Price is of the view that we are going to end up subsidizing the health care of the poor and the indigent one way or the other. We can do it through cost shifting and subsidies conferred on impersonal hospital bureaucracies or we can give the money to the people and let the bureaucracies compete for their patronage. The Price tax credit would be refundable and it would vary by age. But unlike the Obamacare credits, Price’s credit would be the same, regardless of income.

That last feature is huge. The most important reason why the exchanges have been so dysfunctional is the need to verify income.

. . .

Hospitals and health insurers are gaining confidence that their nightmare scenario – millions of Americans instantly losing health insurance once President-elect Donald Trump delivers on a promise to “repeal and replace” Obamacare – is looking more like a bad dream than becoming reality.

The early view from the healthcare sector still includes an end eventually to President Obama’s signature health program.

But Trump’s picks to head the U.S. health department and its top regulator on Tuesday, along with his recent softening on some aspects of the existing law, is a sign to some sector insiders that instead of chaos, an orderly transition of up to three years to replace it with a plan that healthcare companies actually want could be in store.

. . .

Congress may vote to repeal President Barack Obama’s health care law before coming up with a replacement, GOP leaders said Tuesday.

The approach could allow congressional Republicans to take swift action on one of President-elect Donald Trump’s campaign promises, while putting off the hard part. And while repealing the law could be done with GOP votes alone, any replacement plan would likely require the cooperation of minority Democrats in the Senate, something that will not be easy to come by.

. . .

House Republicans are taking pole position in repealing and replacing ­ObamaCare with Donald Trump’s pick of Tom Price as secretary of Health and Human Services.

The Republican lawmaker from Georgia, a confidant of Speaker Paul Ryan(R-Wis.) and Vice President-elect Mike Pence, is a former physician with a deep understanding of both the thorny politics and wonky details of healthcare.

. . .

 

Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies. The class of medicines known as specialty drugs treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers, and hepatitis C. Some medicines can cost $10,000 a month. Even a small cost-sharing requirement means patients could have to come up with thousands of dollars to get the medicines.

. . .

The most likely scenario to achieve reform and assure coverage similar to what currently exists is to pass a reconciliation bill similar or identical to the bill passed approximately a year ago. This bill eliminated funding for the Medicaid expansion and the subsidies in the exchange and also includes a two-year implementation delay. Since the majority of newly insured individuals have come from Medicaid rather than the exchanges, this portion of the repeal, unless accompanied by other changes such as a refundable tax credit, would have the largest effect on the newly insured.

. . .

Any Republican attempt to replace the Affordable Care Act must address Medicaid, which has literally become the 800-pound gorilla in the health-care policy room. Simply rolling back the ACA’s Medicaid expansion would spike the number of uninsured Americans and expose Congress and the Trump administration to withering criticism. On the other hand, leaving Medicaid unchanged exposes the federal budget to the program’s unsustainable cost trajectory: Federal Medicaid spending has doubled over the past decade.

. . .

On Tuesday, President-Elect Donald Trump announced that he will nominate Rep. Tom Price (R., Ga.) for Secretary of the U.S. Department of Health and Human Services. It’s a strong pick, and one that increases the likelihood that Republicans will succeed in repealing and replacing Obamacare. Here’s why.

Price, who chairs the House Budget Committee and represents the northern suburbs of Atlanta, has long been one of the House of Representative’s foremost policy wonks. He previously chaired the Republican Study Committee and the Republican Policy Committee, two of the most significant Congressional engines of conservative policy thinking.

And he has long been passionate about, and constructive on, health care reform.

. . .

With Trump’s election, there is suddenly a lot of question about the fate of Obamacare. Will it be repealed, in part or in whole? And if so, replaced with what?

One place to look for answers is in a new article about Obamacare’s coverage expansion. Learning more about what has already happened with Obamacare turns out to provide some clues about what may happen to it in the future.

That’s because Molly Frean, Jonathan Gruber and Benjamin D. Sommers provide a detailed look, not just at the amount of coverage expansion but also the sources of it. According to the authors’ analysis, they can explain about 70 percent of the decline in the number of uninsured people through three factors: the subsidies for buying insurance; the law’s more generous criteria for Medicaid eligibility; and the “woodwork effect,” in which people who were previously eligible for Medicaid “came out of the woodwork” and signed up for the program in 2014.

. . .

If Donald Trump and the Republican Congress have a mandate to do anything, it is to repeal Obamacare. The law is already cratering. Sick enrollees, former president Bill Clinton laments, are seeing “their premiums doubled and their coverage cut in half.” Even supportive economists admit the program is in a death spiral.

Repeal won’t be easy. But if Trump sets for Congress the same agenda he laid out during the campaign, he could become America’s greatest health-care reformer, all while cutting taxes more than Ronald Reagan and George W. Bush combined.

. . .