The GOP’s long-discussed dreams of repealing Obamacare became closer to reality early Wednesday morning when Donald Trump was elected president.

Six years after President Barack Obama signed the Affordable Care Act into law and after more than 60 attempts to repeal it, Republicans now have a good chance to advance their own agenda.

While on the campaign trail, Trump repeatedly promised voters that he would repeal Obamacare if he was elected president and even called on congressional Republicans to call a “special session” to move forward with rolling back the law.

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Obamacare architect Jonathan Gruber told CNN’s Carol Costello on Monday that it is not possible to just “get rid of the parts” of the health care law that people do not like because that was tried and “premiums went through the roof.”

Costello interviewed Gruber on her show and asked how Americans’ health care premiums would be affected if President-elect Donald Trump repealed parts of the Affordable Care Act that are unpopular after taking office.

“So, let’s say he keeps the parts of the law that people really like,” Costello said. “What would that do to all of our premiums? If he could keep all of the elements that you say that Congress might reject.”

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President-elect Trump and the GOP-controlled Congress can repeal Obamacare pretty easily, but the biggest question is when and if there will be a transition while a replacement gets crafted.

Trump has promised to repeal Obamacare in its entirety and congressional Republicans are on board. However, when the repeal would take effect is largely in doubt, as some Republicans are wary of immediately ending coverage for millions of people without a replacement.

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President-elect Trump said that he was open to keeping parts of Obamacare. The Wall Street Journal reports, “Mr. Trump said he favors keeping the prohibition against insurers denying coverage because of patients’ existing conditions, and a provision that allows parents to provide years of additional coverage for children on their insurance policies.” He’s not the first Republican to advocate keeping these popular provisions of the law. Keeping the under-26 provision is pretty close to a consensus among Hill Republicans. It’s not the ideal policy, in my view. But it’s compatible with a much freer and better-functioning health-care market than we have now, and it’s worth accepting as part of legislation that enables that market.
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Donald Trump hadn’t been president-elect for a week when he appeared to abandon his oft-repeated pledge to repeal Obamacare in its entirety. In interviews with the Wall Street Journal and 60 Minutes, Trump appeared to want to keep, or at least to be willing to accept, the Affordable Care Act’s centerpiece: it’s supposed prohibition on discrimination against health-insurance applicants with pre-existing conditions. Ramesh Ponnuru, my friend and a senior editor of these pages, says the downside of Trump’s triangulation is that retaining those provisions “makes it much, much harder to get rid of the individual mandate” — as if the mandate were the bigger problem. On the contrary, the pre-existing-conditions provisions are the centerpiece of Obamacare.

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Colorado voters rejected a ballot measure that would have created a first-in-the-nation single-payer health insurance system, a significant setback for progressive proponents of universal health care.

Tuesday’s defeat of Amendment 69 was decisive, as predicted. Polling ahead of Election Day showed that two-thirds of residents opposed the measure, which would have established a program called ColoradoCare to cover most people in the state.

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Democrats are already panicked that Donald Trump will repeal ObamaCare and throw millions of people off the subsidy rolls, while some conservatives seem panicked that the President-elect will renege on his campaign promises and millions of people won’t be thrown off the entitlement. Like most inflamed political questions after Mr. Trump’s victory, the health-care debate would benefit from some perspective.

“Either ObamaCare will be amended, or repealed and replaced,” Mr. Trump told the Journal last week, and on “60 Minutes” on Sunday he added that “we’re not going to have a two-year period where there’s nothing. It will be repealed and replaced.” Mr. Trump is being more subtle than his critics.

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Not all of Obamacare would be “shut right down” once the unified Republican government takes power next year, House Majority Leader Kevin McCarthy said Monday.

“You wouldn’t have everything shut right down. … You wouldn’t take everything away,” the California Republican told reporters on Capitol Hill. 

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In an ongoing backdoor attempt to pay off insurers burned by President Barack Obama’s signature legislation, the Affordable Care Act, the Obama administration is creating the framework needed to implement a “public option,” the precursor to a single-payer health-care system. Distracted by the presidential election and the news that ACA insurance premiums will increase by an average of 25 percent in 2017, many have failed to notice the administration’s plan to use a special U.S. Department of Justice fund, called the Judgment Fund, to funnel billions of dollars to insurers without congressional approval. If it successfully executes this plan, the Centers for Medicare and Medicaid Services will have circumvented Congress to secure a taxpayer bailout for insurers — directly contradicting Congress’s intentions as expressed by multiple spending bills, and possibly violating federal law.
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Republicans could pass a budget reconciliation bill that gradually sunsets the law, preserving its subsidies and Medicaid expansion for a time while they agree on a replacement. They’ve already got a script for that approach, after passing a reconciliation bill last January which President Obama vetoed.

Or Congress could pass a replacement plan right away by coupling it with a repeal bill, although it’s questionable Republicans could find consensus in such a short timeframe.

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