Not even 24 hours after the latest “repeal and replace” proposal ran out of steam, Sen. Rand Paul (R-Ky.) ignited a new round of health policy speculation by predicting, during a cable news interview, impending Trump administration action on a longtime Republican go-to idea: association health plans.
“If [consumers] can join large groups, get protection and less expensive insurance … it will solve a lot of problems in the individual market,” Paul said last week on the MSNBC show “Morning Joe.”
Later, President Donald Trump told reporters that he would “probably be signing a very major executive order” that could affect “millions of people.”
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California and several other states will exempt themselves this year from a new Trump administration rule that cuts in half the amount of time consumers have to buy individual health insurance under the Affordable Care Act.
In California, lawmakers are contemplating legislation that would circumvent the rule in future years, too.
The Trump administration’s rule gives people shopping for 2018 coverage on the federal exchange 45 days to sign up, from Nov. 1 through Dec. 15.
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Nearly 8 in 10 Americans say President Donald Trump should be trying to make the health law work, according to poll conducted by the Kaiser Family Foundation. This includes large majorities of Democrats (95 percent) as well as half of Republicans (52 percent) and President Trump’s supporters (51 percent).
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As congressional Republicans’ efforts to repeal and replace the Affordable Care Act remain in limbo, the Trump administration and some states are taking steps to help insurers cover the cost of their sickest patients, a move that industry analysts say is critical to keeping premiums affordable for plans sold on the law’s online marketplaces in 2018.
This fix is a well-known insurance industry practice called reinsurance. Claims above a certain amount would be paid by the government, reducing insurers’ financial exposure and allowing them to set lower premiums.
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Despite days of intense negotiations and last-minute concessions to win over wavering GOP conservatives and moderates, House Republican leaders Friday failed to secure enough support to pass their plan to repeal and replace the Affordable Care Act.
House Speaker Paul Ryan pulled the bill from consideration after he rushed to the White House to tell President Donald Trump that there weren’t the 216 votes necessary for passage.
“We came really close today, but we came up short,” he told reporters at a hastily called news conference.
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Despite heated congressional hearings on whether Rep. Tom Price should head the U.S. Department of Health and Human Services, President Donald Trump’s promise to “repeal and replace” the Affordable Care Act is already in motion.
On Inauguration Day, Trump signed an executive order urging federal officials to “take all actions consistent with law to minimize the unwarranted economic and regulatory burdens” of the federal health law.” Meanwhile, several Republican plans for a replacement to the law are in the works, including proposals to block grant Medicaid and another that would allow states that embraced the law to maintain it.
The American public appears divided on the law, which has resulted in coverage of more than 20 million people. A Kaiser Family Foundation poll conducted in December found that Americans are evenly divided on the fate of the law — 49 percent of respondents said Congress should vote to repeal it, while 47 percent said they should not. Just one in five agreed with the Republican strategy of repealing the law before creating a replacement. (KHN is an editorially independent service of the foundation.)
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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.
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Steven Lopez has gone without health insurance for 15 years, and the Affordable Care Act hasn’t changed his mind. Once again this year he will forgo coverage, he said, even though it means another tax penalty.
Last tax season, the 51-year-old information technology professional and his family paid a mandatory penalty of nearly $1,000, he said. That’s because they found it preferable to the $400 to $500 monthly cost of an Obamacare health plan.
“I’m paying $6,000 to have the privilege of then paying another $5,000 [in deductibles],” said Lopez, who lives in Downey, a suburb of Los Angeles. “It’s baloney — not worth it.”
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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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Having health insurance is vital for 21-year-old Mercedes Nimmer, who takes several expensive prescription drugs to manage multiple sclerosis. So Nimmer was thrilled to get health insurance last year through the Affordable Care Act’s marketplace and qualify for a federal subsidy to substantially lower her cost.
Yet, the government assistance still left her with a $33 monthly premium, a hefty amount for Nimmer, who makes $11,000 a year as a part-time supply clerk.
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