Repeal-and-replace (for Obamacare) is not quite dead. It has been declared so, but what that means is that, for now, the president has (apparently) washed his hands of it and the House Republicans appear unable to reconcile their differences. Neither condition need be permanent. As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.  Don’t be surprised, however, if, in the end, single-payer wins out.

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Senior House Republicans said Thursday that they expected the federal government to continue paying billions of dollars in subsidies to health insurance companies to keep low-income people covered under the Affordable Care Act for the rest of this year — and perhaps for 2018 as well. “While the lawsuit is being litigated, then the administration funds these benefits,” the House speaker, Paul D. Ryan, said Thursday. “That’s how they’ve been doing it, and I don’t see any change in that.”

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The full dimensions of the GOP’s self-defeat on health care will emerge over time, but one immediate consequence is giving up block grants for Medicaid. This transformation would have put the program on a budget for the first time since it was created in 1965, and the bill’s opponents ought to be held accountable for the rising spending that they could have prevented.

The members of the House Freedom Caucus who killed ObamaCare’s repeal and replacement claim to be fiscal hawks. Most of them support a balanced budget amendment. Yet they gave zero credit to a reform that would have restored Medicaid—a safety net originally intended for poor women, children and the disabled—to its original, more limited purposes.

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Under extreme pressure from conservative activists, House Republican leaders and the White House have restarted negotiations on legislation to repeal the ACA. But efforts to revive the legislation in the House could take weeks, lawmakers conceded, as Congress moves forward with a full plate of other time-consuming issues. And the renewed push did not meet with much enthusiasm from Senate Republicans, who said they had other priorities at the moment. Nonetheless, Speaker Paul Ryan vowed to renew efforts to repeal the law, despite last’s week crushing setback when House Republicans tossed aside a repeal bill because they lacked the votes to pass it.

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Nearly two-thirds of Republicans still want Congress to pursue health care reform, a new Morning Consult/POLITICO poll shows.

Among Republicans, 62 percent of registered voters want reform efforts to continue, versus just 30 percent who think lawmakers should stop. Among all voters, 51 percent said the GOP should move on to other efforts, while 37 percent said they want Congress to continue with health care reform.

James C. Capretta argues that going forward, the goal shouldn’t be to find a bill that is acceptable to 100% of the Republican caucus. Even if that were possible, it would entail too much risk of another political debacle. On health care, he says that Republicans will be better off trying to reach a deal with some willing Democrats. That can be done, but only if Republicans first demonstrate they are serious about producing a workable approach that moves decisively away from key ACA provisions without leaving millions without insurance. If they do that, and the CBO produces an estimate showing it would work, they will find they have the leverage necessary to bring some willing Democrats to the table and get a good deal.

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As House Republicans struggle to find a way to repeal ObamaCare, the two GOP senators from Tennessee are looking to temporarily fix an issue that may strike the health insurance exchanges next year.

A bill introduced by Sens. Lamar Alexander and Bob Corker would allow people to use their ObamaCare subsidies to purchase any state-approved plan on the private market if there are no insurers selling policies on the federal exchange in their county.

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On June 21, 2017, health insurers have to decide whether they will sell coverage on the Obamacare marketplaces. “It will give us the first indication of what the ballpark rate increases are, what counties have insurers and which ones don’t,” says Robert Laszewski, an industry consultant who works with insurers that sell on the marketplace. “Insurers will have to make a statement.” The number of insurers selling on the marketplace fell significantly this year. There are 960 counties on Healthcare.gov that had just one health insurer selling coverage in 2017. That was a big increase from the 180 counties in the same situation in 2016.

Secretary of Health and Human Services Tom Price came into office last month ready to lead the charge on repealing ObamaCare. Now, that effort has run into a brick wall, leaving him to oversee a law he fiercely opposes.

President Trump last week predicted that ObamaCare “soon will explode,” stirring speculation that the administration could seek to undermine the law.

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President Donald Trump and GOP lawmakers, seeking to regroup following the collapse of the effort to repeal the Affordable Care Act, have an option for gutting the health law relatively quickly: They could halt billions in payments insurers get under the law.

House Republicans were already challenging those payments in court as invalid. Their lawsuit to stop the payments, which they call illegal, was suspended as Republicans pushed to replace the ACA, but it could now resume—or the Trump administration could decline to contest it and simply drop the payments. Mr. Trump could unilaterally end the payments regardless of the lawsuit.

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