California has been an early and frequent booster of the Affordable Care Act and the vast majority of the state’s politicians are committed to improving, rather than repealing, the law. The best path forward is for California to seize the opportunities in the GOP effort to repeal and replace Obamacare. Two major areas where California could cooperate with the Trump Administration and the Republican Congress include improving coverage and access for the working poor, and controlling health care costs, particularly for small businesses and those who do not receive insurance subsidies.

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Healthcare.gov enrollment came in well below what was anticipated last month. After running very slightly ahead of last year’s numbers in December, January brought the news that about 400,000 fewer people had enrolled on the federal exchanges than did so in 2016. Those are scary numbers, not so much for the absolute size of the decline—it’s roughly 4%—but because any backwards movement is very bad news for the exchanges. Trump was only president for a few days’ worth of open enrollment. Could he really have somehow caused 400,000 people to forgo health insurance?

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The recent debate over the future of Obamacare has obscured an important, but fundamental, truth: The American health care system is exceptional.

It is entrepreneurial and offers patients more control over their health care decisions than anywhere else in the world. One of the primary problems with Obamacare is that it does not prioritize these values. As the Trump administration and congressional Republicans consider what to do after the repeal of Obamacare, they should, as the Hippocratic Oath states, “do no harm” to those elements of our health care system that are functioning well. But they should also take steps to promote policies that emphasize choice and innovation.
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A major insurer on Wednesday reported a huge drop in the number of Obamacare customers it has.

Humana reported in its latest fourth quarter 2016 earnings Wednesday that total enrollment in the individual market, which includes Obamacare’s exchanges, declined by 69 percent in January 2017 compared to the month before.

The company said on Dec. 31 it had about 450,800 in the individual market, which includes Obamacare’s marketplaces. However, in January 2017 membership dropped by 69 percent to 204,000.

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House Republicans have been working with the Congressional Budget Office (CBO) on parts of an ObamaCare replacement that they could include in a repeal bill this spring, lobbyists and aides told The Hill. They have been working with the CBO, Congress’s nonpartisan budget scorekeeper, on the details of tax credits, high-risk pool funding, and changes to Medicaid that could be included in a repeal bill that Republicans hope to pass by the end of March.

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Many recent press reports have centered around the notion that Republicans are stuck in the mud trying to get their repeal and replace promises moving. That line appeared to be reinforced over last weekend when President Trump said in an interview that the process could draw out into next year. He was likely referring to the fact that the whole process, that includes implementing the replacement, could take well past 2017. Instead, Trump was taken literally by the press looking to write stories about how the whole process was foundering. Speaker Paul Ryan quickly countered in his press briefing that Republicans will legislate a repeal and replace of Obamacare this year.

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A Republican proposal to change how Medicaid is financed could save the federal government up to $150 billion, according to a new report. Block-granting Medicaid—when states receive a set amount of federal money to put towards the program—would result in $150 billion less in federal Medicaid spending over five years, according to an analysis released Monday by Avalere Health. Shifting to per capita caps—when states receive a set amount of federal money per beneficiary—would save $110 billion over five years, according to the analysis.

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The orderly transition to a more stable and affordable health-care system is merely beginning. Too much significance is attributed to Republicans adding the word “repair” to their vocabulary, as if this represents a policy change. The insurance markets really do need repair, and doing nothing isn’t realistic amid ObamaCare’s downward spiral. Uncertainty is inevitably priced into premiums, and benefits and rates for 2018 started to be designed and set months ago. They’ll be approved by regulators in the spring, so Mr. Trump’s HHS picks, Tom Price and Seema Verma, need to move fast to bring more predictability to the markets.

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The Trump administration is considering major changes to Obamacare that may help convince insurers to remain in the law’s marketplaces while Congress drafts a replacement plan — but the proposals may also limit enrollment and increase costs for older Americans, according to documents obtained by POLITICO.

The administration is looking to alter rules around insurers charging older customers more, how much cost they can shift onto customers, and who’s allowed to sign up outside the standard enrollment window. They represent changes that the industry had previously asked the Obama administration to make.

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Two of the top Republicans in Congress on Monday said they are pushing ahead with the plan to begin repealing ObamaCare this spring, despite any confusion caused by President Trump saying the process could spill into next year.

House Ways and Means Committee Chairman Kevin Brady (R-Texas) told reporters that he is working off of Speaker Paul Ryan’s (R-Wis.) timeline of moving repeal legislation by the end of March.

“That’s the timetable I’m working off of,” Brady said.

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