Every day brings a new story about Republicans in disarray, the “mirage” of the GOP’s reform and the impossibility of change. The reality is that Congress is on schedule, progress is underway, and the many potential problems are avoidable.

Behind the scenes, members and staff are being briefed on options and the House will release a consensus proposal after the Presidents Day recess. The details matter and are under discussion, but the outlines are emerging. Congress will use the reconciliation budget maneuver to bypass the Senate filibuster and pass a version of the 2015 repeal bill that President Obama vetoed. This time they’ll incorporate as many replacement components as the rules allow to bring more predictability to insurance markets.

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The combination of high-deductible insurance with Health Savings Accounts (HSAs) is central to a market-driven reform of U.S. health care. There is, however, a problem with existing HSA policy that must be fixed if HSAs are to reach their full potential in improving the efficiency of health care arrangements: As currently structured, HSAs are not built to provide easy access to care from well-organized systems of health care. Rather, HSA enrollees buy services on a fee-for-service basis, which is, in most cases, a much less efficient way of getting needed care. The rules governing HSAs should be modified to allow account holders to buy access to care from integrated care systems on a fixed-fee basis.

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The Trump administration proposed new rules on Wednesday to stabilize health insurance markets roiled by efforts to repeal the ACA, by big increases in premiums and by the exodus of major insurers. The move came a day after Humana announced that, starting next year, it would completely withdraw from the public marketplaces created under the ACA. The proposed rules, backed by insurance companies, would tighten certain enrollment procedures and cut the health law’s open enrollment period in half, in hopes that a smaller but healthier consumer base will put the marketplaces on sounder financial footing and attract more insurance companies in states with limited choices.

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The new administration should issue two new rules for the 2018 enrollment season:

  1. It should let online brokers complete enrollments for people who qualify for subsidies. No need to redirect these applicants to HealthCare.gov.
  2. It should stop imposing user fees to prop up its unnecessary website and finance ad campaigns.

These two changes would set loose an army of insurance carriers, traditional brokers and private online exchanges, all competing to enroll people in subsidized coverage.

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House Republican leaders began laying out components of an Obamacare replacement bill at a closed-door meeting with members on Thursday, Feb. 16. Party leaders, including chairs of key committees, proposed age-based tax credits to replace Obamacare’s subsidies, new options for Medicaid, and scrapping taxes. They also floated ideas on how to pay for the replacement plan, such as capping the tax exclusion currently offered only to employer-sponsored health plans. House members received a policy brief that outlines where legislation is headed to help them prepare for next week’s town hall meetings in their districts.
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House Republicans are weighing specific reforms to Medicaid that could be included in a reconciliation measure to overhaul the Affordable Care Act.

How to deal with the federal expansion of Medicaid under the ACA is one of the main unanswered questions as Congress works to overhaul Obamacare — one that has exposed divisions between the House’s most conservative members and GOP lawmakers from states that chose to expand the federal program for low-income Americans.

Rep. Brett Guthrie (R-Ky.), the vice chairman of the Energy and Commerce Health Subcommittee, said Tuesday that lawmakers are considering what types of reforms — specifically shifting to per capita allotments or allowing states to choose block grants — could be included in a House reconciliation bill to repeal the ACA.

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Republican town halls are erupting with protests as Americans fret over the future of their health insurance. But listen to Lamar Alexander for a few minutes, and you might think not a single bad thing will come of the GOP’s plan to rip apart Obamacare and stitch together a replacement.

The folksy Tennessee senator is quietly prevailing upon Republican lawmakers to take a deep breath when it comes to rewriting the health care law that controls a sixth of the American economy. His goal, in a nutshell: to reassure millions of Americans that Republicans aren’t trying to snatch away their health insurance.

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Obamacare is a proven policy failure. Congress and the Trump Administration must completely repeal the law, beginning by seizing the opportunity to accomplish as much of repeal as possible through the reconciliation process. Congress must focus on the fundamentals: equalizing the tax treatment of health insurance; restoring commonsense regulation of health insurance; and addressing the serious need for reform in Medicare and Medicaid by adopting policies that give individuals control over their health care. High quality health care means all Americans should be free to choose a health care plan that meets their needs and reflects their values. Congress must act now to repeal Obamacare and replace it with a new set of options that empower Americans, not government.

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When Dave Hoppe recalls his first big health-care fight, one memory stands out. It was the summer of 1994, and Sen. George Mitchell, the Democratic majority leader, had canceled August recess to force a debate over his party’s health-care monster: HillaryCare.

Senators weren’t happy about losing their break, remembers Mr. Hoppe, who at the time was an aide. “And yet, Republican senators were lining up in the cloakroom; they couldn’t wait to get to the floor,” he says. “They knew this issue. They’d studied it. They were better informed than Democrats about HillaryCare. There was such an esprit de corps. It was energizing.”

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The U.S. Senate approved the nomination of Representative Tom Price (R-GA) to be Secretary of Health and Human Services early this morning by a vote of 52 to 47. As secretary, Price will be responsible for a department with an annual budget of more than $1 trillion and will put him in charge of President Trump’s efforts to repeal and replace Obamacare.

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