Republicans will need to deliver something else that works better than the Affordable Care Act, while avoiding overpromises and disruption of care. “Repeal” of many portions of the ACA is important – done, of course, in a manner that improves, not worsens, people’s lives. The Republicans in Congress and Tom Price, President-elect Donald Trump’s pick to head the Department of Health and Human Services would repeal as much of the ACA as they can reach through the budget reconciliation process.
Within the individual insurance market, people with costly pre-existing conditions will gain and maintain protections against coverage exclusions or higher premiums, as long as they maintain “continuous” eligible coverage, an approach that already operates effectively across the employer-based group insurance market. This will replace the individual mandate, by operating as a positive incentive, rather than a negative burden, to become and remain insured. As mandated coverage requirements are loosened, willing buyers will be able to find willing sellers who can match their preferences and resources.
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