Plus: the administration scrambles on drug prices
Trump’s Immigrant Wealth Test Cleared by Supreme Court
The Supreme Court voted 5-4 Monday to allow the Trump administration to start enforcing a new rule designed to screen out immigrants at risk of becoming “public charges.”
The rule, which was scheduled to take effect last October before being halted by a federal judge, will make it more difficult for immigrants to obtain citizenship or residency if they have used food stamps, housing assistance, Medicaid or other public benefits — or if, in the judgment of immigration officials, they are likely to do so in the future.
Any immigrant who has used one or more benefits for more than 12 months in a 36-month period would be ineligible for residency or entry into the country. Immigrants will have to demonstrate that they have sufficient financial resources to keep them from using such benefits in the future. In evaluating immigrants’ financial status, Department of Homeland Security officials will consider a variety of factors, including wealth, age, health, education, language skills and even credit scores.
A more stringent standard: While restrictive rules about “public charges” date to the 19th century, immigrants have typically been denied residency or citizenship only when they have relied on cash benefits from the government as their primary source of income. Critics say the new standard is too severe, and a federal judge in New York described it as “repugnant to the American dream of the opportunity for prosperity and success through hard work and upward mobility.” But the Supreme Court appeared to agree with the administration’s claim that the rule “represents a reasonable and lawful exercise of the substantial discretion Congress has long vested in the executive branch to make public-charge admissibility determinations.”
What’s next: The ruling reverses a lower court injunction halting enforcement of the new standard (except in Illinois, which is involved in separate litigation), but challenges to the legality of the rule continue, and the case could again land before the Supreme Court in the coming months.
Trump Team Scrambling to Finish Drug Pricing Rule: Report
Frustrated by polling data showing that voters trust Democrats more on the issue of health care, President Trump reportedly lashed out earlier this month at Health and Human Services Secretary Alex Azar. That has led Azar to scramble to pull together details of a plan tying U.S. drug prices to a benchmark of prices in other developed countries, Politico’s Sarah Karlin-Smith and Adam Cancryn reported late Friday:
“There had been internal disagreement among Azar and other key health officials like White House Domestic Policy Council Director Joe Grogan over whether to release the rule on international benchmarking, as Azar wanted, or keep it for leverage as Congress keeps working on drug pricing, as Grogan has argued. Trump’s insistence on an imminent win helped bring the dueling parties together around issuing the rule. … But the administration has little ability to speed up the pace of federal rulemaking. That means even under the most favorable circumstances, the administration won’t be able to demonstrate any real change to consumers for years.”
The pharmaceutical industry strongly opposes the idea of an international price index, as do many Republicans, who object to what they see as government price controls. Republicans have also been wary of backing bipartisan legislation from Sens. Chuck Grassley (R-IA) and Ron Wyden (D-OR), which the White House supports.
Working on a plan to cut insulin costs for seniors: On a related note, Axios’s Caitlin Owens and Jonathan Swan report that the Trump administration is working on a plan to lower out-of-pocket costs for seniors who require insulin, though the details thus far “are unclear or undecided.”
Seniors spent an average of $588 out-of-pocket for insulin in 2016, or almost double what they paid in 2007, according to Axios. But Owens and Swan add that, “Lowering patients' out-of-pocket spending probably wouldn't lower the actual cost of the drug, meaning that it'd get shifted onto taxpayers.”
Number of the Day: 155,798,000
That’s how many individual tax returns were filed last year, according to the IRS. The tax agency issued nearly 112 million refunds totaling almost $321 billion, with the average refund coming in at $2,869, down 1.4% from 2018. The 2020 tax filing season starts today.
How 6 States Achieved Near Universal Health Coverage
A half-dozen states and the District of Columbia have health care insurance rates of over 95%, achieving near-universal coverage. Three researchers at the University of Pennsylvania — including Ezekiel Emanuel, a key architect of Obamacare — said Monday that the Affordable Care Act has everything to do with those results.
Here’s how the states achieved such high insurance rates, according to the authors:
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Expanding Medicaid: States that expanded their Medicaid programs as allowed under the ACA had about half the uninsured rate (6.6%) in 2018 as states that did not do so (12.4%). “Nearly 5 million people would gain health insurance if the remaining 14 states expanded Medicaid,” they write.
- Extending enrollment periods: High-coverage states countered the Trump administration’s efforts to shorten enrollment periods and reduce informational assistance.
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Lowering premiums: States enacted additional subsidies and reinsurance programs to keep premiums low, a crucial factor in maintaining insurance coverage from year to year.
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Simplifying options: Some states limited the number of options available to counteract “choice overload,” which can reduce signups through consumer paralysis.
- Maintaining individual mandates: Five states with low uninsured rates maintain some kind of individual and employer mandates, which may help persuade healthy people to sign up.
The lesson, the authors say, is that near-universal health coverage can be achieved without national legislation. “While it is easy to dismiss the ACA and focus on the promise of Medicare for All, there is a more straightforward path to universal coverage,” they write, “adopting a handful of relatively simple policies and programs at the state level can ensure health insurance coverage for nearly all Americans.”
Read the full analysis of “Obamacare’s Secret Success” at Politico.
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News
- House Members Considering Ending Ban on Earmarks – Roll Call
- Cities Prepare for the Worst as Trump’s Food Stamp Cuts Near – New York Times
- Rainy Days Ahead: States Boost Reserves, Anticipating Slowdown – Roll Call
- Schumer Calls for Faster Funding to CDC as 5th U.S. Coronavirus Case Confirmed – CBS New York
- ‘The Time to Worry Is Now’: The Coronavirus in China Could Threaten Pharma’s Ingredient Sourcing – STAT
- 10-Year Treasury Yield Hair’s Breadth Away From Key 1.60% Level Amid Coronavirus Spread – MarketWatch
- Fed Officials Weigh New Recession-Fighting Tool: Capping Treasury Yields – Wall Street Journal (paywall)
- Negative Debt Pile Surges by $1.2 Trillion in Dash for Havens – Bloomberg
- W.H.O. Warns That Pipeline for New Antibiotics Is Running Dry – New York Times
- When Insurance Won't Cover Drugs, Americans Make 'Tough Choices' About Their Health – NPR
- Trump’s Push to Curb ‘Surprise’ Medical Bills Could Alienate Billionaire Ally Schwarzman – CNBC
- Bloomberg Seeks to Limit Drug Patent Protection to Reduce Costs – Bloomberg
- The Pharmacist Is Out: Supermarkets Close Pharmacy Counters – Wall Street Journal (paywall)
- Wealth-Tax Proposals Would Increase the Trade Deficit, Conservative Group Says in Study – The Hill
- So Long, California? Goodbye, Texas? Taxpayers Decide Some States Aren’t Worth It – Wall Street Journal (paywall)
- Tom Steyer Would Pay $18 Million More in Taxes Under Democrats’ Plan – Bloomberg
Views and Analysis
- America’s Debt Spree Isn’t Stopping. It Might Soon Be Too Late. – Robert J. Samuelson, Washington Post
- Inequality Is a Big and Growing Issue, but a Wealth Tax May Not Be the Solution – Howard Gleckman, Tax Policy Center
- Our Current Economic Boom Is a Mirage, and Our Politics Are Going to Break It – Steven Pearlstein, Washington Post
- The Tax Increases to Come – Wall Street Journal Editorial Board (paywall)
- A Big Infrastructure Deal Faces a New Hurdle – Conor Sen, Bloomberg
- The US Must Continue to Prioritize Research and Development, Especially Through NASA – Rep. Ted Yoho (R-FL), The Hill
- Climate Change Is Real, and Really Expensive – James Nixon, Bloomberg
- Food-Stamp Work Requirements Just Look Cruel – Scott Duke Kominers, Bloomberg
- Self-Insured Companies Do No Better on Cost Control – Drew Altman, Axios
- Joe Biden Lied About His Record on Social Security – Ryan Grim and Lee Fang, The Intercept
- Traders May Hate Treasuries at 1.6%, But What Else Is There? – Brian Chappatta, Bloomberg
- Start of Tax Season 2020 Is Prime Time for Scammers – Michelle Singletary, Washington Post
- We Need to Prepare for US Outbreak of Wuhan Coronavirus – Dr. Scott Gottlieb, CNBC