While the emphasis on moving quickly is not surprising, there is also a significant risk that unnecessary haste could lead to major mistakes in the legislation that would generate strong political backlash. The ACA has extended insurance coverage to millions of people with expensive health problems, and to many lower-income households. Acknowledging this is not the same thing as saying the ACA should not be changed; however, Republicans would be well advised to take the time necessary to ensure that their plan will provide adequate insurance for these populations while remaining consistent with an overall framework of less federal control and regulation and more reliance on market incentives. Moving in this direction would help with public acceptance of the AHCA and improve the chances that what is ultimately passed remains on the books longer than the law it is intended to displace.
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A day after a harsh judgment by the Congressional Budget Office on the House plan to repeal the Affordable Care Act, nervous Senate Republicans on Tuesday suggested changes to the bill. They told Trump administration officials – including the health secretary, Tom Price – that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people.
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The American Health Care Act is taking fire from all sides, not the least from the circular firing squad conservatives have formed, threatening passage of the only piece of repeal and replace legislation that House leaders say will be presented to members for a vote this year.
Conservatives may not like to hear it, but leaders and staffers have crafted what they believe is the best bill possible given the limits of the reconciliation process, the pressures of the legislative calendar, and the need to provide a safety net for those currently receiving ACA coverage.
Democrats want nothing more than to get Obamacare off their political backs. Any replace strategy is risky. But voting against “repeal” could be the death knell for Republicans in 2018.
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The furor over the Congressional Budget Office’s report on the House GOP health bill is concentrated on predictions about insurance coverage, which suits Democrats fine. Lost amid the panic is that CBO shows the bill is a far-reaching advance for the market principles and limited government that conservatives usually favor.
The CBO is not omniscient, but if its projections are even close to accurate then ObamaCare repeal and replacement is the most significant government reform in perhaps three decades. Under conventional (static-revenue) scoring, the bill cuts spending on net by $1.22 trillion and eliminates a raft of new taxes worth $883 billion through 2026.
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This week, the Congressional Budget Office released its cost estimate of the House Republicans’ American Health Care Act. CBO concluded that the proposal would reduce deficits by $337 billion over the next decade, but would result in an increase in the uninsured of 14 million people in 2018 and 24 million in 2026 when compared to current law.
CBO has a poor record of predicting coverage. In 2013 CBO predicted that 24 million people would be on the Obamacare exchanges, that law’s health insurance marketplaces, in 2017. This year, 9.5 million are enrolled.
CBO’s new estimate neglects the behavioral effects that would result from the Republican plan. By dismantling Obamacare, insurance companies would be able to offer a wider variety of plans and people would be more enthusiastic about buying them.
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President Trump’s pick to run Medicare and Medicaid won confirmation Monday from a divided Senate as lawmakers braced for another epic battle over the government’s role in health care and society’s responsibility toward the vulnerable.
Indiana health care consultant Seema Verma, a protégé of Vice President Pence, was approved by a 55-43 vote, largely along party lines. She’ll head the Centers for Medicare and Medicaid Services, a $1 trillion agency that oversees health insurance programs for more than 130 million people, from elderly nursing home residents to newborns. It’s part of the Department of Health and Human Services.
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According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You’d think that eligible individuals would need no prodding to sign up for such a benefit.
And yet, according to its analysis of the GOP ObamaCare replacement, the CBO believes that there are five million Americans who wouldn’t sign up for Medicaid if it weren’t for ObamaCare’s individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance.
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