Recent economic research calls into question the value of ObamaCare’s Medicaid expansion, and indeed the entire Medicaid program. In one study, MIT health economist Amy Finkelstein and her colleagues found that Medicaid produced no discernible improvement in enrollees’ measured physical health outcomes. In another, Finkelstein and colleagues estimated enrollees receive only 20-40 cents of benefit for every dollar the program spends.
Researchers at The Economist went looking for factors to explain why Donald Trump outperformed Mitt Romney’s showing in key states four years prior. They found ”the single best predictor identified so far of the change from 2012 to 2016 in the share of each county’s eligible voters that voted Republican” is how low the county scores on an index of public health measures.
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The House of Representatives has asked the Federal Court of Appeals for the D.C. Circuit to temporarily pause the House lawsuit challenging an ACA subsidy program, a move that could allow the incoming Trump administration to swiftly unwind the ACA exchanges. The House argues that the ACA did not fund payments to health insurance companies to help low-income people pay for their out-of-pocket health care costs, which the Obama administration has been paying anyway. If the court approves the request, it would allow Trump’s new administration time to decide whether it wants to keep defending a pivotal part of the health care law as it plots out a strategy to repeal the ACA. If Trump’s Justice Department doesn’t continue to defend the ACA, the subsidies could be eliminated immediately (unless Congress makes a deliberate decision to legally fund them).
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The Department of Health and Human Services finally released the 2015 Affordable Care Act risk corridor data. The data show the rapid deterioration of the ACA exchanges from 2014 to 2015.
The ACA’s risk corridor program was intended to transfer funds from profitable insurers to unprofitable ones for the first three years of the exchanges (2014 to 2016). The program ran a $2.5 billion deficit for the 2014 plan year as far more insurers incurred losses than made profits. In 2015, the deficit increased to more than $5.8 billion—a 132% increase.
If taxpayers are forced to bail out insurers for these losses, the total tab for 2014 and 2015 now exceeds $8.3 billion. If insurers’ experience in 2016 tracks what happened in 2015, the total 3-year risk corridor deficit will exceed $14 billion. The Obama administration has given mixed signals about whether it will tap taxpayer funds to bail out insurers for these losses. We now know just how much money is at stake.
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Thanks to all of the issues with our vast and complicated healthcare system, any attempts at reform will require massive amounts of effort, political capital, cooperation from various public and private entities and, likely, luck. So while Donald Trump ran on a platform of “repealing and replacing Obamacare”, it might be wise to start with some small changes to the Affordable Care Act (ACA) that could still have large benefits.
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Donald Trump and Republicans in Congress are vowing to repeal and replace the Affordable Care Act, the signature health care overhaul of President Obama.
Trump has offered a few ideas of where he’d like to see a health care overhaul go, such as a greater reliance on health savings accounts, but he hasn’t provided a detailed proposal.
The absence of specifics on health care from the president-elect makes the 37-page plan that Speaker of the House Paul Ryan has released the fullest outline of what Republicans would like to replace Obamacare.
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Repeal of the 2010 health care law is a top priority as soon as Donald Trump takes office in January, Vice President-elect Mike Pence said in a Sunday television interview.
“Decisions have been made, that, by the president-elect, that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free-market solutions that he campaigned on,” Pence said on “Fox News Sunday.”
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Congressional Republicans are itching to dismantle Obamacare, but a group of conservatives say the current plan to take down key parts of the law is not quick enough, and is already pushing for alternatives that completely and immediately repeal it entirely.
Republicans in the House and Senate have pointed to a repeal bill that was approved last year through a procedural move called reconciliation as a means to quickly gut the law after Trump assumes office in January. Reconciliation bills require only a simple 51-vote majority as opposed to 60 votes to break a filibuster, which means they’re a way to quickly pass a proposal in the Senate.
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On Donald Trump’s victory Republicans in Congress are primed for an ambitious agenda, and not a moment too soon. One immediate problem is ObamaCare’s expansion of Medicaid, which has seen enrollment at least twice as high as advertised.
Most of the insurance coverage gains from the law come from opening Medicaid eligibility beyond its original goal of helping the poor and disabled to include prime-age, able-bodied, childless adults. The Supreme Court made this expansion optional in 2012, and Governors claimed not joining would leave “free money” on the table because the feds would pick up 100% of the costs of new beneficiaries.
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Healthcare is the top issue Americans want Donald Trump to address during his first 100 days in the White House, according to a Reuters/Ipsos poll released on Thursday, an apparent rebuke of outgoing President Barack Obama’s signature reform, Obamacare.
Some 21 percent of Americans want Trump to focus on the healthcare system when he enters the White House on Jan. 20, according to the Nov. 9-14 poll, conducted in the week after the Republican won the U.S. presidential election.
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But it is absolutely possible to craft a health-reform agenda that conforms to Trump’s core policy principles: (1) repealing and replacing Obamacare; (2) near-universal coverage; (3) lower health insurance premiums. As a bonus, these goals can be achieved by a plan that reduces federal spending, cuts taxes, and improves health outcomes for the poor.
Few would have predicted that Donald Trump could be a more successful health reformer than Barack Obama. But if he can get over a few important hurdles, it could very well end up being true.
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