Republicans on Capitol Hill are grappling with the likelihood that they will need Democratic support to pass parts of any plan replacing the Affordable Care Act, setting up a complex legislative battle over the law’s future.
President-elect Donald Trump is expected in his first days in office to take executive action voiding parts of the health law that the administration has discretion to change. Soon after that, lawmakers likely would start on their efforts to repeal and replace the law.
With full control of Congress and the White House, Republicans have anticipated being able to repeal the law using a special budget maneuver that would allow them to get around a filibuster by Democrats in the Senate.
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Congressional Republicans are setting up their own, self-imposed deadline to make good on their vow to replace the Affordable Care Act. With buy-in from Donald Trump’s transition team, GOP leaders on both sides of the Capitol are coalescing around a plan to vote to repeal the law in early 2017 — but delay the effective date for that repeal for as long as three years.
“We’re talking about a three-year transition now that we actually have a president who’s likely to sign the repeal into the law. People are being, understandably cautious, to make sure nobody’s dropped through the cracks,” said Senate Majority Whip John Cornyn (R-Texas).
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The new direction of American health care should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. If President-elect Trump and Rep. Tom Price, Trump’s HHS pick, want to make the most of this short window, they should keep four central reforms in mind: 1) Provide a path to catastrophic health insurance for all Americans. 2) Accommodate people with pre-existing health conditions. 3) Allow broad access to health-savings accounts. 4) Deregulate the market for medical services.
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Price is of the view that we are going to end up subsidizing the health care of the poor and the indigent one way or the other. We can do it through cost shifting and subsidies conferred on impersonal hospital bureaucracies or we can give the money to the people and let the bureaucracies compete for their patronage. The Price tax credit would be refundable and it would vary by age. But unlike the Obamacare credits, Price’s credit would be the same, regardless of income.
That last feature is huge. The most important reason why the exchanges have been so dysfunctional is the need to verify income.
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Hospitals and health insurers are gaining confidence that their nightmare scenario – millions of Americans instantly losing health insurance once President-elect Donald Trump delivers on a promise to “repeal and replace” Obamacare – is looking more like a bad dream than becoming reality.
The early view from the healthcare sector still includes an end eventually to President Obama’s signature health program.
But Trump’s picks to head the U.S. health department and its top regulator on Tuesday, along with his recent softening on some aspects of the existing law, is a sign to some sector insiders that instead of chaos, an orderly transition of up to three years to replace it with a plan that healthcare companies actually want could be in store.
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Congress may vote to repeal President Barack Obama’s health care law before coming up with a replacement, GOP leaders said Tuesday.
The approach could allow congressional Republicans to take swift action on one of President-elect Donald Trump’s campaign promises, while putting off the hard part. And while repealing the law could be done with GOP votes alone, any replacement plan would likely require the cooperation of minority Democrats in the Senate, something that will not be easy to come by.
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House Republicans are taking pole position in repealing and replacing ObamaCare with Donald Trump’s pick of Tom Price as secretary of Health and Human Services.
The Republican lawmaker from Georgia, a confidant of Speaker Paul Ryan(R-Wis.) and Vice President-elect Mike Pence, is a former physician with a deep understanding of both the thorny politics and wonky details of healthcare.
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Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies. The class of medicines known as specialty drugs treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers, and hepatitis C. Some medicines can cost $10,000 a month. Even a small cost-sharing requirement means patients could have to come up with thousands of dollars to get the medicines.
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The most likely scenario to achieve reform and assure coverage similar to what currently exists is to pass a reconciliation bill similar or identical to the bill passed approximately a year ago. This bill eliminated funding for the Medicaid expansion and the subsidies in the exchange and also includes a two-year implementation delay. Since the majority of newly insured individuals have come from Medicaid rather than the exchanges, this portion of the repeal, unless accompanied by other changes such as a refundable tax credit, would have the largest effect on the newly insured.
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