Health and Human Services Secretary-nominee Tom Price has a radical idea: Let Medicaid recipients choose their own health insurance plan just as millions of Americans do every year.

Both House Speaker Paul Ryan and Price want to replace Obamacare subsidies with refundable tax credits—which would essentially function like a federal subsidy—for people who do not have access to employer-provided health insurance, Medicare, Medicaid or VA coverage.

But under legislation introduced by Price in 2015 (see section 102), a person in a government-run program such as Medicaid could opt out and take the tax credit instead.

That’s exactly the right thing to do.

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The debate over the future of America’s health system is just beginning. Democrats are certain to use every opportunity to defend Obamacare as a success. So what better time to debunk some of the biggest misperceptions about health policy that liberals have been pushing for decades? Ridding our healthcare debate of these fallacies is vital to building a successful health sector from the ruins of Obamacare. Sally Pipes, President of the Pacific Research Institute, highlights myths such as: “Universal coverage should be the ultimate goal,” “Health care and health insurance are the same thing,” and “No one should ever have to pay out of pocket for health care.”

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Congressional Republicans are pressing Obama administration officials for details on the Affordable Care Act’s Medicaid expansion before they leave office next month.

Sen. Orrin Hatch (Utah) and Reps. Joe Pitts (Pa.) and Tim Murphy (Pa.) wrote to Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt Monday, asking how the agency ensures ineligible people aren’t enrolling in Medicaid. The members asked Slavitt to respond within 30 days of receiving the letter.

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The CMS has made a handful of final changes to the Affordable Care Act’s health insurance marketplaces for 2018, just a little more than a month before Donald Trump takes over the White House and congressional Republicans move to repeal the healthcare reform law.

A final rule published late Friday cements many of the CMS’ proposals from August. Some of the most notable changes involve the ACA’s permanent risk-adjustment program, which funnels money from insurers with lower-cost enrollees to companies that have higher-cost enrollees.

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Lanhee Chen, leading conservative health care expert, says, “There are a lot of people out there probably who assume that Republicans have no ideas on health care, because this has been the Democratic talking point for a long time. I think actually just the opposite is true. It’s not that we don’t have enough ideas as conservatives, it’s that we actually have too many. A lot of thinking and research has gone on the last several years around how you create a health care system that is more consumer friendly, that pays attention to costs first, that recognizes the importance of health care in people’s lives but doesn’t believe that the federal government is necessarily well-suited to make all of those important decisions.”

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Republicans have said they want to move quickly to craft a replacement plan after successfully repealing Obamacare. But it is not clear how they will pay for a key part of that replacement, tax credits to pay down health insurance.

Republicans have not released a replacement plan for repealing Obamacare. However, some Republicans have introduced legislative text that give a sense of the direction the GOP wants to go.

For instance, Rep. Tom Price, the Georgia Republican who President-elect Trump nominated to be secretary of the Department of Health and Human Services, has a plan. Price’s Empowering Patients First Act includes tax credits that are pegged by age instead of income so a person who is younger would get a smaller tax credit than someone older who presumably has higher healthcare costs.

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The Republicans are thinking of leaving Obamacare’s regulations in place because they fear that a bill altering them would die in a filibuster. They are sure they can use a procedure for avoiding filibusters if they target only the law’s tax and spending provisions.

This course could cause the insurance exchanges, already in trouble, to collapse entirely. That’s because the Republican bill would scrap the individual mandate while keeping Obamacare’s requirement that insurers treat sick and healthy people alike.

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Repealing Obamacare could take months and developing replacement health insurance plans could take years, senior Republican aides in the U.S. Congress said on Thursday, discouraging talk of a quick end to the program after President-elect Donald Trump takes office on Jan. 20.

“We are talking a matter of weeks, in two months – but not a matter of many months” for Congress to pass a repeal, one aide said, adding that Republicans “certainly” hope Trump will sign the repeal into law in the first half of 2017.

Congressional Republicans are consulting with the Trump transition team on when the effective date of the repeal should be, another aide said. Setting it a few years out will provide lawmakers time to debate whether and how to replace some elements of the Obamacare law.

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Hundreds of insurers selling health plans in Affordable Care Act marketplaces are being paid less than 2 percent of nearly $6 billion the government owes them for covering customers last year with unexpectedly high medical expenses.

The $96 million that insurers will get is just one-fourth of the sum that provoked an industry outcry a year ago, when federal health officials announced that they had enough money to pay health plans only 12.6 percent of what the law entitles them to receive.

This time, the Obama administration made no public announcement.

. . .

Federal regulators Thursday night extended the midnight deadline for Affordable Care Act insurance by four days, as consumers fought to get through to call center operators and log onto Healthcare.gov to buy insurance that takes effect Jan. 1.

“Nearly a million consumers have left their contact information to hold their place in line,” Healthcare.gov CEO Kevin Counihan said in a statement late Thursday. “Our goal is to provide affordable coverage to everyone seeking it before the deadline, and these two additional business days will give consumers an opportunity to come back and complete their enrollment for January 1 coverage.”

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