As House Republicans passed legislation toppling large portions of the ACA, groups representing hospitals, doctors, consumers and some insurers made no secret of their displeasure. Now, in the Senate, which hopes to complete its own version of a health overhaul by August, Republicans are unambiguous about their intention to draft an entirely new bill in a more deliberate manner with input from outside groups. Sen. Orrin Hatch of Utah, the Senate Finance chairman whose committee is responsible for drafting much of the legislation, has specifically asked for suggestions from industry associations.
. . .
CBO claims that the House repeal and replace bill could degrade the quality of insurance. This editorializing could use some scrutiny. Without government supervision of insurance minutiae and a mandate to buy coverage or pay a penalty, CBO asserts that “a few million” people will turn to insurance that falls short of the “widely accepted definition” of “a comprehensive major medical policy.” Under the House reform, Americans won’t have any problem insuring against a bad health event, even if CBO won’t admit it. The House bill is designed is create more alternatives that can accommodate the diverse needs and preferences of a nation of some 320 million people. CBO has become a fear factory because it prefers having government decide for everybody.
. . .
The political world waited with rapt attention Wednesday for the oracles at the Congressional Budget Office to release their cost-and-coverage predictions for the revised House health reform bill. CBO confirmed that the American Health Care Act (AHCA) is a major fiscal dividend, cutting taxes by $992 billion, spending by $1.1 trillion, and the deficit by $119 billion over 10 years. However, CBO says 14 million fewer people on net would be insured in 2018 relative to the ObamaCare status quo, rising to 23 million in 2026. The problem with this educated guess about enrollment is that CBO’s models put too much confidence in the effectiveness of central planning. CBO’s projections about ObamaCare enrollment are consistently too high and discredited by reality year after year.
. . .
After the House voted last week to repeal and replace ObamaCare, Democrats quickly launched a barrage of false attacks. Minority Leader Nancy Pelosi asserted that the bill would “gut” protections for patients with pre-existing conditions. Never one to shy away from melodrama, she added: “This is deadly. This is deadly.” Apparently the GOP proposal is the second health-care bill Mrs. Pelosi didn’t read. The legislation makes clear: “Nothing in this Act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”
. . .
Barack Obama emerged from his short-lived political retirement on Sunday to call on Members of Congress to show the “political courage” to preserve ObamaCare. But wait. That plea doesn’t square with the deluge of recent stories predicting that Republicans have doomed their majority in 2018 by voting last week to repeal ObamaCare. How does it take “political courage” to oppose something that everyone claims is politically suicidal?
Perhaps because the predictors of Republican doom could be wrong. The midterm election is still 18 months away, and many events will intervene that could influence the result. But even if the campaign does turn on repealing ObamaCare, we’d argue that the politics are better for Republicans if they pass their reform and fulfill a campaign promise than if they fail and then duck and cover.
. . .
Republicans finally hit a home run with a 217-213 vote Thursday to pass a health care bill that will help millions of struggling Americans. They proved they can govern. Yet one of Republicans’ most notable successes is so far getting too little recognition. GOP negotiators embraced the only model that can ultimately see this bill successfully to President Trump’s desk: states’ rights. The compromise is far from perfect—concocted, as it was, under pressure, and with dozens of competing interests in the room. The Senate offers Republicans an opportunity to do much better by building on the idea’s model of states’ rights.
. . .
Against the odds, House Republicans have regained momentum on health-care reform, and they’re nearing a majority coalition. While there may be more swerves before a vote, they ought to appreciate the importance of demonstrating that a center-right Congress—working with President Trump —can govern.
There are still holdouts and others are undecided in the GOP’s moderate and conservative wings, but their differences are narrowing. More members are also recognizing their political mistake in trashing the original ObamaCare repeal and replace bill.
. . .
Aetna Inc. will again scale back its presence in the Affordable Care Act exchanges in 2018, saying it expects losses on the business this year.
Individual plans are a small share of Aetna’s overall business, and the insurer had already scaled back its exchange presence to four ACA marketplaces currently, down from 15 last year.
Aetna said it expects 2017 losses on its individual business will amount to roughly half its loss last year, which was $450 million.
. . .
House conservatives rebelled over the original version of the American Health Care Act, which only partially deregulated insurance markets. The bill maintained the rule known as guaranteed issue, which requires insurers to cover all applicants regardless of medical history. It also relaxed community rating, which limits how much premiums can vary among beneficiaries.
The media and the left thus claim that conservatives want to allow insurers to charge sick people more, and some conservatives agree, which spooks the moderates. But the latest compromise between conservatives and centrists doesn’t repeal guaranteed issue or community rating. It keeps these regulations as the default baseline, and states could apply for a federal waiver if they want to pursue other regulatory relief.
. . .
A renewed effort to bring a House Republican plan to the floor faltered by week’s end, a blow to President Donald Trump’s hopes of landing a health-care deal in his first 100 days. Republicans are vowing to push ahead with the bill, saying it has stalled but not died.
But the herculean struggle to craft a politically viable proposal reflects the party’s sharp divisions and rising support for the ACA. Conservative Republicans want to gut most of the existing law, citing rising premiums and limited choice. Moderate Republicans remain reluctant to support a new plan that erases the ACA’s expanded coverage and patient protections.
. . .