Thought Leadership

Our wide array of published insights drive the debate in Washington.

The Health Implications of Tax Reform

California-Health-Care-Foundation 400x200
This post breaks down the key components of 2017 Federal tax reform and its impact on the health care sector....
+ Read More

Navigating The Section 1332 Waiver Process: For States, A Treacherous Road Ahead

In light of the mounting legislative efforts to make changes to the section 1332 waiver process, especially in the Alexander-Murray market stabilization package, and enhanced state interest in availing themselves of this opportunity, we figured it timely to provide an overview of this aspect of the Affordable Care Act (ACA), the record of how state applications have been adjudicated so far, and the prospects of change to the policy in the near term. Unfortunately, given the considerable uncertainty in both the legislative and executive branches regarding the future of these waivers, states cannot safely expend meaningful resources on developing new applications for the program at this time....
+ Read More

Breaking Down The MACRA Final Rule

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released a final rule making changes to the 2018 Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP includes both the Merit-Based Incentive Program (MIPS) and Advanced Payment Models (APMs). This post explains the key policies implemented in the final rule....
+ Read More

Creating Medicare Advantage Premium Support for All, Part 2: Benefit Design

This is the second installment in my series examining the potential for a bipartisan Medicare-for-all approach that leverages competition among private payers and consumer choice via an advanceable tax credit....
+ Read More

The Alexander-Murray Market Stabilization Package: What’s In It And Where’s It Going?

They may have done it. The apocryphal bipartisan deal to “fix” Obamacare is being struck (at least by two important Senators, for now, in part …). Today, Senators Lamar Alexander of Tennessee and Patty Murray of Washington announced they are converging on an agreement on a short-term package to help stabilize the individual insurance market. Even better, the policies included would likely be somewhat successful in achieving their purported purpose...
+ Read More

In Health Affairs, Billy Wynne Breaks Down the Alexander-Murray Market Stabilization Package

...
+ Read More

The CHRONIC Care Act Passes Senate, Obstacles Remain

his post outlines the key components of the now adopted Chronic Care Act, assessed its outlook in the House, and considered what its progress may tell us about the prospect for more bipartisan action on health care in the future. ...
+ Read More

Senate Bill Isn’t “Better Care” for Anyone

With the release of the Senate’s “Better Care Reconciliation Act of 2017 (BCRA),” the public finally gets a glimpse of legislation crafted in utter secrecy for the past two months, and now we know why. Despite the fanfare and feigned earnestness of the upper chamber’s efforts to improve on the “mean” House-passed American Health Care Act (AHCA), the Senate bill would be disastrous for low-income families, patients with pre-existing conditions, children, and the aged, while undermining health care security for virtually everyone else....
+ Read More

CBO and America’s AHCA Headache

The much-anticipated Congressional Budget Office (CBO) score of the American Health Care Act (AHCA), the GOP’s effort to dismantle the Affordable Care Act (ACA) released yesterday, indicates that the bill would cause 23 million people to become uninsured while reducing the federal deficit by $119 billion. In that sense, there is little change from their assessment of the original version of AHCA. ...
+ Read More

The Bipartisan ‘Single Payer’ Solution: Medicare Advantage Premium Support For All

In my last Health Affairs Blog post, I outlined a potentially bipartisan four-step plan to move past the American Health Care Act’s (AHCA’s) disastrous framework toward a more stable, less expensive health care system. For those seeking incremental, near-term solutions, I hope those recommendations provide helpful guidance. But the AHCA’s reckless drive through the US House of Representatives has taught us something about the current status of health care politics and may have opened the window to more significant, ultimately more successful, reforms....
+ Read More

100 Days of Health Care

Before November 8, no one anticipated that health care would be the predominant focus of the next president’s first 100 days. Now, let the record reflect, that is precisely what has happened. What have we learned in the process and what do we have to show for it? The latter question is easier to answer: nothing, save for considerable uncertainty and burgeoning disruption for the health care system. As for the former, Republicans have hoisted their own petard in epic fashion. ...
+ Read More

What Now?: A Four Step Plan For Bipartisan Health Reform

As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind....
+ Read More