President-elect Donald Trump announced Tuesday that he will nominate Georgia Rep. Tom Price to head the Department of Health and Human Services.

The Cabinet-level pick, which requires Senate confirmation, inserts one of Obamacare’s most outspoken critics into the key position to dismantle it and help Republicans implement their own blueprint for health care reform.

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President-elect Donald Trump on Tuesday morning picked the founder and CEO of a health policy consulting firm, Seema Verma, to serve as Administrator of the Centers for Medicare and Medicaid Services.

“I am pleased to nominate Seema Verma to serve as Administrator of the Centers for Medicare and Medicaid Services,” said President-elect Trump in a statement. “She has decades of experience advising on Medicare and Medicaid policy and helping states navigate our complicated systems. Together, Chairman Price and Seema Verma are the dream team that will transform our healthcare system for the benefit of all Americans.”

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State leaders are positioning themselves to have a key voice in a potential rewrite of ObamaCare next year.

With the election of Donald Trump, Republican leaders in Congress have promised a dramatic overhaul of President Obama’s signature policy.

The National Governors Association (NGA), a proudly bipartisan group representing every state, is now eyeing a more public — and more aggressive — role alongside GOP leaders as they attempt to gut the massive federal program.

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New York may have misallocated roughly $150 million in Obamacare grants, the Department of Health and Human Services Office of the Inspector General said Tuesday. The watchdog office says the state should refund any misspent money to the federal government.

HHS OIG found the state did not have internal procedures necessary to ensure federal funding was allocated properly to set up the state’s Affordable Care Act insurance exchange.

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A new study by Jonathan Gruber, one of the ACA’s chief architects, suggests that roughly two-thirds of new Medicaid enrollees in 2014 were eligible for the program under previous state eligibility criteria—meaning that they were not made eligible by the ACA. Gruber’s results, combined with much higher than expected Medicaid enrollment and spending over the past three years, has profound implications for the distribution of program costs and the effect of a repeal of the ACA. This means that the federal government has likely paid billions more each year than the law allows for the expansion population while states have spent billions less. Additionally, Gruber’s results suggest that if the ACA were repealed, a lot fewer people would likely lose coverage than previously thought.

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It is vital that the new Administration, Congress, and state officials orchestrate a smooth and methodical transition for the repeal of Obamacare. For this smooth transition to take place, Congress should act immediately to initiate repeal and the Administration should take aggressive administrative actions to stabilize the private market for the upcoming 2018 plan cycle. The Administration, Congress, and the states should then coordinate efforts to begin the process to have a set of reforms in place for the 2019 plan cycle.

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With Republicans controlling the White House and Congress in January, they’re faced with delivering on their long-time promise to repeal and replace the ACA. Because Republicans will control the Senate by just 52-48, the Senate will have to navigate the complex reconciliation rules processes to avoid filibusters, which require 60 votes to end. Their key policy challenge is to protect the millions of people receiving coverage under the law and convince insurers to continue to offer coverage.

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The election of Donald Trump as president, along with the Republican Party’s retention of both houses of Congress, sets the stage for the long-promised repeal and replacement of the Affordable Care Act (ACA), popularly known as Obamacare. Obamacare boosters warn that repeal would throw 20 million Americans who have gained health insurance coverage through the law back into the ranks of the uninsured overnight. The truth is more complex. Nearly half of the coverage gains made during Obama’s presidency had nothing to do with ACA provisions and will survive repeal. Many other newly insured people will keep their coverage—if changes are made to health-care financing, and if two popular ACA provisions President-elect Trump has spoken favorably of are retained.

Repealing most of the ACA, retaining a few provisions, and replacing programs in 2018 will rid the country of one the most contentious, complex, and wasteful pieces of social engineering ever enacted—and set the stage for a more efficient, consumer-centered health-care system.

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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.

The Economist now offers additional data suggesting ObamaCare’s supposed beneficiaries don’t place much value on the law.

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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