Congressional Republicans are itching to dismantle Obamacare, but a group of conservatives say the current plan to take down key parts of the law is not quick enough, and is already pushing for alternatives that completely and immediately repeal it entirely.
Republicans in the House and Senate have pointed to a repeal bill that was approved last year through a procedural move called reconciliation as a means to quickly gut the law after Trump assumes office in January. Reconciliation bills require only a simple 51-vote majority as opposed to 60 votes to break a filibuster, which means they’re a way to quickly pass a proposal in the Senate.
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On Donald Trump’s victory Republicans in Congress are primed for an ambitious agenda, and not a moment too soon. One immediate problem is ObamaCare’s expansion of Medicaid, which has seen enrollment at least twice as high as advertised.
Most of the insurance coverage gains from the law come from opening Medicaid eligibility beyond its original goal of helping the poor and disabled to include prime-age, able-bodied, childless adults. The Supreme Court made this expansion optional in 2012, and Governors claimed not joining would leave “free money” on the table because the feds would pick up 100% of the costs of new beneficiaries.
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The House Speaker wants Obamacare dead. The House Budget Chairman — a leading candidate for HHS secretary — wants Medicare reform. But all the focus on Republicans’ health strategies is ignoring the biggest elephant in the room: Donald Trump, a president-elect who’s spent more than a year bucking congressional Republicans — and may not share their priorities, two leading conservative thinkers tell POLITICO’s “Pulse Check” podcast.
“For all the times that the president-elect has expressed his desire to repeal and replace Obamacare … [he] campaigned on universal coverage,” said Avik Roy of the Foundation for Research on Equal Opportunity. “That’s a very different set of principles … than you might expect from a generic Republican president-elect.”
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Healthcare is the top issue Americans want Donald Trump to address during his first 100 days in the White House, according to a Reuters/Ipsos poll released on Thursday, an apparent rebuke of outgoing President Barack Obama’s signature reform, Obamacare.
Some 21 percent of Americans want Trump to focus on the healthcare system when he enters the White House on Jan. 20, according to the Nov. 9-14 poll, conducted in the week after the Republican won the U.S. presidential election.
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But it is absolutely possible to craft a health-reform agenda that conforms to Trump’s core policy principles: (1) repealing and replacing Obamacare; (2) near-universal coverage; (3) lower health insurance premiums. As a bonus, these goals can be achieved by a plan that reduces federal spending, cuts taxes, and improves health outcomes for the poor.
Few would have predicted that Donald Trump could be a more successful health reformer than Barack Obama. But if he can get over a few important hurdles, it could very well end up being true.
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House Republicans and Vice President-elect Mike Pence on Thursday agreed on a plan to punt the government funding debate into early next year and begin preparations to repeal Obamacare.
Emerging from their meeting with Pence in the Capitol, House GOP lawmakers unified behind a continuing resolution that would extend government funding, set to expire on Dec. 9, through March.
“I think the main reason was the Trump admin had a desire to have an input on what’s in that spending bill when they take office,” House Appropriations Committee Chairman Hal Rogers (R-Ky.) told reporters after the meeting.
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The main objective of the Affordable Care Act (ACA) was to increase enrollment in health insurance among those who were previously uninsured. Official estimates from the Census Bureau have consistently overstated the number of people who are uninsured. A major factor in the overestimate is the undercount of people in Medicaid. Also, millions of Americans have been officially uninsured despite their eligibility for public insurance or employer coverage. With the passage of the ACA, fewer than 10 percent of the remaining uninsured do not have a realistic path to securing health insurance. The future of the ACA is now uncertain, but any future policy changes will likely need to provide a sure path to insurance coverage for all Americans as well.
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President-elect Trump has made waves by saying that though he plans to repeal Obamacare, he wants to keep the aspect of it that bans coverage for those with pre-existing conditions. But this is not possible without broader changes to the healthcare system.
The pre-existing condition ban is ultimately one of the primary drivers of the premium hikes we’re seeing within Obamacare. The reason is that with insurers forced to offer coverage to anybody who applies, they incur higher medical costs, and they thus require more signups from younger and healthier people — but those signups aren’t materializing in a large enough volume to offset costs.
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Republicans on Capitol Hill are growing confident that they can begin to repeal Obamacare once President-elect Donald Trump is sworn in, along with a pledge to replace it later.
“We have an Obamacare emergency right now,” said Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate HELP Committee. “I think we could move forward in January on some aspects of repeal but we need to make sure that we are helping people and that we do no harm.”
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Congressional Republicans may be mulling a plan to repeal Obamacare before President-elect Trump takes office, a top GOP leader said Wednesday.
“Nothing has been decided but that is certainly one of the options,” Senate Majority Whip John Cornyn, R-Texas, told reporters after a closed-door GOP meeting on Wednesday.
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