Health Reform


What the ACA is Actually About

Be Not Afraid

Voters are angry and distrustful of Washington. Democrats have lost their nerve. Republicans, sensing weakness, are closing in for the kill. We have seen this health care reform horror movie before.

Read Dr. Len Nichols’ full article in the New England Journal of Medicine here.

Making Health Markets Work Better Through Targeted Doses of Competition, Regulation, and Collaboration

“I write this article not to praise fear, but to bury it, by describing how to amend health market rules in such a way as to preserve key freedoms and personal choice while improving the distributive justice, economic efficiency, and ultimately sustainability of universal access to vital health services.”  Read Dr. Len Nichols’ article in the St. Louis University Journal of Health Law and Policy here.

Government Intervention in Health Care Markets Is Practical, Necessary, and Morally Sound

The purpose of Dr. Len Nichols’ essay is to articulate why it is not possible to make our health system better, sustainable and serve us all without government playing specific and limited but absolutely crucial catalytic roles.  Read more about why government intervention plays a crucial role.

Justice Roberts’s Health Care Stewardship

“Clearly Americans diverge on key features of a desirable society and on the wisdom of using government to achieve even mutually desirable goals. I would argue that debate belongs squarely in the realm of politics and elections, and in the end, the Court agreed. Forms of this debate will live as long as America does. Other milestones will occur this election day and next January, when the new Congress and president take their respective oaths of office.”

Read more about what the Court has asked us to consider.

Consumer Guide To The Supreme Court’s Action On ACA Subsidy Issue

The Supreme Court on Friday agreed to hear a case on a subject that’s important to millions of people who receive subsidies to help purchase coverage under the health-care law. Friday’s decision follows earlier action in July when two U.S. appeals courts issued conflicting rulings on the issue.  KHN’s Mary Agnes Carey answers some frequently asked questions about those court decisions and how they impact consumers.

Read the full article here.

President Obama’s Proposal

This is a brief overview of Obama’s Proposal and the opposition to reform.

Local Debate on Affordable Care Act

Sept. 22, 2014, Bristol, TN.  Len Nichols  moderated a panel at the event sponsored by Wellmont Health Systems, Appalachian School of Law, and the Sorenesen Institute for Political Leadership at UVA.  The topic was entitled “From Policy to Implementation with the Patient Protection and Affordable Care Act:  How do We Get There?”  To read more about the event click here.

Dr. Nichols’ Recent Discussion on State Marketplaces

Len Nichols recently joined other policy experts at George Washington University’s Milken Institute School of Public Health to discuss recent court decisions about legality of subsidies in state marketplaces. Watch video here.

Dr. Nichols Quoted in Bloomberg

Read the full article here.


Implementing the ACA


NAHU’s Capitol Conference Addresses Healthcare Reform under the New Administration

The health insurance industry is rapidly changing and the National Association of Health Underwriters (NAHU) is continuing efforts to focus on marketplace stability while examining the outlook for health reform under President Trump.  Dr. Nichols discussed, “What to Expect with the Unexpected”  at NAHU’s 27th Annual Capitol Conference  See NAHU’s link to the press release.  Also related, see Cort Olsen’s follow up article in Employee Benefits News here.

Fixing ACA’s Marketplaces:  Len Nichols Participates in January 2017 NASI panel


Implementing Insurance Market Reforms Under The Federal Health Reform Law

Lost in the rhetoric about the supposed government takeover of health care is an appreciation of the inherently federalist approach of the Patient Protection and Affordable Care Act.

Read more here.

Report from the States  Health Reform in Virginia:  the Commonwealth’s Way

Dr. Len Nichols answers the question:  has Virginia really made progress toward being prepared to implement a comprehensive health reform strategy over the next few years?  Read more about facilitating a Virginia-specific solution here.

Accountable Care Organization Pathways: Diverse but Ultimately Parallel

Dr. Len Nichols discusses why effective access for tens of millions of Americans is at risk—not to mention most other public priorities and middle-class jobs in a global economy—if we fail to improve the efficiency with which high-quality care is delivered.

Read the full article here.

Payment and Delivery Reforms Inside and Outside the ACA

Medical Home Implementation in Small Primary Care Practices:  Provider Experiences and Perspectives

CareFirst BlueCross BlueShield of Maryland implemented a voluntary patient-centered medical home (PCMH) program in 2011 that did not require formal certification to participate. This study assessed attitudes and awareness of PCMH programs among participating providers in Maryland and Northern Virginia.

Read here about how implementation of PCMH program elements can be facilitated in small primary care practices even if third-party certification is not a requirement.

The Care First Patient Centered Medical Home Program: Cost and Utilization Effects in the First Three Years

This study’s objective was to test whether a patient-centered medical home (PCMH) model that significantly rewarded cost savings and accommodated small primary care practices was associated with lower spending, fewer hospital admissions, and fewer emergency room visits.

Read about the study here.

Obesity and Health System Reform: Private vs. Public Responsibility

Obesity is a particularly vexing public health challenge, since it not only underlies much disease and health spending but also largely stems from repeated personal behavioral choices. The newly enacted comprehensive health reform law contains a number of provisions to address obesity.

Read more.