the market even before it goes into effect

  Last year, both the Senate and House of Representatives passed a bill to repeal major parts of the Affordable Care Act, or ACA; the bill was subsequently vetoed by President Barack Obama. Unlike previous repeal attempts, this bill was able to reach the president’s desk thanks to the budget reconciliation process, which allowed it to bypass a Senate filibuster.

  Since a reconciliation bill does not require 60 votes in the Senate, it may represent the most likely vehicle for congressional Republicans and President-elect Donald Trump to repeal the ACA. Although it would not include a replacement for the ACA, Republicans may argue that delaying the date at which key provisions kick in would provide enough time for a smooth transition.

  This is a fallacy. Even with a delayed effective date, the reconciliation bill approach would cause massive disruption and chaos in the individual market for health insurance. The complete unraveling of the market would occur by the end of 2017.

Hank Sanders: Senate Sketches #1525: A eulogy for Alabamians who did not have to die

  It was a eulogy for so many deceased human beings. It was a eulogy for so many deceased human beings whose names we don’t know. It was a eulogy for so many deceased human beings who we can’t say exactly when and where they died. It was a eulogy for so many deceased human beings who did not have to die. A eulogy, a eulogy, a eulogy.

  This funeral was unique. The place was the steps of the Alabama State House. The time was Wednesday, August 24, 2016 at 11:00 a.m. The names of the deceased were unknown. It was a unique eulogy at a unique funeral, a mock funeral. However, it was dead serious. The funeral dramatized the deaths of up to 1,800 Alabamians over the last three years. The entire funeral was a protest led by SOS (the Save Ourselves Movement for Justice and Democracy). It was a mock funeral, but the deaths were real. It was a mock funeral, but the emotions of the moment were real. A eulogy, a eulogy, a eulogy.

House GOP proposals would make health coverage less secure for all Americans

  Seven years after first promised, Speaker of the House Paul Ryan (R-WI) has released a vague policy white paper that outlines how House Republicans would attempt to replace the Affordable Care Act, which has expanded health insurance coverage to more than 20 million Americans since 2010 at a cost of billions of dollars less than expected. The document is a comprehensive list of conservatives’ recycled, unpopular ideas. Instead of designing a health care system that works for all Americans, the paper outlines a plan to quarantine people who are old and/or sick in separate, more expensive, and unsustainable markets. These reforms would transfer assistance from low-income people to high-income people and from the sick to the healthy. They would not only raise costs for older and less healthy Americans but also would destabilize the entire health care system, shift costs to patients and families, and make everyone’s coverage less secure.

The Great Cost Shift: Why middle-class workers do not feel the health care spending slowdown

  In recent years, the growth in overall health care costs has slowed dramatically. But for millions of Americans with employer-sponsored insurance, or ESI, this slowdown is illusory. From 2008 through 2013, the average annual growth rate of employees’ monthly premium contributions and out-of-pocket expenses, adjusted for inflation, was more than double that of average annual growth in real per-capita national health care spending, which was less than 2 percent per year. This growth has also outpaced employers’ costs of offering these benefits by more than 40 percent.

  Employees experiencing higher health care costs tend to blame the Affordable Care Act, or ACA, even though the law largely leaves the employer-based system alone. In fact, many employers report that the ACA has had only a negligible influence on their health care costs.

Hank Sanders: Senate Sketches #1420: Acting in faith

  We spoke in faith. We prayed in faith. We sang in faith. We marched in faith. It is the same faith the children of Israel had when they marched around the impregnable walls of Jericho some 3,500 years ago and the walls came tumbling down.

  We spoke in faith. We prayed in faith. We sang in faith. We marched in faith. It is the same faith of which the children of Birmingham spoke, prayed, sang and marched with some fifty years ago and the walls of legal segregation came tumbling down.