The Trump administration hopes to move forward with a rule expanding alternatives to ObamaCare plans by this summer, Secretary of Labor Alex Acosta said Monday.

The rule allows for small businesses and self-employed individuals to band together to buy insurance as a group in what are known as association health plans.

“We hope to have that by this summer,” Acosta said Monday during a tax reform event alongside President Trump in Florida.

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Congress has been unable to agree on “market stabilization” for the Affordable Care Act (ACA), and it was left out of the recently passed omnibus. Yet, a key discussion has been missing from the conversation, the need to rethink the single risk pool in the ACA.

Throwing money at the status quo will simply slow a market decline, which could leave millions with no access to affordable coverage. Splitting subsidized lives from nonsubsidized into two different risk pools could provide structural relief that allows markets to stabilize longer term.

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The Centers for Medicare & Medicaid Services (CMS) plans to “wind down” support for the federal exchanges by the time open enrollment hits in 2019 and shift funding to states.

For that strategy to work, the agency is relying on Congress to do something it failed to do several times last year: Pass an ACA repeal.

CMS detailed its plan in a fiscal year 2019 budget justification (PDF) released this week that outlines a $403 million cut to its program operations budget next year. With less funding to oversee the federal exchanges for plan year 2020, CMS would dole out grants that allow states to “assume more control of their markets and expand enrollment options.”

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Ohio officials asked the Trump Administration on Friday to formally waive the Affordable Care Act individual mandate that requires residents to have health insurance, making it the first state to make such a waiver request.

Ohio’s Legislature called for the 1332 waiver last summer, and Congress zeroed out the financial penalty for not having coverage in its tax bill in December.

“The (tax) legislation zeroed out the penalty that is associated with the individual mandate … but … did not eliminate the mandate itself,” Ohio Department of Insurance Director Jillian Froment said in a March 30 letter to HHS Secretary Alex Azar. “That is why Ohio is submitting an application to waive [the mandate].”

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A new law in Iowa could provide the path forward for Republican-led states that are looking for ways around ObamaCare’s rules and regulations.

Iowa Gov. Kim Reynolds (R) on Monday signed a law that will allow the Iowa Farm Bureau to collaborate with Wellmark Blue Cross Blue Shield on self-funded “health benefit plans.”

The plans would be cheaper than traditional ObamaCare plans because they wouldn’t be required to meet federal requirements.

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Donald Trump’s health secretary was on fire during a March 5 address to the Federation of American Hospitals. Alex Azar, the former Eli Lilly executive now charged with overseeing everything from Medicare to the Centers for Disease Control & Prevention, outlined plans to achieve nothing less than the “value-based transformation” of American health care.

“Today’s healthcare system is simply not delivering outcomes commensurate with its cost,” he said. And Azar put his biggest finger on a commonly blamed problem: the fact that American health care is “paying for procedures and sickness” instead of “outcomes and wellness.”

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When Republicans failed to repeal ObamaCare last year, it recalled the old line about snatching defeat from the jaws of victory. That loss, however, should not be allowed to overshadow an important Republican success on health care. Millions of Medicare beneficiaries now get their coverage through private plans under Medicare Advantage—a quiet step forward that brings real benefits. To ensure continued progress, Republicans must resist the temptation to choose short-term savings over long-term reform.

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The tax-reform provision repealing the penalty on those who refuse to participate in ObamaCare has freed millions of Americans to escape a system that exploits them. But while Americans can escape ObamaCare, they still can’t buy insurance in the individual market independent of ObamaCare because private insurers are prohibited from selling it. If this prohibition can be removed through the granting of state waivers by the Department of Health and Human Services, or by the passage of a new federal statute, ObamaCare will collapse into a high-risk insurance pool for the seriously ill rather than become a stepping stone to socialized medicine.

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The Trump administration is preparing to offer Americans an affordable alternative to the high-cost coverage on Obamacare’s exchanges by overturning one of the previous administration’s most burdensome regulations.

On February 20, the Department of Health and Human Services released a proposed rule based on President Trump’s October 12, 2017, Executive Order that would allow insurers to sell “short-term” health plans that provide coverage for up to 364 days. The proposed rule is open for comment for 60 days. The measure would nullify an Obama administration directive issued in October 2016 that banned short-term plans lasting longer than three months.

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In a speech to hospital executives earlier this week, new Health and Human Services Secretary Alex Azar outlined his agenda for improving the value of health services provided to patients. He clearly understands that the number one problem in U.S. health care is the prevalence of wasteful spending on services that drive up costs without improving the health of patients.

The many previous efforts aimed at tackling this immense and complex problem have barely put a dent in it. Azar made it evident that, from his perspective, the solution is a market-driven system with informed and active consumers making cost-effective decisions about their own care. He was also appropriately ambitious as he begins his tenure, putting everyone on notice — including those with vested interests in the status quo, as well as his own HHS employees — that big changes are coming, one way or another.

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