Congressional Republicans are facing their first big decision on taxes under President Trump: Which ones to scrap in the repeal of ObamaCare.
Republicans have in the past sought to erase most of the big tax hikes in the healthcare law, and the chairmen of the tax-writing committees have expressed support for eliminating the taxes in a repeal bill.
“After spending seven years talking about the harm being caused by these taxes, it’s difficult to switch gears now and decide that they’re fine so long as they’re being used to pay for our healthcare bill,” Sen. Orrin Hatch (R-Utah), the chairman of the Senate Finance Committee, said Wednesday.
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President Donald Trump walked back his recent vow that Obamacare would be replaced in short order, telling F0x News’ Bill O’Reilly that the process is “complicated” and “maybe it’ll take till sometime into next year.”
“It statutorily takes a while to get,” Trump said in a wide-ranging interview that aired Sunday during the Super Bowl pre-game show. “We’re going to be putting it in fairly soon, I think that yes I would like to say by the end of the year at least the rudiments, but we should have something within the year and the following year.”
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No one’s interested in trying to save Obamacare’s centerpiece as it faces certain death.
Even as the healthcare industry heavily lobbies Republicans to keep the Affordable Care Act’s other main components, such as its subsidies and Medicaid expansion, doctors, hospitals and insurers are stepping away from the law’s individual mandate for people to buy insurance or pay a fine.
Not even Democrats are campaigning to keep the mandate, which was once viewed as the key to making Obamacare successful. The thought was that the mandate would prompt enough healthy young people to buy coverage to keep premiums stable. But nearly everyone agrees it didn’t work as well as intended. And repealing it is top of list for Republicans.
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Tom Price spent years railing against Obamacare. Now he’ll finally have sweeping power to do something about it.
The Georgia Republican congressman is on the verge of becoming the Trump administration’s top health care official, armed with broad authority to begin unwinding Obamacare by using as much executive power as possible, even as Congress struggles to find consensus on a plan to repeal and replace the health care law. First, he could ax Obamacare’s mandate ensuring coverage for contraception and give insurers more latitude to determine which health benefits they will — and won’t — pay for. Those changes will likely be paired with stricter monitoring of Obamacare enrollees, as the administration aims to win over jittery health plan executives with policies that prioritize insurance market predictability and profitability.
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On the question of what should be done about Medicaid expansion under Obamacare, Republicans should combine two ideas popular in their party: block grants and health savings accounts. The former would let states tailor their Medicaid policies to their local communities, while the latter would give enrollees the ability to choose their own insurers and providers. In essence, Washington could give the states Medicaid block grants, allocated per capita, to provide beneficiaries with high-deductible insurance and health savings accounts.
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ObamaCare could never have survived without forcing many more healthy Americans into the system to subsidize those benefiting from the program—exactly what the single-payer program Bernie Sanders and Hillary Clinton endorsed would have done. In scrapping ObamaCare, Republicans should be careful not to shoulder more than the objectives of finding a cost-efficient way to deal with pre-existing health problems, strengthening Americans’ ability to keep their insurance when they get sick or change jobs, and block-granting Medicaid to the states.
If they try to do more, they will be in danger of only changing the name of ObamaCare. They would then own a program that is detrimental to freedom, fiscal responsibility and economic growth.
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The Trump administration intends to publish a new regulation soon aimed at stabilizing Obamacare’s marketplaces, just as insurers are weighing whether to participate next year.
The administration hasn’t released the text for the regulations or said whether it could be finalized before insurers face the first deadlines this spring for submitting plans for 2018.
The Office of Management and Budget released a notice on a pending rule received Feb. 1 aimed at stabilizing Obamacare markets.
The rule was received the same day that insurers told Congress that they need to know soon whether cost-sharing reduction payments will be reimbursed in 2018.
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The Affordable Care Act’s insurance exchanges have become too risky for major health insurers, and that’s creating further doubt about coverage options consumers might have next year.
Anthem CEO Joseph Swedish said Wednesday his company is waiting to see whether the government makes some short-term fixes to the shaky exchanges before it decides how much it will participate next year. The Blue Cross-Blue Shield carrier is the nation’s second largest insurer and sells coverage on exchanges in 14 states.
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President Trump’s statement that his preferred replacement for the ACA would provide health “insurance for everybody” surprised those who have followed the contentious debate over the health care law since its passage in 2010. In recent years, though, Republicans have emphasized that gains in insurance coverage should not be the sole barometer by which health care reform is measured. Rather, the affordability of that coverage is the key to a better health care system with fewer uninsured Americans. For too long, Republicans have shied away from calling for “universal coverage” because they’ve equated it with the Democratic push for a government-run, single-payer health-care system. But that simply isn’t the case. Market-based reforms can both lower costs and lead to health insurance coverage for more Americans. Any market-based replacement to the ACA should: (1) Expand access to consumer-directed coverage arrangements such as health savings accounts coupled with high-deductible insurance plans; (2) Tailor government assistance to individual situations; (3) Give those with preexisting conditions access to mechanisms, such as properly funded high-risk pools, to help them both acquire and afford coverage; and (4) Allow for alternative pathways to private, tax-preferred coverage, by allowing health plans to be sold across state lines, as well as by giving unions, churches or other civic organizations the opportunity to offer coverage to members.
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Uninsured rates in low-income families have fallen under the Affordable Care Act, yet more than a third of Americans continued to face difficulties paying their medical bills in 2016, a survey found.
Adults in poor families were among the greatest beneficiaries of the ACA, with uninsured rates falling as much as 17 percentage points since it became law in 2010, according to a study from the Commonwealth Fund.
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