Rep. Greg Walden of Oregon, who helped shepherd the party’s health-care overhaul bill through the House last month, sat down with Louise Radnofsky, The Wall Street Journal’s White House reporter, to offer his take on where the repeal and replace effort stands.
“The House has passed the American Health Care Act to try to do reforms, to get cost control on the Medicaid system, give states more flexibility to design plans that will work for them and move people into an insurance product they can afford. We know there’s more work to be done. We believe we gave the Senate some nice headroom and some dollars set aside in there to make other changes. So they’ve got some flexibility. We’ll see where this leads. But I think we’ll get a bill to the president’s desk before August.”
The chief obstacle to repealing and replacing Obamacare may no longer be congressional Democrats. It could be the GOP itself.
Senate Majority Leader Mitch McConnell has promised to hold a vote on the party’s repeal-and-replace plan by the end of June. But as he’s tacked his plan to the center as part of a bid to hold onto moderate Republicans, he’s raised the ire of conservatives who are pressing for a plan that more fully repeals Obamacare.
Senate Republicans must iron out their differences — and not let fear of the unknown derail their seven-year-long plan to repeal Obamacare. The law is collapsing. The GOP may not have made this mess, but the American people are counting on them to clean it up.
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A growing number of major insurers are seeking premium increases averaging 20% or more for next year on plans sold under the Affordable Care Act, according to rate proposals in more than 10 states that provide the broadest picture so far of the strains on the marketplaces.
As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals from a few states that risk leaving some consumers with no exchange plans next year. But the rate requests by major insurers show stress on the marketplaces stretches beyond those trouble spots.
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Obamacare’s second biggest flaw is that even as it upended the half-century long consensus over who should be in Medicaid, the law inexplicably left intact a feature of Medicaid that we have known for decades fuels excess spending: its open-ended matching rate.
So long as states put up a dollar to fund Medicaid, Uncle Sam is obliged to match it with anywhere from $1 to $3 federal dollars depending on that state’s unique matching rate. It has been proven empirically that this formula fuels higher spending. An analysis by Thad Kousser at UC Berkeley showed that all other things being equal, shifting a state from the lowest to highest federal matching rate increases discretionary Medicaid expenditures by 22 percent.
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It’s been just over seven years since President Obama declared: “It is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform. Another way of putting it is we can’t simply put more people into a broken system that doesn’t work” [emphasis added].
Regrettably, the law he signed less than 10 months later fell far short of the president’s own benchmark as it relates to Medicaid. Not only did the ACA fail to impose any cost controls on Medicaid, it likewise contained no reforms to reverse or even corral the perverse incentives that for decades had simultaneously led to indefensible levels of Medicaid overspending even while creating enormous problems of access to the very people the program aimed to help. Instead, it amplified those incentives, making an already-bad situation even worse.
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Senate Democrats are escalating their attack on Republicans’ plans to repeal Obamacare this week, though their party remains divided on how far to take activists’ demands that they shut down the Senate in protest of the GOP’s dismantling of the Affordable Care Act.
Democratic senators are planning to hold the Senate floor until at least midnight on Monday to thrash Senate Republicans for refusing to hold committee hearings on their healthcare overhaul, according to several people familiar with the plan. The round of speeches is being organized by Sens. Patty Murray of Washington state and Brian Schatz of Hawaii.
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Insurers must submit applications by next Wednesday to sell plans through HealthCare.gov, and these will give us some of the first indicators of how high Obama Care costs will skyrocket in 2018. ObamaCare supporters can’t wait to blame the coming premium increases on the “uncertainty” caused by President Trump. But insurers faced the same uncertainty last year under President Obama.
Consider a recent press release from California Insurance Commissioner Dave Jones. He announced that “in light of the market instability created by President Trump’s continued undermining of the Affordable Care Act,” he would authorize insurers to file two sets of proposed rates for 2018—“Trump rates” and “ACA rates.” Among other sources of uncertainty, Mr. Jones’s office cited the possibility that the Trump administration will end cost-sharing reduction payments.
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Conservatives inside and outside the Senate GOP are sounding alarms over the emerging shape of the chamber’s bill to dismantle the Affordable Care Act, a sign that the faction’s support may be increasingly difficult to secure.
Pressure from outside groups has intensified in recent days, and conservative lawmakers have signaled their concern that the Senate bill doesn’t do enough to curb spending on the Medicaid federal-state program for the poor or to reduce health-care premiums—two of their top goals.
“We’re not there yet,” Sen. Ted Cruz (R., Texas), a leading Senate conservative, said Thursday.
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