A research article published in the Journal of Health Politics, Policy and Law by Mark A. Peterson, professor of public policy, political science and law, compares the “political vulnerability and resiliency” of the Affordable Care Act (ACA) with the repeal of the Medicare Catastrophic Coverage Act (MCAA) nearly three decades before. “The political-institutional contexts and the processes of coalition change could hardly have been more different for MCCA and ACA,” notes Peterson in his article, “Reversing Course on Obamacare: Why Not Another Medicare Catastrophic?” in the Duke University Press publication. “However, they had some shared vulnerabilities stemming from program design,” he argues. “The ACA survived the political weakness inherent in its policy attributes due to its particular balance and timing of benefits and costs and by being shielded long enough by election results and the constitutional separation of powers to have its benefits take root.” — Stan Paul
An analysis of the potential impact of a proposed amendment to the American Health Care Act of 2017, known as the Graham-Cassidy plan, found that the now-abandoned proposal could have triggered the near-term collapse of California’s individual health insurance market. The analysis, developed by John Bertko, chief actuary for Covered California, and UCLA Luskin’s Wes Yin modeled two scenarios that examined how California leaders might respond to a federal funding cut of nearly $139 billion between 2020 and 2027. In both cases, the consequences of the cuts would start taking effect in 2020 and quickly lead to millions losing their coverage. In one scenario, California’s individual market could experience what is commonly referred to as a death spiral, according to a news release issued Sept. 25, 2017, by Covered California. “The decline in the number of those receiving financial help to buy individual market coverage, while requiring health plans to provide coverage to those with pre-existing conditions, would very likely lead to the collapse of the individual market by 2021 if not before,” said Yin, an economist and coauthor of the analysis who is also an associate professor of public policy and management at UCLA Luskin.