On November 20, 2012, the U.S. Department of Human Services issued a Notice of Proposed Rulemaking on incentives for non-discriminatory wellness programs in group health plans. These proposed rules take a fair approach to a complicated issue: how to encourage health promotion programs while at the same time protecting individuals from potential health insurance discrimination. Here’s the concern: incentives can …

In an opinion piece in the Wall Street Journal on November 18, James Capreta and Yuval Levin argue that states can effectively “repeal” the Affordable Care Act by refusing to go along with key provisions. They conclude: President Obama won re-election and Democrats maintained control of the Senate this month, but the states hold the future of ObamaCare in their …

One thing was certain in the 2012 Presidential election: the stakes were high for health care reform. Governor Romney started his campaign with standard rhetoric about repealing the Affordable Care Act (ACA), but by the end of the campaign, most pundits had concluded that repeal was highly unlikely, regardless of the outcome of the election. Governor Romney himself had started …

In the midst of all the election coverage—the daily hoopla and scoring of who is up and who is down—it would be very possible to miss an extremely important court decision on the Affordable Care Act, regarding the contraceptive coverage mandate included in the law’s implementation rules. On September 28, 2012, in a case brought by a Missouri mining company, …

In many respects, the Affordable Care Act is a law about health care coverage. It is designed to expand coverage, mostly by using two tools: (1) the requirement for individuals to have/purchase health coverage or face tax penalties (known as the individual mandate), and (2) the expansion of Medicaid eligibility to all with incomes at or below 138 percent of …

When we think of two-tiered care in America, we most often think of the “haves” and “have nots”: those who are covered by health insurance and those who are not. But there is a different way to look at this question, and it may take being outside the U.S. to see it that way. Going back through old issues of …

Much of the discussion and press coverage of the Affordable Care Act (ACA) has been focused on provisions related to the expansion of coverage: the individual mandate, the Medicaid expansion, and to a lesser degree, health insurance exchanges. These provisions don’t go into effect until 2014. Other important parts of the ACA are already in place, and already making a …

Atul Gawande’s latest article in the New Yorker magazine is a hot trending story in health care. It even spawned an editorial in the Wall Street Journal that seemed oddly confused about what Gawande was advocating. In his article, Gawande talks about lessons learned from quality and cost control processes at a restaurant chain called The Cheesecake Factory, and argues …

Since the Supreme Court ruling on the Affordable Care Act (ACA), the discussion about Medicaid has largely focused on a choice states now have: whether or not to expand coverage to those at or below 138 percent of poverty. This issue is extremely important because of the impact it could have on those who are uninsured today. However, there is …

Debates about the Affordable Care Act continue—especially in this election year—but health reform is already happening all around us. All we need to do is look. Case in point: Cheboygan, Michigan, where the local hospital was closed suddenly at the beginning of April, and then resurrected—in a different form—in mid-May. Initial press reports about the closure left the impression that …