We are nearing the grand finale of our long and disheartening election opera, one we dare not ignore because the outcomes matter so much. While the election results will not be determined by public reactions to the Affordable Care Act, the ACA’s fate will be mightily determined by Tuesday’s outcomes. What have we learned about our collective health future over the past 18 months and what might this mean for our health system’s future?

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While Obamacare is currently making headlines for (much) higher than predicted costs, the Centers for Medicare & Medicaid Services (CMS) want to create a national database of highly sensitive personal health information for the 30 million Americans with individual and small group coverage. Under Section 153.610 of a new Health and Human Services (HHS) rule for Obamacare, this proposal would require health plans to send CMS data on enrollees on an unprecedented scale, including:

  • Amount paid
  • Diagnoses received
  • Drugs prescribed
  • Procedures received
  • Health care providers seen
  • Out-of-pocket liabilities assumed
  • Individual demographics
  • Social Security Number

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Speaker Paul Ryan (R-Wis.) on Monday agreed with a radio host who said ObamaCare would not be repealed, likely ever, if Democratic nominee Hillary Clinton wins the presidency on Tuesday.

“Another hard truth: ObamaCare doesn’t get repealed, likely ever, if Hillary wins,” said Milwaukee radio host Jay Weber in an interview with Ryan. “Doesn’t get repealed. Agree?”

“Yes, yeah, I do agree. I do agree,” Ryan responded. “Hillary’s talking about a public option, which is basically double down on government-run healthcare. That’s the opposite of what we’re offering. We actually have a plan to replace ObamaCare. All of us have basically gotten a consensus on what our plan is, but we have to win an election to put it in place.”