Jul 31, 2019

What Democrats are doing on health care

Illustration: Rebecca Zisser/Axios

As Democratic presidential candidates debate their ideal health care system, blue states are making incremental — yet significant — changes to the existing one.

Why it matters: In the states where they have power, Democrats are creating a blueprint for how the ACA could evolve under Democratic control in Washington.

Where it stands: California recently passed the most ambitious expansions of the ACA to date.

  • It made the ACA's premium subsidies available to middle-class people, and made undocumented children and young adult immigrants eligible for the state Medicaid program.
  • "This isn’t just the ACA warmed over. This is actually taking steps beyond it to make it better," said Peter Lee, executive director of Covered California, the state ACA exchange.

Other states have also made significant changes.

What's next: If a future Democratic president wanted something less ambitious than "Medicare for All," these reforms will provide a starting point.

The other side: Republican-led states are surging ahead on their own reforms, like adding work requirements to Medicaid.

The bottom line: "Red states and blue states are moving in very different directions on health care, taking advantage of new flexibility on the one hand and combating efforts by the Trump administration on the other," said Larry Levitt of the Kaiser Family Foundation.

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Rates for Affordable Care Act plans aren't going up much

Illustration: Sarah Grillo/Axios

Premiums for Affordable Care Act coverage are going down in some places, and barely rising in others.

The big picture: Health insurers raised ACA rates dramatically over the past few years, largely due to political chaos. But their plans have still proven to be extremely profitable. Now many companies are lowering premiums as they expect to send money back to their customers.

Go deeperArrowAug 22, 2019

Wealthier people are ditching the ACA exchanges

Data: Centers for Medicare & Medicaid Services; Chart: Axios Visuals

The universe of people covered by the Affordable Care Act keeps narrowing.

Between the lines: People who make too much money to qualify for help paying their premiums are fleeing the ACA’s insurance exchanges. But the exchanges are still pretty stable for people who receive premium subsidies, according to new federal data.

Go deeperArrowAug 13, 2019

Trump's shrinking health care legacy

Photo: Alex Wong/Getty Images

President Trump came into office in 2017 with big ambitions on health care. But he’ll end this term with a lot less to show.

The big picture: If Trump ends up being a one-term president — and that’s not a prediction, just 1 of the 2 possibilities in 2020 — his health care legacy would be pretty modest.

Go deeperArrowAug 20, 2019