Influential members of Congress are supporting reenacting a health care bill that passed Congress last January called the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, or H.R. 3762. That bill would have repealed Obamacare’s tax hikes, Medicaid expansion, and insurance exchange subsidies. But critically, this partial repeal bill does not get rid of Obamacare’s tens of thousands of pages of insurance regulations, which are responsible for the law’s drastic premium hikes. If Republicans pass a replica of H.R. 3762 in the first quarter of 2017, they will be making a potentially catastrophic mistake that might make it impossible for them to replace Obamacare later on. To avoid those pitfalls, they need to wipe out Obamacare’s costliest insurance regulations in the new partial repeal bill and retain about three-fifths of Obamacare’s tax hikes to create fiscal room for the replacement.

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About 6.4 million people have signed up for health insurance next year under the Affordable Care Act, the Obama administration said Wednesday, as people rushed to purchase plans regardless of Republican promises that the law will be repealed within months.

The new sign-ups — an increase of 400,000 over a similar point last year — mean the health care coverage of millions of consumers could be imperiled by one of the first legislative actions of Donald J. Trump’s presidency. Hundreds of thousands of other people who took no action will be automatically re-enrolled by the federal government in the same or similar plans, officials said, and their coverage could be threatened as well. Consumers still have until the end of January to enroll.

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The news is all full of supporters of the Affordable Care Act warning about how the health insurance system will collapse if, as various Republican repeal programs propose, the “individual mandate” is immediately gutted while parts of the ACA briefly solider on. It’s not that the people issuing the warning aren’t correct. Repeal of the individual mandate without some immediate replacement will clearly reduce the stability of whatever markets would otherwise remain as the ACA continues its death march. It’s just that many of them are hypocrites.

It was the Obama administration and supporters of the ACA who essentially gutted the individual mandate.

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Galen Institute President Grace-Marie Turner on why she supports President-elect Donald Trump’s pick for Tom Price as the next Health Secretary.

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Do you think it is a bit strange that after 7 years, Republicans in Congress still don’t have a replacement plan for Obamacare? Or that they now tell us that developing one will take 3 or 4 more years. And of course, once they have a plan it will take state governments and insurance companies two or three more years to phase it in. So, we are looking at a decade’s delay. That’s if we are lucky.

Suppose the tables were turned.  If Obamacare were a Republican reform and Democrats controlled Congress, how long would it take the Democrats to come up with a better plan? They’d do it in a heartbeat. They would do it by doing what Democrats are traditionally good at: putting ideology aside and finding solutions that make all the major stakeholders better off.

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With Republicans controlling both ends of Pennsylvania Avenue next year, they have a great, and rare, opportunity for reform. The question now is whether Donald Trump and a new congressional generation can enact center-right reform solutions, and the first proving ground will be ObamaCare. If Republicans don’t repeal the law immediately, the danger is that the natural inertia of Congress takes over and nothing changes. But the more time they put between repeal and replace, the more the danger will grow. Now’s the chance to show they can reform the entitlement state with solutions that improve the daily lives of Americans.

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In crafting an Obamacare replacement, Donald Trump and Republican congressional leaders will have to unite on complicated changes affecting the financial and physical well-being of millions of people. Republicans have “a really narrow path,” says Grace-Marie Turner. “They’ve got to deal with the politics of this, they’ve got to make sure they come up with good policy, and they also have to process challenges.” House Ways and Means Chairman Kevin Brady (R-TX) says of the challenge, “Unlike Obamacare, which ripped up the individual market, this will be done deliberately, in an appropriate timetable.”

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When President-elect Donald Trump chose Representative Tom Price of Georgia to be his health and human services secretary, the American Medical Association swiftly endorsed the selection of one of its own, an orthopedic surgeon who has championed the role of physicians throughout his legislative career.

Then the larger world of doctors and nurses weighed in on the beliefs and record of Mr. Price, a suburban Atlanta Republican — and the split among caregivers, especially doctors, quickly grew sharp.

“The A.M.A. does not speak for us,” says a petition signed by more than 5,000 doctors.

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Beginning in January, the Republican-controlled Congress, working with the incoming Trump administration, will have the opportunity to roll back the Affordable Care Act and replace it with a plan that is less driven by federal control and regulation. The starting point for this effort ought to be that everyone in the United States should have health insurance, protecting them against major medical expenses. To do so, the GOP should:

  • Grandfather Coverage Provided by the ACA
  • Accept and Clarify Medicaid’s Role as the Safety Net Health Insurance Program
  • Impose Cost-Discipline and Generate Revenue with an Upper Limit on the Tax Preference for Employer-Paid Premiums
  • Build an Effective Auto-Enrollment Program to Achieve Higher Levels of Coverage