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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The main objective of the Affordable Care Act (ACA) was to increase enrollment in health insurance among those who were previously uninsured. Official estimates from the Census Bureau have consistently overstated the number of people who are uninsured. A major factor in the overestimate is the undercount of people in Medicaid. Also, millions of Americans have been officially uninsured despite their eligibility for public insurance or employer coverage. With the passage of the ACA, fewer than 10 percent of the remaining uninsured do not have a realistic path to securing health insurance. The future of the ACA is now uncertain, but any future policy changes will likely need to provide a sure path to insurance coverage for all Americans as well.

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President-elect Trump has made waves by saying that though he plans to repeal Obamacare, he wants to keep the aspect of it that bans coverage for those with pre-existing conditions. But this is not possible without broader changes to the healthcare system.

The pre-existing condition ban is ultimately one of the primary drivers of the premium hikes we’re seeing within Obamacare. The reason is that with insurers forced to offer coverage to anybody who applies, they incur higher medical costs, and they thus require more signups from younger and healthier people — but those signups aren’t materializing in a large enough volume to offset costs.

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