What happens to Obamacare after its namesake leaves the White House? The Affordable Care Act (ACA) has faced fierce opposition from congressional Republicans and many GOP-led state governments, survived unexpected legal challenges, and overcome a disastrous rollout of healthcare.gov. Through it all, ACA supporters could count on President Barack Obama to defend the law. But come January 20, 2017, that will change. If Donald Trump becomes president and Republicans maintain congressional majorities, the GOP could seek to repeal major ACA provisions, though Trump’s health care agenda is uncertain.
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One of the more controversial parts of the Affordable Care Act is its expansion of Medicaid. A new study from the Mercatus Center at George Mason University reviews Medicaid’s longstanding problems, discusses the incentives states face as a result of the elevated federal reimbursement rate for the ACA Medicaid expansion population, and analyzes the impact of the expansion. Overall, the expansion significantly adds to Medicaid’s unsustainable spending trajectory, likely fails to produce outcomes worth the corresponding cost, and creates a large federal government bias toward nondisabled, working-age adults at the expense of traditional Medicaid enrollees.
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If Donald Trump is elected president, one thing that is fairly certain is that we’d hear loud calls from some quarters for the incoming administration and Congress to move quickly in 2017 on a “clean” repeal of Obamacare. “Clean” means that the bill would go as far as possible to repeal the health care law without being encumbered politically by new provisions to replace it. Some conservatives will advise against embracing any new reform because of the political risk, but lawmakers should ignore this advice. If GOP leaders pass up the chance to pursue a market-based approach to health reform when given the chance, they will have no one to blame but themselves as U.S. health care slides inexorably toward full governmental control in coming years.
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What are the prospects for action on the Affordable Care Act (ACA) during the next Congress and presidential administration? There is no easy answer to that question in this unusual election year, although one’s first reaction might be “not much.” As Larry Leavitt, MPP, noted in the JAMA Forum recently, the presidential platforms suggest fundamentally different, maybe even irreconcilable, approaches.
At the risk of being proven wrong, it also seems reasonable to assume that there will continue to be a political standoff in practice next year, with neither party able to push through its preferred solutions for health care.
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The latest data from the Centers for Disease Control suggests that the number of uninsured has declined roughly 22 million since 2013, and 17.8 million since 2010 (darn you, financial crisis!). And today we got data from the Census Bureau, which suggests that the number of uninsured people has fallen from 13.3 percent to 9.1 percent since 2013, or by about 12.8 million. There are other surveys too. But we hardly need more numbers.
How can everyone get such different answers? Well, for one thing, methodologies differ.
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Obamacare used the law’s vast authority to get control over the design and composition of health benefits. Clintoncare will try to use these same administrative riggings to get power over the pricing of these products and services. To rescue President Obama’s struggling health-care law, Hillary Clinton has proposed resurrecting the “public option.” This failed idea—a government-run health-care plan to compete with private insurers—can’t save Obamacare. But introducing it across the country would move the U.S. much closer to the single-payer system progressives have always longed for.
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The Congressional Budget Office’s latest long-term forecast, released last month, is a bracing report. As President Obama’s term comes to end, CBO finds that the federal government is on track to run up historically large deficits over the coming three decades, pushing federal debt to 141% of GDP, up from 39% in 2008.
The president has mostly avoided talking about the federal budget during his time in office, but he did promise that the Affordable Care Act — ObamaCare — would help lower deficits in the short and long term. CBO backed him up on this claim in 2010, estimating that the deficit would be reduced by 0.5% to 1.0% of GDP over the medium term. But the agency’s new forecast shows why the law is more likely to make the deficit worse, not better.
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Eight of the states that will determine the Senate majority in November are likely to see significant reductions in the number of insurers participating in ObamaCare marketplaces.
The likely departures of insurers in Illinois, Wisconsin, Florida, Pennsylvania, Ohio, North Carolina, Arizona and Missouri are pushing the healthcare law toward the center of some of the most competitive Senate races in the country.
GOP strategists say Obama-Care’s troubles this year are morphing into a perfect storm for their candidates, providing a boost in a year when the party is defending 24 Senate seats.
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This week, the Georgia Chamber of Commerce released a new plan to impose more of Obamacare on their state. The Chamber acknowledged that their “guiding principle” in crafting the Medicaid expansion plan was simply to “take advantage of all federal dollars available.” As such, they’re lobbying for policymakers to expand Medicaid to a new welfare class of more than 700,000 able-bodied adults.
Although the “plan” has few details – so far it consists solely of two PowerPoint slides – one thing is certain: it will be a more costly way to expand Obamacare that combines some of the most expensive aspects of other expansion plans from around the country.
The state-run insurance marketplaces created under the Affordable Care Act may not be sustainable, a GOP report released Tuesday by a House committee concludes.
The Energy and Commerce Committee report concludes that the $5 billion the federal government committed to building state-based exchanges has resulted in a failed experiment, and says that none of the exchanges are currently financially self-sustaining. The report comes ahead of a hearing Wednesday on the Affordable Care Act called by the committee’s health and oversight subcommittees.
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