Throughout the campaign, President-Elect Donald Trump’s entire health message consisted of promising to repeal the Affordable Care Act.

That remains difficult with Democrats still commanding enough power in the Senate to block the 60 votes needed for a full repeal. Republicans could use fast-track budget authority to make some major changes to the law, although that could take some time. In the short term, however, Trump could use executive power to make some major changes on his own.

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The GOP’s long-discussed dreams of repealing Obamacare became closer to reality early Wednesday morning when Donald Trump was elected president.

Six years after President Barack Obama signed the Affordable Care Act into law and after more than 60 attempts to repeal it, Republicans now have a good chance to advance their own agenda.

While on the campaign trail, Trump repeatedly promised voters that he would repeal Obamacare if he was elected president and even called on congressional Republicans to call a “special session” to move forward with rolling back the law.

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Obamacare architect Jonathan Gruber told CNN’s Carol Costello on Monday that it is not possible to just “get rid of the parts” of the health care law that people do not like because that was tried and “premiums went through the roof.”

Costello interviewed Gruber on her show and asked how Americans’ health care premiums would be affected if President-elect Donald Trump repealed parts of the Affordable Care Act that are unpopular after taking office.

“So, let’s say he keeps the parts of the law that people really like,” Costello said. “What would that do to all of our premiums? If he could keep all of the elements that you say that Congress might reject.”

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President-elect Trump and the GOP-controlled Congress can repeal Obamacare pretty easily, but the biggest question is when and if there will be a transition while a replacement gets crafted.

Trump has promised to repeal Obamacare in its entirety and congressional Republicans are on board. However, when the repeal would take effect is largely in doubt, as some Republicans are wary of immediately ending coverage for millions of people without a replacement.

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Colorado voters rejected a ballot measure that would have created a first-in-the-nation single-payer health insurance system, a significant setback for progressive proponents of universal health care.

Tuesday’s defeat of Amendment 69 was decisive, as predicted. Polling ahead of Election Day showed that two-thirds of residents opposed the measure, which would have established a program called ColoradoCare to cover most people in the state.

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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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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 total repeal of ObamaCare will prove difficult — but there’s plenty Donald Trump and his fellow Republicans can do to effectively dismantle President Obama’s signature domestic program.

Trump could exempt more people from the individual mandate to buy insurance, and his administration could stop assisting consumers with enrollment.

If the government stops fighting a lawsuit that’s trying to put an end to subsidies for low-income people’s bills, insurers’ costs would go up, and they could choose to drop out of the markets.

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