President-elect Trump has made waves by saying that though he plans to repeal Obamacare, he wants to keep the aspect of it that bans coverage for those with pre-existing conditions. But this is not possible without broader changes to the healthcare system.

The pre-existing condition ban is ultimately one of the primary drivers of the premium hikes we’re seeing within Obamacare. The reason is that with insurers forced to offer coverage to anybody who applies, they incur higher medical costs, and they thus require more signups from younger and healthier people — but those signups aren’t materializing in a large enough volume to offset costs.

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Republicans on Capitol Hill are growing confident that they can begin to repeal Obamacare once President-elect Donald Trump is sworn in, along with a pledge to replace it later.

“We have an Obamacare emergency right now,” said Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate HELP Committee. “I think we could move forward in January on some aspects of repeal but we need to make sure that we are helping people and that we do no harm.”

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Congressional Republicans may be mulling a plan to repeal Obamacare before President-elect Trump takes office, a top GOP leader said Wednesday.

“Nothing has been decided but that is certainly one of the options,” Senate Majority Whip John Cornyn, R-Texas, told reporters after a closed-door GOP meeting on Wednesday.

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Steven Lopez has gone without health insurance for 15 years, and the Affordable Care Act hasn’t changed his mind. Once again this year he will forgo coverage, he said, even though it means another tax penalty.

Last tax season, the 51-year-old information technology professional and his family paid a mandatory penalty of nearly $1,000, he said. That’s because they found it preferable to the $400 to $500 monthly cost of an Obamacare health plan.

“I’m paying $6,000 to have the privilege of then paying another $5,000 [in deductibles],” said Lopez, who lives in Downey, a suburb of Los Angeles. “It’s baloney — not worth it.”

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Virtually every Republican member of Congress who has been interviewed on TV has assured the national viewing audience that a top priority come January will be to repeal Obamacare. They make it sound easy. It is easy. At least defunding Obamacare is easy. And without any money to spend, what we call Obamacare would wither on the vine in short order.

Congress has already done this once.  A procedure known as “reconciliation” deals with budget matters and it can’t be filibustered. That means if Republicans all vote in lock step the Democrats can’t stop them. Last year, Republicans in the House and the Senate voted to take all they money out of Obamacare through their reconciliation bill. The bill did not repeal the Obamacare mandates or Obamacare regulations because those are non-budget matters. But with no money to spend, all those mandates and regulations aren’t worth the paper they are written on.

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According to a recent statistical analysis, medical care determines only about 11 percent of health—far less than individual behavior (38 percent), social circumstances (23 percent), and genetics and biology (21 percent). The preponderance of evidence demonstrates that much of what we spend on health care does not translate into better health outcomes and that collectively we don’t receive nearly enough benefit to justify the costs in higher taxes, higher premiums and lower wages.

As Congress and the incoming Trump administration consider how to replace the Affordable Care Act (ACA), they should focus on the drivers of excessive spending, the primary one of which is comprehensive health insurance. By doing so, President-elect Trump can best attempt to deliver on his promise of “great health care for much less money.”

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President-elect Donald Trump says he wants to preserve health insurance coverage even as he pursues repeal of the Obama-era overhaul that provided it to millions of uninsured people.

How his administration handles a pending lawsuit over billions of dollars in insurance subsidies will reveal whether Trump wants an orderly transition to a Republican-designed system or if he’d push “Obamacare” over a cliff. Stripping away the subsidies at issue in the case would put the program into a free-fall.

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Two top House Republicans on health policy reiterated promises Monday to replace the Affordable Care Act after repealing it.

Rep. John Shimkus (R-Ill.), who is vying to lead the Energy and Commerce Committee next year, said the House GOP’s “Better Way” health plan will be the starting point for reform efforts. He referenced high-risk pools as the best way to require insurers to cover pre-existing conditions without having a mandate to purchase plans. Tax credits would help people afford coverage, he said.

“We just want to bring more choices, more competition,” Shimkus said. “Competition drives higher quality, lower cost. Always does, always will.”

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President Obama will be leaving office with the Affordable Care Act, his signature policy initiative, in deep peril.  An incoming Republican president and Congress, concerned with the cost of ACA exchange plans jumping by an average 25 percent next year and employee health care costs rising, have pledged to repeal the law.  For his part, the President sought to shift the blame for rising out-of-pocket cost from the ACA’s flaws to employers and insurers.  During a recent speech defending the law, he said the ACA has had no impact on the affordability of employer-provided health care benefits “except to make it a better value.”  As the President put it, “if your premium is going up, it’s not because of Obamacare.  It’s because of your employer or your insurer — even though sometimes they try to blame Obamacare for why the rates go up.  It’s not because of any policy of the Affordable Care Act that the rates are going up.”

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Oscar Insurance Corp., the Silicon Valley-backed health-care startup, continued to lose tens of millions of dollars in the third quarter as the company exits some markets and works to diversify away from of its Obamacare business.

The New York-based company sells health insurance to individuals in new markets set up by the Affordable Care Act. Its attempt to reinvent the insurance business has been marked by large losses — in the third quarter, closely held Oscar lost $45 million in New York, Texas and California, according to filings with regulators. That follows losses of $83 million in those states during the first six months of this year.

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