Politics and Healthcare – Nothing Is Easy

Pink cherry blossom and magnolia trees blooming at the White House in Washington, DC during the springtime

I had the pleasure of spending the day on Tuesday in Washington to discuss my favorite legislative topic – healthcare. First stop, the White House, where I met with the Special Assistant to the President for Health Policy. This was a lively discussion which covered rising drug prices, the opioid crisis, mental health parity and… [Read More]

The Affordable Care Act Scorecard


The 2016 healthcare.gov enrollment has been heralded as a success by many, and no doubt, we have seen coverage expansion under the Affordable Care Act. But – and there are some pretty significant buts – 2014 enrollment was 9.3 million with 9 million enrolled in Medicaid. 2015 enrollment increased to 11.9 million; however, as of… [Read More]

Educating Legislators about Healthcare Reform

healthcare cost2

Earlier this month, the President released his 2017 budget proposal which seeks to modify the controversial 40% excise Cadillac Tax. In 2020, the tax threshold is estimated to be approximately $10,800 for single plans and $29,100 for family plans. However, another change would address regional cost variances by tying the threshold to average marketplace “gold” plan in the states… [Read More]

Will the Future President Fix Healthcare?

presidential election health policy

As I listen to the leading presidential candidates, I can’t help but think, as Donald Trump boasted that he would do “something terrific” and “people are going to go out and negotiate great plans with lots of different competition…[and stuff],” that he is exhibiting the least market knowledge and the most schoolyard bravado of all… [Read More]

Why I’m Pessimistic about Another Healthcare Consortium

healthcare us government aca

Last Thursday, The Wall Street Journal published an article about a group of 20 major employers covering 4 million members, who were “banding together to use their collective data…in a bid to hold down the cost of…health-care benefits.” The effort was motivated by the health policy think tank, American Health Policy Institute, to study the… [Read More]

Learning from the Failure of Health Republic

Flag and Stethoscope

On Wednesday, in my role as the legislative chair for the New York State Association of Health Underwriters (NYSAHU), I was invited to participate in a roundtable discussion which included the members of the NYS Senate Standing Health and Insurance Committees chaired by Senators Hannon and Seward, the head NYS regulator, the head of the… [Read More]

New York to Allow Pregnancy as a Qualifying Event

healthcare cost

The realities of adverse selection are starting to show through as many state exchange filings are requesting double digit increases for insurance plans on the healthcare exchanges. In fact, silver plans, which are the most prevalent (accounting for two thirds of 2015 purchases), would increase 14% in the unlikely event that rates are accepted as… [Read More]

Doc Fix – Is it Finally Fixed?

Doc Fix – Is it Finally Fixed

Price controls don’t work to control cost inflation. Politicians are not the most steadfast policymakers; over time, changing and re-changing direction. Nowhere have these two truisms been more evident than in the debate surrounding the Medicare sustainable growth rate (SGR) formula. In 1997, Congress imposed a formulaic price control to reign in the escalating budget… [Read More]

The Great Debate: Cannon v. Gruber

The Great Debate: Cannon v. Gruber

Two weeks ago, I had the privilege of attending the 2015 Sun Life Wake Up Summit which featured a debate on ACA topics between two of the greatest intellectuals on the subject. Jonathan Gruber, one of the architects of the law, represented the pro-ACA position and Michael Cannon, a key driver behind the King v…. [Read More]

ACA Gyrations: Politics Affecting Real Lives


In this blog we have been highlighting the debate surrounding the Affordable Care Act. The thing that our politicians seem to lose is that the “debate” impacts real people. In speaking with the Harvard Business Review, Robert Reich recently discussed the current debate: the definition of full-time work. ACA defines eligible full-time employees as those… [Read More]