The current situation presents an opportunity to replace the Affordable Care Act with a more sustainable bipartisan law. But repeal must wait until a consensus is built around a replacement plan. Not doing so – starting with repeal and delay – threatens to destabilize the individual market and harm not only those who receive subsidies from the ACA, but also everyone who now purchases insurance in the individual market.
Estimates show that premiums would jump at least 20 percent and cause 4.3 million to lose health insurance as soon as next year, and that’s nothing compared to the damage that would be inflicted if a replacement plan subsequently failed to emerge. The current version of repeal through reconciliation, leaving in place the ACA’s insurance market reforms, would nearly destroy the individual market if its provisions took effect, causing 30 million people in total to lose health insurance, leaving more uninsured than before the ACA.
Fixing the ACA is important, but replacing it with a durable plan to make health coverage broadly affordable will take time and constructive bipartisan collaboration.
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Republican leaders in Congress have announced their intention to repeal key parts of Obamacare in early 2017, but delay the implementation of that repeal until 2019 or 2020. Some conservatives are complaining about this delay, arguing that the GOP should replace Obamacare immediately. But GOP leadership is right—and here’s why.
The fundamental problem is that in order to fully replace Obamacare, Republicans need to come up with a bipartisan plan that can attract the 60 votes necessary to overcome a Democratic filibuster.
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Staff for House Republicans will be briefed Thursday afternoon on how to repeal Obamacare using special budget reconciliation rules that could allow them ditch big parts of the healthcare law next year.
House Budget Committee staffers will explain at a 1:30 p.m. meeting how the budget reconciliation process works, lay out how it can be used on the Affordable Care Act and answer questions, according to an invitation sent to Republicans on Monday.
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Though Republicans are itching to start on their promises to “repeal and replace” the Affordable Care Act, many of them worry about repercussions if the process stalls or takes too long.
The GOP will most likely have to take a piecemeal approach to rolling back the health care legislation, a process Senate Majority Leader Mitch McConnell has said will be the first priority of the 115th Congress.
A new health care law might not take effect for up to three years, The Associated Press reported, in order to give Congress and President-elect Donald Trump enough time to come up with a feasible replacement.
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As a physician, I know well the problems with Obamacare. I don’t think anyone has more disdain for this big government takeover of our healthcare system. It needs to be stopped, and we must replace it with reforms that move us in the opposite direction.
I will vote to repeal Obamacare in January. I believe it is something that the Republican Congress must do.
However, in our fervor to repeal Obamacare, conservatives should not forget or abandon the principles that make us conservative in the first place. Quirky, arcane rules allow Congress to repeal Obamacare with a simple majority but only if Congress passes a budget first.
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Only four of the original 24 Obamacare health co-ops remain standing after Maryland’s co-op announced Dec. 8 it was suspending the sale of individual health insurance policies, the Daily Caller News Foundation Investigative Group has found.
With the near-collapse of Maryland’s co-op — called Evergreen Health — at least 989,000 individuals nationwide have lost their health insurance coverage when the nonprofit co-ops stopped selling insurance to customers, according to TheDCNF’s tally.
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An important part of Donald Trump’s healthcare agenda is his pledge to let consumers and employers avoid unwanted regulatory costs by purchasing insurance licensed by states other than their own, a change that would make health insurance both more affordable and more secure. The Congressional Budget Office has estimated that allowing employers to avoid these unwanted regulatory costs would reduce premiums an average of 13%. That’s a nice contrast to what Bill Clinton calls ObamaCare’s “crazy system where…people [who] are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.”
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In a recent podcast, Weekly Standard editor Bill Kristol made the observation:
if Obamacare had worked, Hillary Clinton would be the president-elect, right? I do think those those premiums going up two weeks before the election probably moved the necessary number of votes.
That got me to thinking how one might prove this empirically. The short answer is that I cannot prove this proposition beyond a shadow of a doubt, but the evidence is stronger than one might suppose.
To be sure, national exit polls showed that the most important issues in this campaign were the economy (52%), terrorism (18%), immigration (13%) and foreign policy (13%). However, according to David Wasserman’s definitive vote tallies at Cook Political Report, a swing of only 38,595 votes in 3 states (MI, PA, WI) would have given the election to Hillary Clinton. This represents 0.0293% of votes cast, making it the 7th closest presidential election in history in terms of this metric (p. 330). The issue for our purposes here is whether we could make a good case that Obamacare was the factor that led these crucial election-deciding voters to pull the lever for Trump rather than Clinton.
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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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The head of America’s Health Insurance Plans, the national trade association representing health insurers, lists three key priorities for reform:
1. Commit to policies that support continuous coverage for everyone—those who utilize insurance to obtain quality care and those who are healthy but have insurance to protect them in case they get sick. Both types of consumers must be insured for coverage to remain affordable.
2. Commit to market stability in 2017 and 2019 by funding temporary, transitional funding programs at least through January 1, 2019.
3. Reduce health costs for millions of Americans by eliminating the health-insurance tax on insurers, which is passed along to employers and consumers in the form of higher premium costs.
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