Republicans are pitching Obamacare “repeal and delay”—the idea of quickly repealing the ACA, but leaving it in place for three years as they craft a replacement. But one key health care expert threw cold water on that idea. Robert Laszewski, president of Health Policy and Strategy Associates, warned the strategy could send the market into “death throes.”  He argues that to stabilize the insurance market and ensure that health insurers don’t flee is for the federal government to guarantee to cover their losses. But the politics of that aren’t easy because it would mean funding the three R’s— (risk adjustment, reinsurance, and risk corridors, all programs that subsidize insurance carriers that have significant losses.)

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Republicans on Capitol Hill are grappling with the likelihood that they will need Democratic support to pass parts of any plan replacing the Affordable Care Act, setting up a complex legislative battle over the law’s future.

President-elect Donald Trump is expected in his first days in office to take executive action voiding parts of the health law that the administration has discretion to change. Soon after that, lawmakers likely would start on their efforts to repeal and replace the law.

With full control of Congress and the White House, Republicans have anticipated being able to repeal the law using a special budget maneuver that would allow them to get around a filibuster by Democrats in the Senate.

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Congressional Republicans are setting up their own, self-imposed deadline to make good on their vow to replace the Affordable Care Act. With buy-in from Donald Trump’s transition team, GOP leaders on both sides of the Capitol are coalescing around a plan to vote to repeal the law in early 2017 — but delay the effective date for that repeal for as long as three years.

“We’re talking about a three-year transition now that we actually have a president who’s likely to sign the repeal into the law. People are being, understandably cautious, to make sure nobody’s dropped through the cracks,” said Senate Majority Whip John Cornyn (R-Texas).

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House and Senate budget leaders are teeing up a vote to repeal most of ObamaCare by Jan. 20, 2017, according to multiple sources. The leaders of the House and Senate Budget committees are planning the vote for the first week of January, to deal an immediate blow to ObamaCare after President-elect Donald Trump’s inauguration, according to a Senate GOP aide. Another source off Capitol Hill said the Trump transition team has signed off on the plan and that the traditional vote-a-rama process could take place as early as Jan. 5.
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The new direction of American health care should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. If President-elect Trump and Rep. Tom Price, Trump’s HHS pick, want to make the most of this short window, they should keep four central reforms in mind: 1) Provide a path to catastrophic health insurance for all Americans. 2) Accommodate people with pre-existing health conditions. 3) Allow broad access to health-savings accounts. 4) Deregulate the market for medical services.

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Price is of the view that we are going to end up subsidizing the health care of the poor and the indigent one way or the other. We can do it through cost shifting and subsidies conferred on impersonal hospital bureaucracies or we can give the money to the people and let the bureaucracies compete for their patronage. The Price tax credit would be refundable and it would vary by age. But unlike the Obamacare credits, Price’s credit would be the same, regardless of income.

That last feature is huge. The most important reason why the exchanges have been so dysfunctional is the need to verify income.

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Congress may vote to repeal President Barack Obama’s health care law before coming up with a replacement, GOP leaders said Tuesday.

The approach could allow congressional Republicans to take swift action on one of President-elect Donald Trump’s campaign promises, while putting off the hard part. And while repealing the law could be done with GOP votes alone, any replacement plan would likely require the cooperation of minority Democrats in the Senate, something that will not be easy to come by.

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House Republicans are taking pole position in repealing and replacing ­ObamaCare with Donald Trump’s pick of Tom Price as secretary of Health and Human Services.

The Republican lawmaker from Georgia, a confidant of Speaker Paul Ryan(R-Wis.) and Vice President-elect Mike Pence, is a former physician with a deep understanding of both the thorny politics and wonky details of healthcare.

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The most likely scenario to achieve reform and assure coverage similar to what currently exists is to pass a reconciliation bill similar or identical to the bill passed approximately a year ago. This bill eliminated funding for the Medicaid expansion and the subsidies in the exchange and also includes a two-year implementation delay. Since the majority of newly insured individuals have come from Medicaid rather than the exchanges, this portion of the repeal, unless accompanied by other changes such as a refundable tax credit, would have the largest effect on the newly insured.

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Any Republican attempt to replace the Affordable Care Act must address Medicaid, which has literally become the 800-pound gorilla in the health-care policy room. Simply rolling back the ACA’s Medicaid expansion would spike the number of uninsured Americans and expose Congress and the Trump administration to withering criticism. On the other hand, leaving Medicaid unchanged exposes the federal budget to the program’s unsustainable cost trajectory: Federal Medicaid spending has doubled over the past decade.

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