The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Democrats are already panicked that Donald Trump will repeal ObamaCare and throw millions of people off the subsidy rolls, while some conservatives seem panicked that the President-elect will renege on his campaign promises and millions of people won’t be thrown off the entitlement. Like most inflamed political questions after Mr. Trump’s victory, the health-care debate would benefit from some perspective.

“Either ObamaCare will be amended, or repealed and replaced,” Mr. Trump told the Journal last week, and on “60 Minutes” on Sunday he added that “we’re not going to have a two-year period where there’s nothing. It will be repealed and replaced.” Mr. Trump is being more subtle than his critics.

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Not all of Obamacare would be “shut right down” once the unified Republican government takes power next year, House Majority Leader Kevin McCarthy said Monday.

“You wouldn’t have everything shut right down. … You wouldn’t take everything away,” the California Republican told reporters on Capitol Hill. 

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Republicans could pass a budget reconciliation bill that gradually sunsets the law, preserving its subsidies and Medicaid expansion for a time while they agree on a replacement. They’ve already got a script for that approach, after passing a reconciliation bill last January which President Obama vetoed.

Or Congress could pass a replacement plan right away by coupling it with a repeal bill, although it’s questionable Republicans could find consensus in such a short timeframe.

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Over the past few years, pundits have dismissed the Republican Party’s chances of repealing and replacing Obamacare. But with President-elect Donald Trump’s victory Tuesday and the GOP’s successful effort to keep control of Congress, conservatives now have a real chance to eliminate the health care law. The question is how to do it.

Three years into its implementation, the Affordable Care Act has clearly failed. The law has wrecked the individual market for health insurance—premiums have soared, coverage has been canceled en masse, and choices have been drastically curtailed. The cost of the law’s major coverage provisions—Medicaid expansion and subsidies for plans purchased through the exchanges—have soared. In fact, the per enrollee cost of the Medicaid expansion is nearly 50 percent above estimates.

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In a move virtually ignored outside Washington and largely unnoticed even within it, last December the House and Senate passed legislation repealing much of Obamacare. President Obama promptly vetoed the measure — an obstacle that will disappear come January 20. As reporters and policymakers attempt to catch up and learn the details of a process they had not closely followed, three important lessons stand out from last year’s “dry run” at repealing Obamacare.

Republicans’ path on Obamacare could prove more complicated than the new conventional wisdom in Washington suggests. If past is prologue, last year’s reconciliation bill provides one possible roadmap for how the congressional debate may play out.
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A nationwide exit poll shows almost half of voters believe Obamacare went too far.

About 45 percent told NBC News that the law went too far, while 31 percent believe it didn’t go far enough and 18 percent said it was just right, according to a nationwide exit poll released Tuesday.

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The chairman of the National Republican Senatorial Committee said a GOP alternative to the Affordable Care Act must be mindful of those who currently have coverage through the law.

“Clearly we don’t want to do any harm to people in the system now,” Sen. Roger Wicker (R-Miss.) said at a Wednesday news conference at the Republican National Committee. “We want to be mindful.”

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We are nearing the grand finale of our long and disheartening election opera, one we dare not ignore because the outcomes matter so much. While the election results will not be determined by public reactions to the Affordable Care Act, the ACA’s fate will be mightily determined by Tuesday’s outcomes. What have we learned about our collective health future over the past 18 months and what might this mean for our health system’s future?

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In July analyst Paul Westra of the brokerage firm Stifel Nicolaus warned of a looming “restaurant recession,” noting that it might be the first sign of a more widespread U.S. recession in 2017. He said this in a bearish report that downgraded 11 restaurant stocks.

The facts on the ground support his gloomy forecast. Restaurant traffic has declined 2.8% from the start of the year through September, according to the Restaurant Industry Snapshot, a survey of some 25,000 restaurants by research firm TDn2K. At this pace, the firm said, “2016 would be the weakest annual performance since 2009, when the industry was recovering from the recession.”

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Rising health care costs have become the hallmark of a partisan Obamacare law that was sold with promises to lower them. The Obama White House just announced that health care premiums will rise again this year for millions of Americans by an almost unbelievable 25% under Obamacare. And that’s just a national average. Many Pennsylvanians face hikes in their health premiums as high as 55%; Oklahomans up to 69%, and Arizonans as much as 116%.

Behind these numbers are the stories of families and individuals struggling just to make ends meet already.

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