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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Obamacare repeal and replace is going to turn into a huge tax cut. Those reading the tea leaves would do well to consult two sources as to how and why: the 2015 repeal bill, and the House GOP “Better Way” health care blueprint. Just as in the 2015 bill, which was vetoed by President Obama, Congress aims to repeal all of the 20 major new or higher taxes in Obamacare. It’s important that this repeal be effective at the beginning of 2017, both to get rid of negative Obamacare taxes as soon as possible and to lower the current law’s revenue baseline for tax reform.

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Trump administration officials have a lot of work ahead of them, but also a tremendous opportunity to make history. Returning the executive branch to its proper role under the Constitution will also spur Congress to enact reforms that make health care better, more affordable, and more secure.

Michael F. Cannon, Director of Health Policy at the Cato Institute, outlines 14 ways Trump-administration officials can restore the Constitution’s limits on executive power, provide relief to Americans suffering under Obamacare, and hasten repeal.

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