Lots of observers, including some very well placed ones in Congress, argue that health care will just be put aside now for a time and will wait for a later opportunity. They say it’s time to turn to tax reform. The “put it aside” argument assumes that the Trump administration will just continue to administer Obamacare as it has been, which is unlikely. This fall we may well see a much expanded “hardship exemption” for the individual mandate that could render the mandate essentially void, and the administration may also stop providing funds for cost-sharing reduction payments if Congress does not appropriate money for them.

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Senate Minority Leader Chuck Schumer says he and his colleagues are ready to work with Republicans on an adjustment to the ACA “that stabilizes markets, that lowers premiums.” However, framing the purpose of the talks in this way discourages rank-and-file Republicans to participate in negotiation that has the singular purpose of shoring up the ACA. What is needed is a thorough, top-to-bottom negotiation between both parties over fundamental aspects of the entire health system. For example: How much flexibility should states have to run Medicaid? What can be done to bring more cost discipline to the entire system? What can be done to ensure major health entitlement programs are affordable over the long-term?
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Health insurers appeared likely to offer Affordable Care Act plans in all U.S. counties next year, despite months of drama and worries among some state officials about last-minute exits, ahead of a late-Wednesday deadline.

Some major insurers that had signaled that they might pull back, including Cigna Corp. , Health Care Service Corp., Molina Healthcare Inc., Highmark Health and Independence Blue Cross, this week said they would stick to the states and regions where they had filed to offer ACA coverage.
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This week, the Tax Court gave Benjamin and Delores Gibson the bad news that they would have to pay back a premium credit of $4,628.80 that went to Benjamin Jr. The Gibsons filed their 2014 return claiming Junior as a dependent even though he had not been living with them for much of the year. There is an interesting practice question here. Dependency is a matter of fact, not an election, but when it comes to older kids not living at home, it can be treated as, in effect, an election. Preparers need to be alert to the health care credit implications of claiming a dependent and weigh that against other benefits.

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Senate Republicans on Tuesday abandoned their latest effort to replace ObamaCare, or, more precisely, a handful of Senators defeated the Graham-Cassidy proposal despite their campaign rhetoric. Mark them down as ObamaCare’s saviors.

Top billing goes to Kentucky’s Rand Paul, who rode into Congress in 2010 on repealing the Affordable Care Act but in office has become the definition of a feckless libertarian. He helped to kill the Senate’s first replacement bill over the summer because it did not repeal every last footnote in the law. Then he supported “skinny repeal” that merely repealed the individual and employer mandates and medical-device tax, justifying that vote as realistic.
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Senate Majority Whip John Cornyn (R-Texas) on Tuesday said Congress should move onto tax reform and not try to pair it with a new plan to repeal ObamaCare.

Cornyn signaled the widespread GOP fear that adding a health-care debate to the tax bill will only bog down a reform package that is President Trump’s new top priority.

Cornyn, the No. 2 Republican in the Senate, said he does not support combining tax reform and ObamaCare repeal in a single budget reconciliation measure that would allow the GOP to protect their bill from a Democratic filibuster.
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Middle-class Americans, who have been hardest hit by Obamacare, are desperate for Congress to do something — anything — to lower costs.

Today, health insurance can cost more than a mortgage. The average family of four will face a staggering $22,622 in health insurance and related medical costs this year ($14,300 for premiums with an $8,322 deductible). The average annual cost of a mortgage (principal and interest) is about $18,000 for a $309,000 house.
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In those countries with the longest experience of single-payer government insurance, published data demonstrates massive waiting lists and unconscionable delays that are unheard of in the United States. In England alone, approximately 3.9 million patients are on NHS waiting lists; over 362,000 patients waited longer than 18 weeks for hospital treatment in March 2017, an increase of almost 64,000 on the previous year; and 95,252 have been waiting more than six months for treatment — all after already waiting for and receiving initial diagnosis and referral.
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In 47 of 50 cities surveyed, the lowest-priced plan would be officially unaffordable under Obamacare affordability standards for families earning 401% of the federal poverty level (about $82,000 per year in the contiguous US, making them ineligible for Obamacare subsidies).
Among these, the average three-person household would need to earn an additional $28,939 per year before the lowest-cost plan becomes affordable according to Obamacare rules.
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Republicans in the U.S. Senate have just over a week, until Sept. 30, to pass an Obamacare repeal bill with a bare majority (instead of 60 votes). But in the rush of whip counts and CBO scores, don’t forget: This is an incredibly dangerous debate for Republicans. The public, through a variety of poll results, has made plain that it doesn’t like what the GOP is doing.

The latest YouGov poll, for example, found that 38 percent of respondents picked Democrats as the party that would do “a better job handling the problem of health care”; 24 percent picked Republicans. The Affordable Care Act, meanwhile, has a positive net favorable rating, and the various GOP repeal-and-replace bills have generally polled terribly.
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