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Health Policy


The State-Level Future of Healthcare Reform

The State-Level Future of Healthcare ReformThis week I’d like to share my latest analysis for The Atlantic – on the future of Obamacare – and some news on my firm’s newest, and perhaps most important, contract: helping to address the serious structural challenges facing Puerto Rico.

The Future of Obamacare

With the Supreme Court set to decide King v. Burwell in the next month or so, many speculate that Obamacare’s days are numbered. I argue, instead, that Obamacare we will have with us always, in some form – but that form is likely to change somewhat from how it stands today.

Where a conservative alternative has been formulated, the proposed changes from standard Obamacare have been fairly mild: Beyond predictable attempts to shave benefits and impose work requirements, the Republican modifications to Medicaid expansion have centered on ideas that many Democrats would find acceptable and (in some cases) have even proposed themselves: partial financial responsibility, incentives for healthy behavior, and “premium assistance” – which reflects the conservative preference for government aid in buying private insurance over government-provided insurance. The likely result is a national consensus, at some point in the future, on a plan that both parties could have agreed upon a long time in the past.

To read more, click here.

The Future of Puerto Rico

Puerto Rico for several years has been rated with Greece and California as among the biggest bond risks in the world, due to persistent structural budget deficits. But these budget and debt woes are caused by deeper economic challenges: Over half the island’s population lives below the US poverty line, and, like most islands, it lacks natural resources for export. The long-term answer requires investment in Puerto Rico’s one asset – its people. Public Works has been asked to help address the Commonwealth’s immediate budget shortfall – and to resolve it in the long-term with improved education, health care, economic development, and government efficiency.


Obamacare: Great Public Policy, Lousy Name

Everything you need to know about the Obamacare debate:  The problem isn’t the “care” – it’s the “Obama.”

Polls show overwhelming support for virtually every component of the Act – prohibiting insurers from refusing to cover people with pre-existing conditions, allowing young Americans of working age to continue on their parents’ insurance, requiring all businesses with more than 50 employees to provide health coverage for their workers – except the (in) famous “individual mandate.

Read the full story in Aspenia Online.