In a move virtually ignored outside Washington and largely unnoticed even within it, last December the House and Senate passed legislation repealing much of Obamacare. President Obama promptly vetoed the measure — an obstacle that will disappear come January 20. As reporters and policymakers attempt to catch up and learn the details of a process they had not closely followed, three important lessons stand out from last year’s “dry run” at repealing Obamacare.

Republicans’ path on Obamacare could prove more complicated than the new conventional wisdom in Washington suggests. If past is prologue, last year’s reconciliation bill provides one possible roadmap for how the congressional debate may play out.
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A total repeal of ObamaCare will prove difficult — but there’s plenty Donald Trump and his fellow Republicans can do to effectively dismantle President Obama’s signature domestic program.

Trump could exempt more people from the individual mandate to buy insurance, and his administration could stop assisting consumers with enrollment.

If the government stops fighting a lawsuit that’s trying to put an end to subsidies for low-income people’s bills, insurers’ costs would go up, and they could choose to drop out of the markets.

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The Wall Street Journal, The Washington Post, CBS News and other news outlets have led with headlines over the weekend touting the big news that Donald Trump is willing to keep parts of the Affordable Care Act––notably the pre-existing condition protections and the ability for children up to the age of 26 to stay on their parents policies.

Except this isn’t news.

In May, Trump’s policy advisor told Healthline that a Trump administration would consider keeping the children to age 26 provision.

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President-elect Donald Trump spoke with Israeli Prime Minister Benjamin Netanyahuand Egyptian President Abdel Fattah Al Sisi on Wednesday and will have his first post-election meeting with President Barack Obama on Thursday to discuss the transfer of power between their two administrations in January.

Mr. Trump’s transition team has been gathering for months, and they packed into an office on Wednesday a block away from the White House to continue drafting blueprints for the new administration. Among the proposals: a policy that would ban many members of the transition team from lobbying the same federal agencies they are helping shape.

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The presidential election outcome itself could create more problems for the ACA. The insurance plans sold on the law’s exchanges have already experienced substantial losses due to adverse selection, leading many insurance companies to pull back on their participation. The prospect of a Trump administration steering ACA implementation may be enough to convince some of the insurers still offering products on the exchanges in 2017 to rethink their plans. If more insurance companies head for the exits, the exchanges could become even less stable than they already are.

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The White House is urging people to sign up for coverage through ObamaCare, hours after the Republican electoral sweep that likely dooms the healthcare law’s future.

Spokesman Josh Earnest said Wednesday the Obama administration remains committed to its enrollment drive, which opened Nov. 1.

“There is no specific thing in mind that we’re going to do differently now,” Earnest said as he addressed reporters for the first time since President-elect Donald Trump declared victory.

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The Affordable Care Act transformed the medical system, expanding coverage to millions, injecting billions in tax revenue, changing insurance rules and launching ambitious experiments in quality and efficiency.

Less of that might disappear under President-elect Donald Trump’s pledge to “repeal and replace Obamacare” than many believe, say policy analysts. Republicans promising change might not quickly admit it, but in some respects Obamacare’s replacement may look something like the original.

“It gets into a questions of semantics,” said Mark Rouck, an insurance analyst for Fitch Ratings. “Are they really repealing the act if they replace it with new legislation that has some of the same characteristics?”

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The chairman of the National Republican Senatorial Committee said a GOP alternative to the Affordable Care Act must be mindful of those who currently have coverage through the law.

“Clearly we don’t want to do any harm to people in the system now,” Sen. Roger Wicker (R-Miss.) said at a Wednesday news conference at the Republican National Committee. “We want to be mindful.”

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Majority Leader Mitch McConnell signaled the Senate would move swiftly to repeal Obamacare now that the GOP Congress will have a Republican president next year.

“It’s pretty high on our agenda as you know,” the Kentucky Republican said on Wednesday. “I would be shocked if we didn’t move forward and keep our commitment to the American people.”

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After it became clear that Donald Trump had defeated Hillary Clinton for President, a lot of the news coverage focused on one of Donald Trump’s key policy promises: that, “on day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” But fully repealing Obamacare—let alone replacing it with better reforms—will be far more difficult than a lot of observers believe.

To start, full repeal of Obamacare can’t happen unless 60 U.S. senators vote for it, thanks to the filibuster. And there aren’t 60 votes in the Senate for full repeal; if advocates are lucky, there will be 52. (In 2017, Republicans will control either 51 or 52 Senate seats, depending on the outcome of a runoff in Louisiana.)

Republicans could, in theory, get rid of the filibuster, but Senate Majority Leader Mitch McConnell (R., Ky.) and others have routine expressed opposition to that idea.

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