Over the past few years, pundits have dismissed the Republican Party’s chances of repealing and replacing Obamacare. But with President-elect Donald Trump’s victory Tuesday and the GOP’s successful effort to keep control of Congress, conservatives now have a real chance to eliminate the health care law. The question is how to do it.
Three years into its implementation, the Affordable Care Act has clearly failed. The law has wrecked the individual market for health insurance—premiums have soared, coverage has been canceled en masse, and choices have been drastically curtailed. The cost of the law’s major coverage provisions—Medicaid expansion and subsidies for plans purchased through the exchanges—have soared. In fact, the per enrollee cost of the Medicaid expansion is nearly 50 percent above estimates.
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In a move virtually ignored outside Washington and largely unnoticed even within it, last December the House and Senate passed legislation repealing much of Obamacare. President Obama promptly vetoed the measure — an obstacle that will disappear come January 20. As reporters and policymakers attempt to catch up and learn the details of a process they had not closely followed, three important lessons stand out from last year’s “dry run” at repealing Obamacare.
Republicans’ path on Obamacare could prove more complicated than the new conventional wisdom in Washington suggests. If past is prologue, last year’s reconciliation bill provides one possible roadmap for how the congressional debate may play out.
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A total repeal of ObamaCare will prove difficult — but there’s plenty Donald Trump and his fellow Republicans can do to effectively dismantle President Obama’s signature domestic program.
Trump could exempt more people from the individual mandate to buy insurance, and his administration could stop assisting consumers with enrollment.
If the government stops fighting a lawsuit that’s trying to put an end to subsidies for low-income people’s bills, insurers’ costs would go up, and they could choose to drop out of the markets.
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The Wall Street Journal, The Washington Post, CBS News and other news outlets have led with headlines over the weekend touting the big news that Donald Trump is willing to keep parts of the Affordable Care Act––notably the pre-existing condition protections and the ability for children up to the age of 26 to stay on their parents policies.
In May, Trump’s policy advisor told Healthline that a Trump administration would consider keeping the children to age 26 provision.
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President-elect Donald Trump spoke with Israeli Prime Minister Benjamin Netanyahuand Egyptian President Abdel Fattah Al Sisi on Wednesday and will have his first post-election meeting with President Barack Obama on Thursday to discuss the transfer of power between their two administrations in January.
Mr. Trump’s transition team has been gathering for months, and they packed into an office on Wednesday a block away from the White House to continue drafting blueprints for the new administration. Among the proposals: a policy that would ban many members of the transition team from lobbying the same federal agencies they are helping shape.
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Sources say President-elect Donald Trump’s transition team for HHS will be led by Andrew Bremberg, who worked at the agency under President George W. Bush administration and more recently has been an adviser to Senate Majority Leader Mitch McConnell and Wisconsin Gov. Scott Walker’s fleeting presidential bid.
Bremberg was on Walker’s team when the candidate unveiled a healthcare proposal that included repealing the Affordable Care Act and splitting Medicaid into smaller programs with separate funding.
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Although it came late as a campaign issue, ObamaCare was on the ballot again on Tuesday. And it lost big. President-elect Trump connected with voter anger about the law, saying that health costs are overwhelming families’ ability to pay their bills, and even their mortgages. Those voters helped produce Tuesday’s stunning electoral result. Both Speaker Ryan and Leader McConnell are ready to begin work on repealing and replacing ObamaCare; we offer an agenda for action.
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The presidential election outcome itself could create more problems for the ACA. The insurance plans sold on the law’s exchanges have already experienced substantial losses due to adverse selection, leading many insurance companies to pull back on their participation. The prospect of a Trump administration steering ACA implementation may be enough to convince some of the insurers still offering products on the exchanges in 2017 to rethink their plans. If more insurance companies head for the exits, the exchanges could become even less stable than they already are.
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The White House is urging people to sign up for coverage through ObamaCare, hours after the Republican electoral sweep that likely dooms the healthcare law’s future.
Spokesman Josh Earnest said Wednesday the Obama administration remains committed to its enrollment drive, which opened Nov. 1.
“There is no specific thing in mind that we’re going to do differently now,” Earnest said as he addressed reporters for the first time since President-elect Donald Trump declared victory.
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The Affordable Care Act transformed the medical system, expanding coverage to millions, injecting billions in tax revenue, changing insurance rules and launching ambitious experiments in quality and efficiency.
Less of that might disappear under President-elect Donald Trump’s pledge to “repeal and replace Obamacare” than many believe, say policy analysts. Republicans promising change might not quickly admit it, but in some respects Obamacare’s replacement may look something like the original.
“It gets into a questions of semantics,” said Mark Rouck, an insurance analyst for Fitch Ratings. “Are they really repealing the act if they replace it with new legislation that has some of the same characteristics?”
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