The Kaiser Family Foundation asked Americans about replacing the Affordable Care Act, and 55 percent of those surveyed want the Senate to reject a bill that passed the House unless the Senate makes major changes. Joe Antos says, “Not only do Democratic respondents think that the things that are going wrong are really on President Trump’s watch and he’s responsible but most Republicans believe that, too.”

The Trump administration is apparently preparing to overhaul Obamacare’s birth control mandate, purportedly allowing any employer to seek a moral or religious exemption from the requirement, according to a draft regulation obtained by Vox. The ACA requires nearly all employers to offer health insurance that covers access to a wide array of contraceptive methods—a mandate that has faced numerous court challenges. The draft proposal, if finalized, would significantly broaden the type of companies and organizations that can request an exemption.
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The CBO has refused to adjust its computations to the ever-more-apparent failings of the Affordable Care Act. When the CBO says that 23 million fewer people will have insurance coverage under the AHCA than under the ACA—a statistic that politics have converted into a mantra—that figure is predicated on fictional ACA participation. The CBO assumes 18 million people will be enrolled in ACA exchanges in 2018 and that enrollment will continue to grow until 2026. No one on any side of the political spectrum believes this to be true.

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Senate leadership staff will huddle this week with their colleagues on three key committees to begin drafting the chamber’s legislation to repeal and replace the 2010 health care law. “The drafting process is going to get underway,” said John Thune of South Dakota, the third-ranking Senate Republican. “Now we have enough direction, we’ve had enough meetings, we’ve got enough input from our members to know sort of what the main issues are, and kind of where the moving points are and how we can dial things. We’ll start putting stuff together and get it out there and let people react to it.”

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If the Senate were simply to remove the House bill’s uniform tax credit and continue the hybrid model past 2019 through 2020 and beyond, the bill would most likely get a better coverage score from the CBO. The Senate would be able to direct more financial assistance to those who need it, whether because of old age, ill health, or low income. Indeed, the Senate could tweak the exact formulas for age and income adjustment to maximize the number of people with health insurance in the most cost-effective way.

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For Majority Leader Mitch McConnell, writing a Republican-only health care bill that can pass the Senate boils down to this question: How do you solve a problem like Dean, Lisa, Patrick, Ted, Rand and Susan?

Those are some GOP senators whose clashing demands McConnell, R-Ky., must resolve. Facing solid Democratic opposition to demolishing former President Barack Obama’s 2010 overhaul, Republicans will lose if just three of their 52 senators defect.

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The Trump budget assumes Obamacare repeal. On the tax side of this, it particularly assumes repeal of the 3.8% point surtax on capital gains, dividends, and other savings (known as the “net investment income tax,” or NIIT). There are approximately 20 other new or higher taxes in Obamacare that also will be repealed. Tax reform assumes they are gone before starting on a new system.

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As House Republicans passed legislation toppling large portions of the ACA, groups representing hospitals, doctors, consumers and some insurers made no secret of their displeasure. Now, in the Senate, which hopes to complete its own version of a health overhaul by August, Republicans are unambiguous about their intention to draft an entirely new bill in a more deliberate manner with input from outside groups. Sen. Orrin Hatch of Utah, the Senate Finance chairman whose committee is responsible for drafting much of the legislation, has specifically asked for suggestions from industry associations.

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The Congressional Budget Office released its latest Obamacare-related estimatelast week, predicting that the House-passed bill to repeal and replace the embattled law would lead to 23 million more uninsured people by 2026. Although CBO itself acknowledges that this latest prediction is “especially uncertain,” one thing is true: CBO is wrong. The Galen Institute’s Doug Badger explains why in a new Galen Institute paper that can be found here. The agency’s errors are not only significant—one prediction of 2016 exchange-based enrollment missed by 140%–but the agency is also consistent: it regularly over-estimates the number of people who would get insurance through the Obamacare exchanges.

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CBO claims that the House repeal and replace bill could degrade the quality of insurance. This editorializing could use some scrutiny. Without government supervision of insurance minutiae and a mandate to buy coverage or pay a penalty, CBO asserts that “a few million” people will turn to insurance that falls short of the “widely accepted definition” of “a comprehensive major medical policy.” Under the House reform, Americans won’t have any problem insuring against a bad health event, even if CBO won’t admit it. The House bill is designed is create more alternatives that can accommodate the diverse needs and preferences of a nation of some 320 million people. CBO has become a fear factory because it prefers having government decide for everybody.

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