Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies. The class of medicines known as specialty drugs treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers, and hepatitis C. Some medicines can cost $10,000 a month. Even a small cost-sharing requirement means patients could have to come up with thousands of dollars to get the medicines.

. . .

The most likely scenario to achieve reform and assure coverage similar to what currently exists is to pass a reconciliation bill similar or identical to the bill passed approximately a year ago. This bill eliminated funding for the Medicaid expansion and the subsidies in the exchange and also includes a two-year implementation delay. Since the majority of newly insured individuals have come from Medicaid rather than the exchanges, this portion of the repeal, unless accompanied by other changes such as a refundable tax credit, would have the largest effect on the newly insured.

. . .

Any Republican attempt to replace the Affordable Care Act must address Medicaid, which has literally become the 800-pound gorilla in the health-care policy room. Simply rolling back the ACA’s Medicaid expansion would spike the number of uninsured Americans and expose Congress and the Trump administration to withering criticism. On the other hand, leaving Medicaid unchanged exposes the federal budget to the program’s unsustainable cost trajectory: Federal Medicaid spending has doubled over the past decade.

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On Tuesday, President-Elect Donald Trump announced that he will nominate Rep. Tom Price (R., Ga.) for Secretary of the U.S. Department of Health and Human Services. It’s a strong pick, and one that increases the likelihood that Republicans will succeed in repealing and replacing Obamacare. Here’s why.

Price, who chairs the House Budget Committee and represents the northern suburbs of Atlanta, has long been one of the House of Representative’s foremost policy wonks. He previously chaired the Republican Study Committee and the Republican Policy Committee, two of the most significant Congressional engines of conservative policy thinking.

And he has long been passionate about, and constructive on, health care reform.

. . .

With Trump’s election, there is suddenly a lot of question about the fate of Obamacare. Will it be repealed, in part or in whole? And if so, replaced with what?

One place to look for answers is in a new article about Obamacare’s coverage expansion. Learning more about what has already happened with Obamacare turns out to provide some clues about what may happen to it in the future.

That’s because Molly Frean, Jonathan Gruber and Benjamin D. Sommers provide a detailed look, not just at the amount of coverage expansion but also the sources of it. According to the authors’ analysis, they can explain about 70 percent of the decline in the number of uninsured people through three factors: the subsidies for buying insurance; the law’s more generous criteria for Medicaid eligibility; and the “woodwork effect,” in which people who were previously eligible for Medicaid “came out of the woodwork” and signed up for the program in 2014.

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If Donald Trump and the Republican Congress have a mandate to do anything, it is to repeal Obamacare. The law is already cratering. Sick enrollees, former president Bill Clinton laments, are seeing “their premiums doubled and their coverage cut in half.” Even supportive economists admit the program is in a death spiral.

Repeal won’t be easy. But if Trump sets for Congress the same agenda he laid out during the campaign, he could become America’s greatest health-care reformer, all while cutting taxes more than Ronald Reagan and George W. Bush combined.

. . .

 

President-elect Donald Trump has selected Rep. Tom Price (R-GA), a leading critic of the Affordable Care Act, to head the Department of Health and Human Services. If confirmed by the Senate, he would play a central role repealing and replacing the ACA. Price, an orthopedic surgeon, has for years been refining his own detailed plan for health reform, the Empowering Patients First Act. It would repeal the law, but, among many other changes, would provide support for those not eligible for employer-based coverage or public programs through age-adjusted refundable tax credits. (Price also played a key role this year in developing the House Better Way proposal unveiled by Speaker Paul Ryan in June that takes the legislative process a step further.)

. . .

The health care crowd in the Beltway is abuzz this morning with press reports that president-elect Donald Trump has named Georgia Congressman Tom Price, M.D. as Secretary of the Department of Health and Human Services. In a related move, he will name longtime Mike Pence aide Seema Verma to the critical role of administrator of the Center for Medicare and Medicaid services. As a result, there’s a raft of interest in how Obamacare “repeal and replace” will now proceed.

It’s important to not get ahead of ourselves here and reflect on what a huge pro-taxpayer accomplishment Obamacare repeal will be. By all accounts, Obamacare will be off the books early in 2017, perhaps before the Patriots win their fifth Super Bowl in NRG Stadium in Houston on the first Sunday in February. Understandably, most of the attention has been focused on the health care aspects of this. But this action will be an enormous tax cut for the American people, with implications for tax reform later in the year.

. . .

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.

. . .

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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