Tracking Emerging Public Health Challenges – March 20, 2016 – Obamacare Subsidies
“About a month ago, CNN reported that Donald Trump was determined to make health care “a central focus of his midterm sales pitch,” which seemed difficult to believe but apparently was a sign of things to come.
In fact, in his remarks to House Republicans this week, the president said, in reference to health care: “We can own the issue. For the first time ever, Republicans can own that issue.”
“The latest national NBC News poll, released this week, asked respondents which party they trust more on a range of issues. Democrats fared well on some questions, including a 20-point advantage on one issue: health care.” (1)
“Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, said the healthcare system needs more than improvement.
Speaking at the HIMSS Global Health Conference & Exhibition Thursday, Oz said the system needs to be completely overhauled. And he outlined some of his plans.
“The current system will not work,” Oz said. “I don’t know how many times this is said to us. I’ve been hearing it for decades and never really processed it.”
Now that he’s running CMS, the largest payer in the world, Oz said he sees a clearer picture.
Other industries are using technology to lower costs for consumers. Oz says that’s not happening in health care, and he says that needs to change.
“If you look at the cost increases in health care, the doctors’ salaries and nurse salaries are increasing at slower than the inflation. Pharma is increasing at the rate of inflation. Hospitals are increasing at twice the rate of inflation because they have manpower issues. They have technologies that have not been able to keep up with the complexity of care they give,” Oz said.
“The reason health care, historically, is not taking technology and used it in the way that we thought it could be used, and it’s actually been inflationary, is we use technology at the end of the care cascade,” he added.
Hospitals are using tech to deliver more costly care for patients who need an MRI or are coming in for a heart attack.
Instead, Oz said he wants to “win the battle for health, not in the ER or in the ICU, but in your home, in your kitchen, your bedroom, in your living room, with remote patient monitoring and better tools.”
A heart surgeon, Oz said that a key to helping patients survive a heart attack is the administration of Lasix, a drug that helps people pass fluid, or, as Oz said on stage, “It helps you pee, literally getting you pee the fluid out helps.” But if doctors could get a patient that drug at home, the patient doesn’t need to come to the hospital, he said.
“You never come in the ER, you don’t die, you don’t go to the IC, you don’t pass go, and you don’t get to collect $200 for the health care system either,” Oz said. “The whole thing works better for us.” (2)
“A House Energy and Commerce health subcommittee hearing on “Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape” quickly became a referendum on who is to blame for America’s affordability crisis, and whether hospitals and physicians can remain viable under current policy.
Democrats on the committee argued Republicans had created the healthcare affordability crisis by cutting Medicaid and ACA support, while Republicans pointed to ACA‑era structures, consolidation and opaque pricing as the main culprits.
However, beyond the political crossfire, witnesses from hospital leaders, physician groups, employer coalitions and disability services told converging stories of a system where coverage is thinning, costs are rising faster than payments, and administrative friction is grinding down both patients and providers.
Together, they underscored that affordability debates on Capitol Hill are now inseparable from the day‑to‑day viability of hospitals, independent practices and the safety‑net services that keep vulnerable patients out of high‑cost settings.
Eight takeaways from the hearing:
1. A $43 billion administrative burden on hospitals
2. Hospital supply, drug costs outpacing revenue growth
3. 340B draws criticism from both sides of the aisle
4. Site-neutral payments come under fire
6. Employers running out of patience
7. The physician payment crisis is a consolidation accelerator
8. Hospital consolidation’s defenders are increasingly isolated. (3)
“This brief highlights trends contributing to rising healthcare costs and identifies issues shaping this year’s policy debates, though there is little expectation for much legislative action at the federal level during an election year.
1. Healthcare costs remain top of mind for many Americans
2. Premiums have increased across commercial and individual marketplaces
3. The public and private sectors are looking for solutions as U.S. spending on prescription drugs continues to increase
4. Price transparency for healthcare prices has momentum
5. Federal and state policymakers show interest in addressing the impacts of healthcare consolidation
6. The use of artificial intelligence in healthcare is likely to accelerate coding intensity, placing upward pressure on healthcare spending
7. States are responding to funding and program implementation pressures with changes to Medicaid beginning in 2027
8. Effective distribution of the Rural Health Transformation Funds will require rapid state action.” (4)
“Below, we take a close look at the health care landscape now that subsidies are gone, and dig into how frustration over soaring health care costs could impact the 2026 midterms.
1.The subsidies are a priority for voters, even if they aren’t for members of Congress
2.At least 1 million fewer people are no longer insured through the ACA marketplace
3. Republicans’ proposed replacement for the ACA could leave major gaps for most enrollees
4.Minority groups will likely be most impacted by lost coverage
5.Downstream costs may outweigh short-term savings.” (5)
Senate Democrats lay out plans to overhaul health insurance after setbacks under Trump, https://www.statnews.com/2026/03/19/democratic-senators-outline-health-insurance-reform-plan/
Dems’ election-year health pitch targets insurers, Trump tax law, http://www.modernhealthcare.com/politics-regulation/mh-democrats-trump-tax-law-aca-subsidies/
The Trump health care policy red and blue states are embracing, By Kelly Hooper, https://www.politico.com/news/2026/03/15/trump-health-policy-both-parties-bullish-on-00813177
“More states are encouraging businesses to help employees sign up for Obamacare.
They’re using a policy backed by President Donald Trump — the same Donald Trump who spent much of the fall deriding Obamacare as the “Unaffordable Care Act” — to do it.
Trump issued those broadsides to explain why he didn’t support an extension of government subsidies that made Obamacare plans more affordable for millions. Those subsidies have now expired, sending premiums soaring. But Trump has continued to support a 2019 rule issued in his first term that allowed states to offer tax credits to businesses that help employees enroll in Obamacare plans.
That offer is now finding more takers, among Republicans and Democrats, as state lawmakers look for ways to keep the uninsured rate down. Obamacare enrollment has already dropped by more than 1 million this year, with further decline expected. At least six states, including Ohio and Connecticut, are looking at offering the tax credits to businesses that adopt the Trump policy, known as Individual Coverage Health Reimbursement Arrangements, to stem the damage. ICHRAs allow employers to give workers a tax-exempt subsidy to purchase Affordable Care Act coverage, as opposed to offering a traditional group plan.
Connecticut is one of several states where lawmakers are introducing and passing bills to incentivize small businesses to adopt the Trump policy. Employers who offer to help their workers with Obamacare premiums can write off the amount they contribute on their taxes.” (5)
1.Trump pushes GOP to focus on health care in midterms, which would be fine with Democrats, by Steve Benen, https://www.ms.now/rachel-maddow-show/maddowblog/trump-pushes-gop-to-focus-on-health-care-in-midterms-which-would-be-fine-with-democrats
2.Dr. Oz: ‘The current system will not work’, by Ron Southwick, https://www.chiefhealthcareexecutive.com/view/dr-oz-the-current-system-will-not-work-
3.House hearing dissects healthcare’s cost problem: 8 takeaways, By Alan Condon, https://www.beckershospitalreview.com/finance/house-hearing-dissects-healthcares-cost-problem-8-takeaways/
4.Eight Trends Shaping 2026 Healthcare Costs, By Lynne Cotter, Emma Wager Twitter, Hattie Xu, Tom Lebert, Julia Harris, Brad Brockbank, and Matthew Rae Twitter, https://www.healthsystemtracker.org/chart-collection/eight-trends-shaping-2026-healthcare-costs/
5.5 Points on the Impact of Congress Letting ACA Subsidies Expire, by Farrell Brenner, https://talkingpointsmemo.com/fivepoints/5-points-on-the-impact-of-congress-letting-aca-subsidies-expire
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai