Republicans could pass a budget reconciliation bill that gradually sunsets the law, preserving its subsidies and Medicaid expansion for a time while they agree on a replacement. They’ve already got a script for that approach, after passing a reconciliation bill last January which President Obama vetoed.
Or Congress could pass a replacement plan right away by coupling it with a repeal bill, although it’s questionable Republicans could find consensus in such a short timeframe.
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Over the past few years, pundits have dismissed the Republican Party’s chances of repealing and replacing Obamacare. But with President-elect Donald Trump’s victory Tuesday and the GOP’s successful effort to keep control of Congress, conservatives now have a real chance to eliminate the health care law. The question is how to do it.
Three years into its implementation, the Affordable Care Act has clearly failed. The law has wrecked the individual market for health insurance—premiums have soared, coverage has been canceled en masse, and choices have been drastically curtailed. The cost of the law’s major coverage provisions—Medicaid expansion and subsidies for plans purchased through the exchanges—have soared. In fact, the per enrollee cost of the Medicaid expansion is nearly 50 percent above estimates.
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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.
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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