Stay up-to-date on Healthcare Reform

healthmarkets.com: Below is a summary of recent events to help you stay current on healthcare reform news all in one place. To make your voice heard on these issues, visit OurCareBill.org,  a non-partisan movement that lets you share your opinion on healthcare legislation with friends, family and even Washington!

News Update for January 19, 2017

Trumpcare Could Auto-Enroll You in Coverage Without Asking

Republicans in Congress are considering the idea of automatically enrolling everyone in coverage unless they choose to opt out. This auto-enrollment idea has been presented before in some of the top Obamacare replacement proposals. But there is no agreement among Republicans as of yet about implementing this idea. A senior GOP aide said, “There’s a lot of work being done to look into it.”

Obamacare Critic to Lead Efforts in Replacing the Healthcare Law

Representative Greg Walden (R-OR), who has been a longtime opponent of Obamacare, is now the Chairman of the Energy and Commerce Committee, which oversees healthcare policy. In an interview with Politico, Walden said his plan is to “repair” and “rebuild” the healthcare law—a softer approach than that of some of his fellow Republicans who emphasize “replacement” of the law. “Walden insists that any replacement plan for Obamacare won’t be ‘preordained’ by GOP leaders. Rather, he said he intends to solicit ideas from colleagues on both sides of the aisle and is already in touch with governors and those in the health care market.”

Republican Governor Wants States to Lead Obamacare Replacement

Governor Scott Walker of Wisconsin wants each state to be in control of the Obamacare replacement process. Walker told CNBC’s “Squawk Box”: “We’re one of the best states in the nation in terms of coverage. We have one foundation called No Insurance Gap, and we didn’t take the Obamacare Medicaid expansion, we didn’t set up a state exchange, yet we have one of the lowest rates of uninsured in the country.” He also added, “We can do it elsewhere as well. Just give us the flexibility to do it state by state.”

Republican Senator Wants Party to Work With Democrats on Obamacare

In an interview with CNBC’s “Squawk Box” on Thursday, Senator Ron Johnson (R-WI) said that Republicans will need help from Democrats to fix the healthcare law. “My thought process is let’s start working with Democrats, let’s transition to a system that’ll actually work that Democrats are talking about. They want to fix it, let’s fix it for the benefit of the American public,” Johnson said.

Tom Price Wants Access to Health Insurance for All, But Not Coverage for All

In a courtesy hearing before the Senate Health, Education, Labor and Pensions Committee on Wednesday, Trump’s nominee for secretary of the Department of Health & Human Services, Tom Price (R-GA), said he wants every American to have access to health insurance. However, Price didn’t say the same thing as Trump concerning “insurance for everyone.” “During Wednesday’s hearing, Price also insisted his ideas for replacement would put patients at the center of their care by providing them with more choices and fewer mandates.”

Pence Promises Affordable Coverage for Everyone

On Wednesday, Mike Pence said that the replacement for Obamacare will “make health insurance affordable for everyone.” “Pence promised an ‘orderly transition out of Obamacare’… and said that the incoming administration is ‘very close’ to completing a plan with Congressional leadership.”

News Update for January 18, 2017

Republican Senator Proposes That States Can Decide if They Want to Keep the Health Law

Senator Bill Cassidy (R-LA) proposed to Democrats that states can keep the health law if they like it, get rid of it, or transition to a replacement system using health savings accounts (HSAs) and automatic health insurance enrollment. Cassidy commented, “You can go to the reddest state and say we have the option to root and branch it, and you can go to the bluest state and say we have the option to keep what we like.” With Cassidy’s plan, “Republicans say, ‘You have the option to keep your plan,’ and we mean it.”

Republican Senators Plan to Introduce Obamacare Replacement Next Week

Senator Susan Collins (R-ME) and Senator Bill Cassidy (R-LA) will be introducing legislation for replacing Obamacare to lawmakers on Monday. “The Cassidy-Collins plan comes after congressional Republicans voted last week to lay the groundwork for ObamaCare repeal by passing a budget resolution that includes rules for repeal.”

Budget Committees Say 18 Million More Uninsured if Obamacare Is Repealed Without Replacement

On Tuesday, the nonpartisan Congressional Budget Office along with Congress’ Joint Committee on Taxation issued a report, which claims that health insurance premiums would increase for millions of people and 18 million more would become uninsured in one year if most of the healthcare law is repealed without a replacement. The budget committees reviewed a Republican bill – which was vetoed by President Obama last January – that proposed getting rid of federal subsidies, Medicaid expansion, and tax penalties for people who don’t buy insurance and for large employers that don’t offer coverage. If Republicans pass a new health law that gets rid of these provisions, individual insurance premiums (excluding employer-sponsored coverage) would go up by 25 percent after the first year of passage and double by 2026. In addition, the uninsured rate would jump to 32 million over the next 10 years.

News Update for January 17, 2017

How ACA Repeal Could Affect Large Employer Health Plans

Certain provisions in the Affordable Care Act (ACA) that apply to individual health and small employer plans also apply to large employer group plans. For example, the ACA mandated that all health plans must meet a minimum value of coverage. Because of this provision, “large employers generally no longer offer so-called ‘mini-med’ policies with very skimpy benefits.” Another provision that may affect large employer group plans is the ACA’s “no waiting period” mandate, which ensured that employers can no longer let new employees wait to enroll in health benefits for more 90 days.

Ryan and Trump May Battle Over Possible Medicare Reform

House Speaker Paul Ryan and President-elect Donald Trump may go head-to-head over their views on Medicare reform. Ryan wants reform for entitlement benefits like Medicare and wants to turn Medicare into a voucher program. However, Trump said during his campaign that he doesn’t want entitlement reform. “But if Ryan sides with Trump and doesn’t include his proposal to turn Medicare into a voucher program in the budget, it may never pass.”

Obamacare Replacement Under Trump May Utilize Marketplace Competition

Sean Spicer, incoming White House press secretary, said in an interview with NBC’s “Today Show” that Trump’s plan is “to get insurance for everybody through marketplace solutions, through bringing costs down, through negotiating with pharmaceutical companies, [and] allowing competition over state lines.” Concerning an expansion of government healthcare, Spicer commented that there would be improvements on access to healthcare and costs would go down through marketplace competition.

Trump, Price, and GOP Leaders Have Opposing Views on Obamacare

Trump said over the weekend that he wants “insurance for everybody.” But Trump’s vision for healthcare not only differs from that of his own party, but it also seems to be different from that of his pick for Health and Human Services Secretary, Tom Price. Price’s conservative proposal for healthcare favors a complete overhaul of the current system and doesn’t include universal coverage for everyone. With opposing ideas from Trump and Price, Republican lawmakers aren’t sure how to proceed with drafting a replacement plan.

Obamacare Becoming More Popular Among Americans

Despite the pending repeal of the healthcare law by Republicans, survey results show that Obamacare is growing in popularity. “And half of Americans—50 percent—say they have little to no confidence that Republican proposals to replace the law will make things better.” The survey also found that 45 percent of people think the healthcare law is a good idea while 41 percent thinks it’s a bad idea.

News Update for January 16, 2017

Rand Paul Drafting New Health Law to Replace Obamacare

Senator Rand Paul (R-KY) said he’s writing legislation to replace Obamacare, which includes making the sale of limited-coverage insurance policies legal. In a CNN “State of Union” interview on Sunday, Paul said, “That means getting rid of the Obamacare mandates on what you can buy.” Paul also talked about small businesses being able to join together to better negotiate health insurance prices.

Trump May Have Hurt His Party’s Repeal-and-Replace Plans by Promising Universal Healthcare

Regarding an interview that President-elect Donald Trump did over the weekend, the Washington Post writes, “We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.” Health insurance for everyone is known as universal healthcare, which has not been a part of the Republicans’ healthcare reform plans.

House Approves Budget Resolution

The House approved the Republicans’ budget resolution measure on Friday with a vote of 227 to 198. This approval prevents Democrats from using a Senate filibuster to stop the repeal-and-replace process. With the budget resolution now approved by both the House and Senate, the next step for Republicans is to decide which parts of the healthcare law to reform.

Chuck Schumer Issued Warning Over Obamacare Repeal

Senate Leader Chuck Schumer (D-NY) warned Republicans that Democrats will not help them if they repeal Obamacare without first implementing a replacement plan. Schumer reported that he would work with Republicans to improve Obamacare or create reform bills, but only under certain conditions. “So long as it covers as many people as the ACA, so long as it helps bring healthcare costs down, so long as it doesn’t move our healthcare system backward,” he said.

GOP Lawmakers Want to Cut Funding for Optional Medicaid Benefits

Senate Finance Committee Chair, Orrin Hatch (R-UT), and House Energy & Commerce Committee Chair, Greg Walden (R-OR), sent a letter to the Medicaid and CHIP Payment and Access Commission (MACPAC) asking for a report that would help them find ways to cut spending for optional benefits and eligibility groups under Medicaid. “They gave MACPAC until Jan. 25 to outline what it would take to create such a report. A spokeswoman for MACPAC confirmed receipt of the letter and said it will respond by the deadline.”

News Update for January 13, 2017

House Lawmakers Set to Follow the Senate’s Lead on Repealing the Health Law

Lawmakers in the House of Representatives are expected to give a final vote on approving the Republicans’ budget resolution measure today. But Rep. Andy Harris of Maryland, a member of the conservative House Freedom Caucus said, “We’d like to see a little more flesh on the bone before we sign on the dotted line.”

House Liberty Caucus Doesn’t Want the Budget Resolution to Pass

Members of the House Liberty Caucus want House lawmakers to reject the budget resolution that passed in the Senate on Thursday. “‘This may be the worst budget ever seriously considered by Congress,’ said caucus Executive Director Matt Weibel, in a statement announcing the recommendation. ‘It never balances, and it grows the national debt by more than $9 trillion over the next decade—to nearly $30 trillion—dwarfing debt increases proposed by even the most far-left budgets.’”

Republican Governors Fight to Protect Their State’s Healthcare

Republican governors whose states have benefited from Obamacare are at odds with their fellow Republicans in Congress over the health law. These governors could have some influence over how the House will vote on the budget resolution. Tommy Thompson, a former governor of Wisconsin and a former secretary of the Department of Health and Human Services said, “They will have a much more or a substantial influence on things like Medicaid.”

ACA Repeal May or May Not Lead to a Market Meltdown

Some policy experts think that Republicans are at risk of causing a meltdown of the insurance market and 30 million people to lose coverage if they repeal the healthcare law without an immediate replacement system. But some healthcare industry leaders think a market crash may not happen because they feel like Republican lawmakers are listening to their proposals on how to smoothly transition through the repeal-and-replace process to avoid a crash.

The Future of Young Adults Being Able to Stay on Parents’ Health Plan

Senate Republicans voted against legislation that would keep certain parts of Obamacare intact, including the provision allowing young adults to stay on their parents’ health plan up to age 26. But some insiders feel that this topic will come up again when it comes time to draft a replacement healthcare law. Health policy expert Joe Antos thinks this provision will remain under the new administration because Trump has said he wants to keep this part of the law, and proposals from several Republicans support keeping the up-to-26 provision.

Six ‘Sleeper’ Health Items That Could Disappear if the Health Law Gets Repealed

Kaiser Health News reported on what they call “health law sleepers.” These are parts of the health law that you may not be aware of that could go away under a repeal. These include:

1. Calorie counts at restaurants and fast food chains
2. Workplace requirements for breast-feeding rooms
3. Limits on surprise medical costs from hospital emergency visits
4. Non-profit hospitals’ community health assessments
5. A women’s right to choose her own OB/GYN
6. Therapy coverage assurances for families who have kids with autism

News Update for January 12, 2017

Republicans Are One Step Ahead in Repealing Obamacare

• The Republicans’ budget resolution measure to start the process of repealing Obamacare was approved in the Senate on Thursday with a simple majority vote of 51 to 48. This puts Republicans one step ahead for the next voting session, which is expected to take place among House members this Friday. “We must act quickly to bring relief to the American people,” said Senate Majority Leader Mitch McConnell (R-KY).
• The approval of the budget resolution involved voting on 19 of its amendments. Senators began voting about 6:30 p.m. on Wednesday and ended around 1:30 a.m. on Thursday.
• The passing of the bill came with much protest from Democrats on the Senate floor. “One by one, Democrats rose to voice their objections. Senator Maria Cantwell of Washington said that Republicans were ‘stealing health care from Americans.’ Senator Ron Wyden of Oregon said he was voting no ‘because health care should not just be for the healthy and wealthy.’” Senator Cory Gardner (R-CO), who presided over the voting, had to bang his gavel several times to tell Democrats they were out of order. “Debate is not allowed during a vote,” he said. The passing of the budget resolution is more of a procedural step that the Republicans need to introduce a special type of legislation known as a reconciliation bill, which will allow them to repeal major parts of Obamacare. You can read more here.

Republican Senator Says the Party Doesn’t Have Total Agreement on Obamacare

“Sen. Ron Johnson said Thursday he ‘will freely admit that Republicans in the House and Senate don’t have total agreement’ on an Obamacare replacement plan despite a late-night budget move to begin repealing the law.” The Republican senator from Wisconsin also said, “I don’t think you’re going to see one massive plan like Obamacare. You’re going to see a step-by-step approach targeting the individual damage of the individual reforms, and we’ll put in replacements for each individual one of those problems. Anyway, that would be my approach. Other people have different ideas.”

Largest U.S. Lobby Group Weighs in on Obamacare Repeal

The U.S. Chamber of Commerce, which is the country’s largest business lobby group, said on Wednesday that quickly repealing Obamacare without having a replacement plan could be a mistake. The group also appealed to the incoming Trump administration to not put up trade barriers. “As a new healthcare plan takes shape, it’s important to remember things were far from perfect before we started, before Obamacare,” Chamber President Tom Donohue said in his annual address outlining the group’s priorities. “Repeal alone is not going to fix our health care, there should be a smooth transition.” You can get more details on the lobby group’s views here.

News Update for January 11, 2017

Trump Pushes for Swift Repeal and Replacement of the Healthcare Law

• President-elect Donald Trump demanded on Tuesday that Congress repeal the health care law now and pass a replacement law quickly. Trump said in an interview with the New York Times, “We have to get to business. Obamacare has been a catastrophic event.” Congress has scheduled for voting to take place this week on the Republicans’ budget resolution bill to repeal certain parts of Obamacare. But Trump appears to be unaware of the voting schedule because he commented that repeal votes should “probably [happen] sometime next week.” Regarding replacement, Trump said it should take place, “very quickly or simultaneously, very shortly thereafter” the repeal. Trump also “threatened Democrats who might stand in his way, saying he would campaign against them, especially in states that he won in November. ‘It may not get approved the first time, and it may not get approved the second time, but the Democrats who will try not to approve it’ will be at risk, he said, warning that ‘they have 10 people coming up’ for re-election in 2018. That alluded to Democratic senators in states he won.”
• Trump also said in his New York Times interview, “I feel that repeal and replace have to be together, for very simply, I think that Democrats should want to fix Obamacare. They cannot live with it, and they have to go together.” But these comments contradict the desires of some of his fellow Republicans who want to have a solid replacement plan before tackling a repeal. “Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Paul Ryan (R-WI) insisted Tuesday that they have no intention of moving ahead with repeal without a consensus replacement plan.” And with the amendment to delay repeal legislation that GOP leaders submitted on Tuesday, Republicans are further divided on the structure and timing of a replacement healthcare law. Read more here in this Washington Post article.
• Lawmakers were surprised at Trump’s demands and some scoffed at the idea of a repeal and replace happening so quickly. Senate Finance Chairman Orrin Hatch said, “That would be pretty fast. It’s possible. I don’t know that it will happen, but it could.” Many GOP leaders were also expecting that Trump would provide more specific details as to what he wants. “‘It would be very helpful for him to weigh in and say exactly basically what he wants done,’ said Sen. Ron Johnson (R-Wis.), before Trump’s interview broke. ‘He’s going to carry a fair amount of weight.’”

GOP Rep Says Obamacare Replacement Bill Will Be Shorter

The Chairman of the House Ways and Means Committee said on Wednesday that the bill to replace Obamacare will be shorter and have more direct language. Rep. Kevin Brady (R-TX) said in an interview, “One big thing, I think people are assuming Republicans will act like Democrats with a 2,000-page bill that no one knows what’s in it. We’re doing just the opposite. Our replacement is going to be step-by-step, thoughtful and understandable.” Brady also commented that the White House will receive legislation to repeal Obamacare in February.

Some Obamacare Enrollees Want the Health Law Repealed

Research from the Kaiser Family Foundation found that the number of Obamacare plan members who are dissatisfied with their coverage increased from 14 percent in 2014 to 29 percent in 2016—some wanting to see Obamacare repealed. Although, some hope that the Republicans’ repeal-and-replace plan will be more financially beneficial. “‘What people really care about is lowering what they and other people have to pay,’ said Liz Hamel, director of public opinion and survey research at the Kaiser Family Foundation. ‘They care less about how you get there and the details. They only want to hear their costs are going down, and that’s where people feel disappointed in the ACA.’” Kaiser found that the cost of premiums and deductibles are two of the biggest concerns. And that unfairness is a major complaint for some enrollees. “In their view, they are being hit with higher costs, while low-income Americans receive free or low-cost treatment.”

News Update for January 10, 2017

Republicans’ Repeal-and-Delay Plan Faces Challenges

• Republicans in the Senate introduced a budget reconciliation bill last Tuesday as a way to repeal major portions of Obamacare. “On Monday night, however, five GOP Senators … submitted an amendment to the bill in the Senate that would extend the deadline for the committees to craft a repeal bill from its current January 27 deadline to March 3.” Senator Bob Corker (R-TN), who was among GOP leaders who submitted the amendment, said on Monday night, “By extending the deadline for budget reconciliation instructions until March, Congress and the incoming administration will each have additional time to get the policy right.” Corker also commented on the fact that Trump had said the repeal-and-replace process should happen at the same time. Senator Tom Cotton (R-AK) is among several GOP leaders who are adamant about a replacement plan before a repeal. Cotton told reporters, “It would not be the right path for us to repeal Obamacare without laying out a path forward.” This Business Insider article talks more about the story.
• Senator Rand Paul (R-KY) is also strongly opposed to repeal-and-delay, “as he argues that the two votes must happen simultaneously.” Paul said to CNN’s Wolf Blitzer on Monday, “I will do everything in my power to have a vote on it the day we repeal Obamacare.”
• In a phone conversation between Senator Rand Paul and President-elect Donald Trump, Paul reported, “He showed willingness and openness and was interested in getting a replacement that could be passed as part of repeal. Now, we’re trying to get a bill out there this week.” Paul also commented that Trump didn’t provide any details about what would be included in a replacement plan. You can read more about his story here.
• For a repeal to happen, “Republicans need a House majority, 50 Senate votes, and soon-to-be President Trump to pass repeal and delay.” If the party loses 3 Senate votes, this will bring the number of Senate Republican votes down to 49, and the repeal-and-delay bill won’t pass. Along with Democrats who are against the repeal-and-delay bill, at least 3 Senate Republicans are now in opposition.
• With the addition of 3 Republican senators who expressed opposition to repeal-and-delay at the Senate meeting Monday night, the number of Republicans who oppose this strategy now total 9. Besides the Senate, “members of the House Freedom Caucus on Monday evening issued their own call for slowing down the repeal process.” In light of these events, the Republicans’ expectation for a smooth and quick repeal-and-replace is unlikely.

News Update for January 9, 2017

GOP Planning Quick Repeal of Obamacare

• “The Senate is expected to take a long string of votes on Wednesday, known as a ‘vote-a-rama,’ on a budget resolution that is the first step to repealing ObamaCare.” This voting process allows Democrats to offer provisions that could make things difficult for Republicans. However, Democrats don’t have enough votes to stop the budget resolution.
• Republicans told the press that they will act quickly to pass a new healthcare law, but they didn’t provide a timeline for doing so. Senate Majority Leader Mitch McConnell (R-KY) commented, “We will be replacing it rapidly after repealing it.”
• Trump advisers, Kellyanne Conway and Reince Priebus, told interviewers that Trump is still deciding on how fast replacing Obamacare will take. In an interview on CNN’s “State of the Union,” Conway said, “Well, it really depends what — what the piece of legislation is.” Conway didn’t provide any details about Trump’s timing for a replacement, but said that a replacement solution should allow people to buy coverage across state lines and use health savings accounts. Priebus gave a little more detail about Trump’s possible plan in his interview on CBS’ “Face the Nation.” He said, “I will tell you that it would be ideal if we could do it all in one big action. But look, it may take time to get all the elements of the replace in place.”

Senate Democrats Plan to Hold Late-Night Meeting to Oppose Repeal

“On Monday night, Senate Democrats plan to stay up late, delivering floor speeches and Facebook Live broadcasts attacking the Republicans’ drive to dismantle President Barack Obama’s signature health care law.” This late-night fight against Obamacare repeal was organized by Senate Minority Leader Chuck Schumer (D-NY). Schumer said, “We are taking to the floor and social media to denounce this plan and warn the American people that the Democrats will be fighting tooth and nail against this potentially catastrophic move.”

Obama Open to Calling New Healthcare Law ‘Trumpcare’

President Obama told the press on Sunday that he’s fine with Republicans creating changes to the healthcare law and naming it “Trumpcare” instead of “Obamacare.” “The president … also suggested that he has wanted to make the kind of changes to ObamaCare that Trump and fellow Republicans in control of Congress are seeking.” Obama said, “But they wouldn’t cooperate because they didn’t want to make the system work.”

News Update for January 6, 2017

Few Americans Support Republicans’ Repeal-and-Delay Plan

• According to a Kaiser Family Foundation poll released today, just 20 percent (1 in 5) of Americans are in favor of lawmakers voting to repeal the health law immediately and figuring out a replacement plan later. The survey also found that:47 percent don’t think there should be a vote to repeal
• 48 percent are in favor of a vote to repeal28 percent support a vote to delay a repeal until there’s a replacement plan
• 20 percent support a vote to repeal immediately and figure out a replacement plan later
• 5 percent either don’t know or refused to answer concerning a vote to repeal and replace
• The survey revealed that “Obamacare isn’t even people’s top health care concern. The vast majority—67 percent—say their top priority is finding a way to lower their health care costs.” The second priority for Americans is lowering prescription drug costs, which came in at 61 percent.
• Kaiser Family Foundation’s president, Drew Altman, said, “For me, the really pertinent question, the big question, is: Is there a mandate for repealing the ACA without a replacement plan? What we see in our poll and what we see in our focus groups is: If there is, it is a very weak one. It’s not obvious there’s a mandate for repealing the ACA without putting a replacement plan on the table.”

Paul Ryan Says Lawmakers Will Act on Bills to Replace Obamacare, Not Just Repeal It

House Speaker Paul Ryan (R-WI) told the press on Thursday that, “Our legislating on Obamacare, our repealing and replacing and transitioning, the legislating will occur this year.” “Ryan spokeswoman AshLee Strong said by ‘legislating,’ Ryan meant lawmakers will write legislation and vote on it.” John Cornyn (R-TX), who is the No. 2 GOP leader of the Senate, said he would make creating new legislation for healthcare a top priority in his chamber. However, he didn’t comment on whether or not senators would finish writing legislation this year. Cornyn also told reporters that, “The Senate operating at warp speed is still nothing compared to what the House can do.”�

Democrats Appeal to Republicans for Compromise on Health Law

“With Republican leaders pressing to dismantle the Affordable Care Act, possibly within weeks, moderate Senate Democrats reached out on Thursday to Republicans, appealing for them to slow down the repeal efforts and let lawmakers try to find acceptable, bipartisan changes to make the existing law work better.” Senator Tim Kaine (D-VA), who was selected to be the Democratic Vice President, said, “There’s so much we can improve, but by pushing an immediate repeal through a partisan budget process, we won’t have the opportunity to work together to build on that common ground.”

Republican Governors Want to Save Medicaid Expansion From Repeal

Some Republican governors are appealing to congressional members of their party to keep ACA Medicaid expansions, but GOP experts don’t think their appeals will persuade congressional Republicans to do so. Several Republican governors also report on how Medicaid expansion is helping their states. Republican Ohio Governor John Kasich said on Wednesday that expansion was a major factor in helping those in his state who struggle with opioid addiction—about 700,000 people in Ohio were able to get Medicaid because of the expansion. Kasich commented, “Thank God we expanded Medicaid because that Medicaid money is helping to rehab people.” Republican Michigan Governor Rick Snyder in an interview with The Detroit News said, “I hope they carefully look at the success we’ve had in Michigan. We’re seeing a huge increase in coverage.”

News Update for January 5, 2017

Republicans Divided Over Obamacare Repeal-and-Replace

• The meeting between Vice President-elect Mike Pence and Senate GOP members was meant to bring unity on the proposal to get rid of Obamacare. However, many senators expressed disagreement on repealing and replacing Obamacare because doing so could crush the budget. Some of the rising members of the party argued that dismantling the healthcare law that has provided coverage to millions of Americans is a more difficult undertaking than simply campaigning against it. Senator John Thune (R-SD) in commenting on the chaos within the caucus said, “Most of the issues are with respect to replace. I don’t think repeal is that complicated. We’ve done that once. But yes there are budgetary considerations when it comes time to replace. It’s complicated, we’ve got a lot of moving parts.” Because of different opinions among members of the House and Senate, the party has not reached a consensus on how long the healthcare law will remain in effect and how to replace it.
• The disagreement within the party is also due to the lack of details from Trump and Pence. According to Pence, Trump will use executive orders to “ensure that there is an orderly transition during the period after we repeal Obamacare to a market-based healthcare economy in America.” But Senator Shelley Moore Capito (R-WV) said, “We’re not sure exactly what direction we’re going to go to have a full and careful transition period.” Another member of the party, Senator Rand Paul (R-KY), has made public criticisms about repealing Obamacare. On Wednesday, Paul sided with Democrats to vote against a motion to debate resolutions for a repeal.

Battle Over Obamacare Leads to a War of Words

• Trump issued a warning to Republicans in Congress that rushing to repeal the health law could spark backlash, and that they would fare better by allowing Democrats to own what he described as “the failed Obamacare disaster.” This morning, Trump said of Senate Minority Leader Chuck Schumer (D-NY) that he is the “head clown” of the Democrats, and that he and his party “know how bad Obamacare is and what a mess they are in.” Trump posted on Twitter in several tweets, “Instead of working to fix it, they do the typical political thing and BLAME. The fact is ObamaCare was a lie from the beginning. ‘Keep you [sic] doctor, keep your plan!’ It is time for Republicans & Democrats to get together and come up with a healthcare plan that really works—much less expensive & FAR BETTER!”
• Schumer counteracted by proposing an investigation of Tom Price, whom Trump selected for Secretary of the Department of Health and Human Services, because of stocks he has with health insurance companies. This Reuters article writes that Price, an orthopedic surgeon, “bought and sold more than $300,000 in stock in about 40 healthcare, pharmaceutical and biomedical companies over the past four years while sponsoring and advocating legislation that could influence those companies’ shares.”
• “President Barack Obama delivered a mandate to Democrats on Wednesday: ‘Don’t rescue’ Republicans on Obamacare.” This mandate was issued at a meeting Obama had with Democrats at Capitol Hill, the same day Vice President-elect Pence visited the hill. Price said to reporters, “The reality is that I was here in March of 2010 in another capacity when Obamacare was signed into law. I remember all those promises. We were told that if you like your doctor, you can keep it. Not true.” You can read more about this story here.

Democrats Warn the GOP About the ‘Pottery Barn Rule’

According to this Washington Post article, the “Pottery Barn rule” is: “You break it, you own it.” And Democrats are saying that’s exactly what Republicans will be faced with. Schumer said at a news conference, “They’re going to own it and all the problems in the health-care system.” Schumer argued that Republican alternatives to health care will be practically impossible to implement because their plans require a major source of funding that would likely require approval votes from Democrats. Senator John Cornyn (R-TX), who is the 2nd ranking leader of the GOP, in response to Schumer’s comments, said, “I understand his political argument. He’s praying and hoping for failure, which means he’s praying and hoping for more pain on the part of the American people. I would hope they would get past that and would agree to work with us, because a long-term, sustainable replacement for Obamacare is going to need to be done on a bipartisan, consensus-building basis.”

News Update for January 4, 2017

Republicans Introduced a Budget Resolution to Repeal Obamacare

• Congress convened yesterday and their first order of business to dismantle Obamacare was to introduce a budget resolution, which was done by Senate Budget Committee Chair Michael Enzi (R-WY). “Republicans aren’t actually going to repeal all of Obamacare…but they’re going to repeal enough of it to reverse almost all of the coverage gains made under it,” states this Vox article. The article also mentions that the budget resolution repeal bill can’t be filibustered, so Democrats won’t be able to stop the Republicans’ plan “unless three or more Republican senators defect (or 24 House members do). [If this doesn’t happen], it’ll be smooth sailing for the repeal effort from there on out.”
• The budget resolution can only repeal parts of Obamacare, which include tax credits that help make buying health insurance more affordable, the individual mandate to buy health insurance, and the employer mandate to offer health coverage or pay penalties. But the resolution “isn’t expected to include measures that would replace the health law with a new insurance program.”
• After introducing the budget resolution, Enzi posted a press release on his website that says, “Today, we take the first steps to repair the nation’s broken health care system, removing Washington from the equation and putting control back where it belongs: with patients, their families, and their doctors.” If the resolution is approved, the committees involved in deciding which parts of Obamacare to repeal and when repeal changes would go into effect have until January 27 to do so.
• Approval of the resolution requires 60 votes in the Senate of which 52 are Republicans. “That means they [Republicans] won’t be able to pass a full repeal of the law on their own, and it is unlikely eight Democrats would join to overturn President Barack Obama’s signature legislation.”

Repealing Obamacare Could Prove Difficult

Republicans’ repeal efforts may be halted if they don’t get the majority votes they need from the 40-member Freedom Caucus. Leader of the caucus, Rep. Mark Meadows of North Carolina, commented on Tuesday, “It would have to be an unbelievable, compelling case to suggest we need more than two years to repeal and replace the Affordable Care Act.” He also said, “If we’re going to repeal it, we need to repeal the taxes.” One health policy expert said, “Repealing all of the taxes will be politically difficult and structurally problematic.”

Obama and Pence Hold Dueling Meetings at Capitol Hill

• President Obama met with Democrats today, and he commented, “Keep up the fight. Tell the stories about the people who have benefited from it. The more you can get that message through, the better off we’re going to be.” After Vice President-elect Mike Pence’s meeting with House Republicans, he told reporters the goal is to get repeal legislation for Trump to sign by February 20. Pence also commented, “Trump’s team is already working with GOP congressional leaders on plans to undo Obama’s law with both legislation and executive action the president and federal agencies would be able to take.” This ABC News article provides more details.
• Following Pence’s meeting, House Speaker Paul Ryan (R-WI) told reporters, “We have plenty of ideas to replace it [Obamacare].” However, Ryan didn’t provide any details about the ideas; he just said that ideas can be expected in the “weeks and months ahead.”

Democrats Prepared to Fight for Obamacare

• Democrats are ready to fight to keep Obama’s signature health law intact. Two of the most outspoken advocates of Obamacare are Senate Minority Leader Chuck Schumer (D-NY) and House Minority Leader Nancy Pelosi (D-CA). Schumer told the press that, “They have no idea what to put in place of the Affordable Care Act. Republicans will soon learn that you can’t keep the good parts of the ACA and remove the rest of the law and still have it work.” Pelosi commented, “They don’t have the votes for a replacement plan. Repeal and then delay is an act of cowardice.”
• Under the slogan, “Make America Sick Again,” Democrats are launching a counter-attack against the Republicans’ repeal bill by having rallies and using the stories of Americans in red states who’ve benefited from Obamacare. Democrats are “urging followers to bombard lawmakers’ district offices and phone lines with calls against repeal. And they’re targeting moderate Republicans in Alaska, Arizona, Maine, Nevada and Tennessee who are up for reelection in 2018—or who could be influential in the repeal vote—with a seven-figure television and print ad campaign.” The main point of their message is to convey that repeal of the health law without a replacement is reckless.

Trump Advisor Says No One Will Lose Coverage After Obamacare Repeal

Senior advisor to Trump, Kellyanne Conway, stated in an interview with MSNBC’s “Morning Joe” that people who currently have health insurance won’t lose their coverage when Obamacare is repealed and replaced. Conway said, “We don’t want anyone who currently has insurance to not have insurance.” She also commented, “There’s no question that there will be different health insurance coverage in this country under President Trump. Some people, some experts, say it could take years to complete the process.”

News Update for January 3, 2017

Trump Says ‘Obamacare Just Doesn’t Work’

President-elect Donald Trump wrote on Twitter this morning that, “People must remember that Obamacare just doesn’t work, and it is not affordable—116% increases (Arizona). Bill Clinton called it ‘CRAZY.’” He also made a follow-up tweet saying, “The Democrat Governor of Minnesota said, ‘The Affordable Care Act (Obamacare) is no longer affordable!’—And, it is lousy healthcare.” In an NBC Today interview this morning, incoming counselor to Trump, Kellyanne Conway, reported that he “is committed to retaining those pieces [of the Affordable Care Act] his advisers say are working.”

Pence Plans to Rally With House Republicans on Obamacare Repeal

Vice President-elect Mike Pence plans to meet with House Republicans this Wednesday to discuss repealing Obamacare. This Politico article calls the meeting “a counter-punch to President Barack Obama’s visit to the Hill the same day.”

Republican-Led Congress Convenes Today and They Plan to Quickly Tackle ACA Repeal

• The Republican Party now has control of Congress, which convened at noon today. The first thing on the Republicans’ agenda is to proceed with their repeal-and-delay strategy for Obamacare, which involves getting rid of major overhauls and putting off some of their proposed changes for up to 4 years.
• “They plan to pass a truncated budget resolution for the remainder of the fiscal year—already a quarter over—that includes special instructions ensuring that the final repeal legislation could circumvent any Democratic filibuster.” But Republicans may face some challenges because some are divided on how to tackle the ACA and rewrite the tax code while others are hesitant about issues like making major changes to Medicare. You can get more details on this story here.

Republicans’ Lawsuit Against Obamacare Subsides May Be in Jeopardy Under Trump

The House Republicans’ lawsuit against the Obama administration concerning health insurance subsidies faces uncertain outcomes under the Trump administration. But because the case is suspended, House lawmakers report that this will “provide the president-elect and his future administration time to consider whether to continue prosecuting or to otherwise resolve this appeal.” This New York Times article talks more about this issue.

President Obama Will Meet With Democrats to Save Obamacare

• “Obama will visit Wednesday with House and Senate Democrats, the day after the 115th Congress convenes and Republicans, who have the majority in both chambers, are expected to start repealing and replacing Obamacare.”
• Obama’s meeting with Democratic leaders is to discuss how they can protect the ACA from being dismantled by the Republicans. While some Democrats are not in agreement with how to keep the ACA and others are willing to help Republicans with a replacement plan, “almost all are united against attempts to repeal it.”

Democrats Sent Letter to Trump to Veto Cuts to Medicare and Medicaid Funding

In regard to Trump’s campaign promise not to cut funding for Medicare, Medicaid, and Social Security, “Senate and House Democrats, led by Bernie Sanders, are calling on the president-elect to veto any legislation that would slash funds for Medicare and Medicaid.” This call-to-action was sent in a letter to Trump that states, “Sunday, Jan. 15, will be a ‘day of action.’ Rallies will be held around the country to vigorously oppose the Republican plan to end Medicare as we know it and throw our health care system into chaos.” Democrats in support of the letter are against the Republicans’ proposal to turn Medicare into a voucher program.

Self-Employed Worried About ‘Job Lock’ if ACA Is Repealed

Some self-employed business owners fear that if the ACA is repealed, they may have to close their businesses and go back to finding a job to get access to affordable health insurance. (Taking a job you don’t want just to get health insurance is called “job lock.”) The prospect of losing protections for preexisting conditions is also a concern for some self-employed individuals with major health problems who were able to get coverage because of the ACA. For one entrepreneur (Namir Yedid) who left his job to start a tech company and was later diagnosed with cancer, this Modern Healthcare article stated, “He’s angry that the Republicans are rushing to repeal the law without telling the public exactly what they’re going to put in its place, making it impossible for people to plan their business lives.” If an ACA repeal removes the provision that allows young people to stay on their parents’ health plan until age 26, some are worried that this could discourage young people from pursuing entrepreneurship.

News Update for Dec. 22, 2016

Nancy Pelosi Urges Democrats to Fight for Obamacare

House Minority Leader Nancy Pelosi (D-CA) wrote a letter to Democrats saying, “In January, we will face a new Congress and a new Administration. House Democrats stand ready to fight vigorously for America’s hard-working families.” Pelosi called on Democrats to “plan press events to ‘highlight the risks’ of repealing the ACA and ending the Medicare guarantee.” This article from The Hill talks more about how Pelosi is planning to fight to protect Obamacare.

Democratic Governors Warn Republicans About Obamacare Repeal

Members of the Democratic Governors Association wrote a letter to top Republican leaders in which they “estimated that states could face nearly $69 billion in costs for uncompensated care over the next 10 years if the health law is repealed.” Democrats who signed the letter called the Republicans’ repeal and delayed replacement plan “nothing more than a Washington, D.C. bait-and-switch.”

GOP Congressman Says Americans Need to Manage Their Own Healthcare Costs After Repeal

• Congressman Bill Huizenga (R-MI) told reporters that changes in the way healthcare is delivered will be a sure thing after Obamacare is repealed, so Americans will need to become more responsible for their treatment costs. In his interview, Huizenga gave an example of when his son injured his arm, and he took his son to the doctor the next day because an immediate emergency room visit would have been more costly. As reported in this Huffington Post article, “The Michigan congressman’s comments are in line with a long-held, free-market view of the health care system.”
• Huizenga reported that delaying treatment for his son’s broken arm is “an example of the kind of choices Americans would face if Republicans’ repeal of the health care law shifts more out-of-pocket costs to consumers.” (Although, he later said in another interview “that using the experience of his son’s broken arm was a bad example to cite.”) When asked about health savings accounts, he said, “We as consumers and users of this need to get better acquainted with what are the true costs. HSAs can do that.”

News Update for Dec. 21, 2016

Obamacare Recipients File Motion to Protect Cost-Sharing Payments

In regard to the lawsuit Republicans filed against the Obama administration for using federal dollars to pay for cost-sharing subsidies, a group of Obamacare recipients filed a motion to enter the case with the hope of protecting cost-sharing payments from being defunded. “The consumers argue that they should be allowed to become parties to the case because once President-elect Donald Trump enters office, the interests of Obamacare defenders will no longer be represented.” They also warned that their health coverage would be in jeopardy because insurance companies would pull out of the market if these payments are cancelled.

White House Encourages Researchers to Protect Obamacare Data from Trump

Independent researchers who began taking measures to “download key health care data and documents before Jan. 20” say they were further motivated to so by top White House health reform official Jeanne Lambrew “who also sounded alarms [that] the new administration might expunge reams of information from public websites and end access to data.” Researchers aim to quickly collect data released by new offices that were created under the Affordable Care Act (ACA) “to regulate health insurance and test reforms.” They argue that collecting ACA data is essential because it may be needed to support the Democratic Party’s case for keeping major parts of the ACA intact.

Democrats Urge Trump to Work With Them on Drug Price Reform

• A group of 19 Democratic senators wrote a letter on December 20 in which they urged Trump to cooperate with them on the issue of rising prescription drug costs. The letter noted 5 areas that Trump should help with: “allowing the Medicare program to negotiate prescription prices, increasing transparency, stopping abusive pricing, passing reform on incentives for innovation and supporting generic competition for branded drugs.”
• Democrats want Trump to work with them on legislation that would “lift the ban on the HHS secretary negotiating drug prices for Medicare Part D beneficiaries” and “combat overnight price hikes or regular, unjustified price increases.”

News Update for Dec. 20, 2016

Trump’s Pick for Budget Director Could Shape ACA Repeal

President-elect Donald Trump has named conservative Republican, Mick Mulvaney (R-S.C.), as his pick for Director of the Office of Management and Budget. Mulvaney is a strong opponent of the Affordable Care Act (ACA) and Planned Parenthood, and he was among leaders who held a “standoff over the ACA that led to a government shutdown” back in 2013. The Trump administration’s repeal of the ACA could be shaped by Mulvaney’s views, which include having less involvement from the federal government in healthcare, a premium-support system for Medicare, and Medicaid block grants for states. You can get more info on Mulvaney’s views here.

Connecticut Hospitals and Clinics Fear Medicaid Cuts Under Trump

The Republicans’ proposed scaling back of Medicaid expansion is a major concern for Connecticut’s hospitals and clinics. The Chief Medical Officer of the Hartford Healthcare system, Dr. Rocco Orlando, stated that cuts to Medicaid would result in revenue loss of “tens of millions of dollars” and would lead to “staff reductions and scaling back of services.” Orlando also stated that “Connecticut hospitals’ fiscal stability and sustainability, as well as patient access to care, will be compromised” if the ACA is repealed and Medicaid cuts remain in effect. For clinics, the Republicans’ block grant proposal would reduce or freeze “federal Medicaid spending” for the Connecticut’s clinics that serve low-income residents.

Counties That Support Trump May Be Impacted the Most by a Repeal

A study conducted by Gallup revealed that of the 8 county types that experienced an increase in health insurance coverage above the national average, “six of those types— representing about 77 million people or 33 million votes, a quarter of the total cast—sided with Mr. Trump, some by very large margins.” Some of the county types where Trump voters reside are in “large parts of Florida, Michigan, Pennsylvania, and Wisconsin,” and those counties are considered “rural Graying America, Rural Middle America and Working Class Country counties.” These areas were among regions that the ACA targeted to expand coverage, and thus would be greatly impacted by a repeal. This Wall Street Journal article talks more about this subject.

News Update for Dec. 19, 2016

How a Repeal Could Affect Job-Based Coverage

The ACA removed the coverage limit on how much an insurance plan will pay for medical services over a person’s lifetime, which has been instrumental for people diagnosed with serious medical conditions. But a repeal could bring this back, which would affect both individual and employer-sponsored health insurance. Some experts don’t think a ban on coverage limits will remain if the ACA is repealed and that this issue may be left up to the states to decide. Experts also predict that the mandate, which requires companies with 50 or more full-time equivalent employees to offer health coverage, may be repealed because it has led to such problems as “companies limiting their full-time hiring.” However, it’s expected that “many firms will ‘continue offering coverage to their employees because employees insist on it,’” said University of Michigan law professor Nicholas Bagley.

New Rules for Obamacare Marketplaces

On December 16, the Obama administration issued a new regulation for the 2018 insurance marketplace. The regulation “seeks to address some insurer complaints with how the marketplaces operate.” Some of these complaints have led to insurers leaving the marketplaces. The regulation has also implemented a new formula that changes the way payments to insurers are calculated. This was done to help protect insurers from the financial loss of insuring high-cost enrollees. But “insurers have complained that it does not work effectively.” Given that the GOP plans to delay an Obamacare replacement, it’s expected that the marketplaces will “remain in operation in some form for a couple of years.”

Obamacare Enrollment Hits Record High

In the wake of the Trump-GOP plan to repeal the healthcare law, more than 670,000 Americans signed up for Obamacare on December 15—the “busiest single enrollment day since the healthcare law’s coverage expansion began three years ago.” This enrollment came from the 38 states that participate in the marketplaces and includes new and returning Obamacare sign-ups—many of which are low-income Americans who receive premium subsidies.

A Repeal Could Push Residents Back to Free Clinics in Iowa

In Iowa, an increasing number of low-income and homeless patients are receiving care from the Eastern Iowa Health Center (EIHC) instead of the area’s free clinic. Joe Lock, CEO of the EIHC, argues that “those patients could be pushed back to the free clinic or to hospital emergency rooms” if they become uninsured due to Obamacare repeal. Darlene Schmidt, who is the chief executive of the free clinic, said, “We’ll have to come up with resources. Right now we don’t have the dollars or the volunteers to provide [that level] of care.” If a repeal happens, about 230,000 Iowa residents who have coverage through Obamacare and Medicaid would be affected.

News Update for Dec. 16, 2016

Repealing and Replacing Obamacare

• Congressional Republicans who previously said replacing Obamacare could take 3 years are now saying they want to keep Obamacare for up to 4 years. However, they’re still planning to begin the repeal process early next year by starting with a vote for a proposed budget on January 3. The Republicans’ plan is to repeal Obamacare “with small bills that tackle one part of the health care system at a time.” They’re also planning to put together health care laws based on House Speaker Paul Ryan’s “A Better Way” proposal. But this plan is not yet official.
• On replacing Obamacare, House Republicans reported that their goal is to “guarantee ‘universal access’ to health care and coverage.” But that this goal is “not necessarily to ensure that everyone actually has insurance.” A House leadership aide told reporters, “Our goal here is to make sure that everybody can buy coverage or find coverage if they choose to,” and “repealing major provisions” in Obamacare will be a top “priority for the first 100 days of the Trump administration.”
• If Obamacare is repealed and revenue provisions for premium subsidies go away, some Republicans and health policy experts warn that federal revenue would be reduced by nearly $1.2 trillion over a 10-year period. An option GOP strategists are considering is doing a repeal while keeping some of the ACA’s financial provisions intact. Another option is to give states federal funding to run their own health coverage systems and allow states to set up their own ACA reform models. Find out more about the GOP’s repeal plans.

News Update for Dec. 15, 2016

Democrats Open to Replacing Obamacare

Although Democrats in the Senate oppose repealing Obamacare, they’re willing to help Republicans with replacing it. Democratic Senator Claire McCaskill of Missouri said, “If it makes sense, I think there’ll be a lot of Democrats who would be for it.” Another Democratic leader, Senator Chris Coons of Delaware, believes that if the GOP can keep the best parts of Obamacare that give millions of Americans access to affordable coverage while addressing some of its flaws, “we [Democrats] should work hard with Republicans on that. But we don’t know yet if they’re serious.” The GOP may have some leverage in getting certain Democrats on their side because 25 Democrats are up for re-election in 2018 with 10 from states that President-elect Donald Trump won.

HHS Secretary Reiterates Warning on Dangers of Repeal

The current secretary of the Department of Health and Human Services (HHS), Sylvia Mathews Burwell, met with Congress last week to warn that a repeal will cause chaos. On December 14, Burwell spoke with CNN to talk more about this issue. Burwell warned that even if Trump does a partial repeal, it would lead to a downward spiral of the entire healthcare system and that drafting a replacement plan would be a “massive endeavor.” She told CNN, “It is a difficult task and our system is one where when you move one piece, it’s related to another piece. It’s like a Jenga puzzle. And if you pull a piece out, you can make the thing tumble.” You can get more details on Burwell’s warnings in this CNN article.

News Update for Dec. 14, 2016

A Repeal Bill Before Trump’s Inauguration May be Unlikely

Congressional Republicans hope to pass a repeal bill between January 3 when lawmakers reconvene and January 20 on inauguration day. But Republican G. William Hoagland, who is a senior staff member of the Senate Budget Committee and senior vice president at the Bipartisan Policy Center said, “No way. I just don’t think it’s possible.” Ed Lorenzen, who serves as a senior adviser to the nonpartisan Committee for a Responsible Federal Budget, thinks January 20 isn’t possible. But he said, “I think they could do it by the end of January.” He also stated, “Mechanically they can get it done. The bigger question is, can they decide what should be in the package?”

Nancy Pelosi Doesn’t Think Repeal Will Happen

In a statement to reporters, House Minority Leader Nancy Pelosi (D-CA) said, “They’re not going to repeal it. I don’t think they’re going to repeal the Affordable Care Act.” Pelosi argues that Republicans and the Trump administration will find repealing and replacing Obamacare to be an enormous task. She also predicts that they won’t repeal the law because people would lose benefits they value and “they won’t be able to replace it because that would cost the government money they don’t want to spend.”

News Update for Dec. 13, 2016

ACA Repeal Set to Begin Early Next Year

• On Monday, December 12, Senate Majority Leader Mitch McConnell said that the Senate will begin voting to repeal the Affordable Care Act (ACA) shortly after Jan 1. “And then we will work expeditiously to come up with a better program than current law, because current law is simply unacceptable and not sustainable.” However, McConnell did not give an answer on a timeline for a replacement.
• Although Republicans plan to repeal much of the ACA, they say they don’t want to do any harm to the millions of people who get health coverage under the law. Health insurance consultants argue that repealing the healthcare law and “expecting that [the] insurance market [will] remain healthy may be [a] fantasy.”

Millions With Preexisting Conditions Could be Denied Coverage

A study from the Kaiser Family Foundation found that “52 million non-elderly adult Americans (27% of those under the age of 65)” with a preexisting condition would be at risk of being denied coverage if they were buying a health insurance policy in the individual market prior to the ACA. So without ACA protections for preexisting conditions, this group would likely be turned downed by insurance companies if a repeal happens. More details on people at the highest risk can be found in this Kaiser Health News article.

News Update for Dec. 12, 2016

Republicans Divided Over Obamacare Repeal

• Republicans continue to be divided on delaying an Obamacare replacement for 3 years. Some House Republicans feel that this 3-year strategy “is too long to leave voters, insurers and health care providers in suspense.” Like other GOP leaders, Texas Republican Senator John Cornyn supports President-elect Donald Trump’s healthcare plan, and he said, “We’re not going to let anybody fall through the cracks.”
• Some Republicans are pushing to keep many portions of Obamacare through 2019, while others say they see no reason to move so slowly. Republicans are battling over what exactly a replacement plan will look like and when to schedule a replacement.

Opposition to Obamacare Repeal Continues

• Possible market disruptions from Trump and the GOP’s repeal and replacement plan continue to be a major concern for groups like the American Academy of Actuaries, which wrote a letter to Republican lawmakers last week warning that insurers will pull out of state marketplaces if Obamacare is repealed.
• Insurance companies and healthcare industry groups continue to lobby against Congress and Trump over a repeal. Some insurers are saying they would have a hard time remaining in the state marketplaces if Obamacare subsidies and the individual mandate are eliminated. If Obamacare is repealed, one health insurance executive said of the individual market, “We could see a situation where no carrier would want to offer insurance.”
• Hospital lobby groups that oppose the delayed repeal-and-replace strategy project that their members would lose more than $200 billion. The country’s largest health insurance lobby group reported that its members need time to transition to new rules under a different health insurance system and assurance that there will be money from the government to fund the system. Check out this New York Times article for more backstory.

Some Physicians Oppose Tom Price as Pick for HHS Secretary

More than 4,800 physicians have signed a petition in protest of Tom Price’s nomination by Trump for secretary of the Department of Health and Human Services. Some also feel that Price is interested in protecting physicians, and not patients. This is due in part to a 2011 bill that Price co-sponsored to limit what doctors must report about malpractice judgments, hospital discipline, and other confidential information, all of which is used by health licensing boards and hospitals when hiring medical professionals. One physician from a consumer advocacy group said, “Dr. Price is a physician who is just obviously responding to pressure from colleagues in the medical field who’d like to be exempt from being held accountable.”

News Update for Dec. 9, 2016

Obamacare Supporter Group Wants to Block Repeal

• A coalition that supports Obamacare plans to stop Congress from doing a repeal without a simultaneous replacement. The coalition stated that “repeal and delay is no better than repeal. American families deserve to know what will happen to them before Congress acts.”
• Organizers of the coalition say their protest could include rallies in Washington, D.C., as well as the states and districts that Republicans in Congress represent. The group also plans on “mobilizing constituents, including Trump voters who would be negatively affected by repeal.”

Doctors Form Organization to Fight Trumpcare

Clinician Action Network (CAN), a group composed of healthcare providers, plans to take an active role in opposing legislation that supports Trump’s healthcare reform, as well as reform proposals from Tom Price whom Trump nominated for secretary of the Department of Health and Human Services (HHS). A spokesperson for CAN said, “We’re going to be very responsive to legislation that is being introduced and voted on in Congress, both at the state level and the national level.” You can get more backstory on CAN in this Huffington Post article.

Current HHS Secretary Warns About Dangers of Repeal

Current HHS secretary Sylvia Mathews Burwell met with Democrats in Congress to issue a warning about the dangers of the Republicans’ repeal-and-delay strategy. Burwell stated that there would be market chaos if Obamacare is repealed but a replacement for it is delayed, which is in agreement with healthcare industry experts’ concern that insurance companies will drop out of the market.

News Update for Dec. 8, 2016

The Uninsured Rate Could Be Higher if Obamacare Is Repealed

According to a study from the Urban Institute, if Obamacare is repealed the uninsured rate could be higher than what it was pre-Obamacare. Below are some highlights from the study.

• 8 million Americans would become uninsured, which would push the uninsured rate to 58.7 million in 2019.
• Of the 29.8 million who would become uninsured, 5 million of those people would lose coverage because of eliminating premium tax credits, Medicaid expansion, and the individual mandate. The remaining 7.3 million would lose insurance due to the collapse of the non-group insurance market.
• 82 percent of the newly uninsured would be working families.
• 9 million fewer people would have Medicaid or CHIP coverage in 2019.
• Nearly 9.3 million people who would have received tax credits for individual health insurance in 2019 would stop receiving assistance.

News Update for Dec. 7, 2016

Many Trump Supporters at Risk of Becoming Uninsured

Non-Hispanic whites and those without college degrees are among President-elect Donald Trump’s biggest supporters who benefited the most from Obamacare. So these 2 groups are included in those most at risk of becoming uninsured if Obamacare is repealed. If a repeal happens:

• The uninsured rate would jump to 58.7 million in 2019
• 80 percent of those without college degrees would become uninsured
• 56 percent of non-Hispanic whites would lose health insurance
• 24 percent of those with some college-level education would lose coverage
• 3 in 10 high school graduates would become uninsured

Far-Right Republicans Want Obamacare Replaced Much Sooner

Trump and Republican leaders may face strong resistance from ultra-conservative House Republicans because of the delayed 3-year plan to replace Obamacare. Congressman Mark Meadows (R-NC), who is elected to be the next chairman of the House Freedom Caucus, reported that the GOP’s new outlook on Obamacare is “the first big fight I see coming for the Freedom Caucus.” He also stated that any delays in replacing Obamacare until after the 2018 elections — when some Republicans hope to win seats in the Senate — “will meet with major resistance from Freedom Caucus members.” Read more on why the caucus is challenging Trump for a quicker Obamacare replacement.

Health Insurers Issue Demands Over Obamacare Repeal

• Health insurance trade groups have publicly demanded what they need from the Trump administration to remain in the state marketplaces if a repeal happens. Their demands for Trump and Congress include:A clear commitment that the government will continue subsidizing health insurance for low-income people
• Keep rules that encourage young and healthy Americans to enroll in health insurance
• CNN Money also reported more demands from insurance companies, which include:Making it harder for people to enroll in coverage outside of open enrollment periods to prevent people from only signing up for insurance when they get sick.
• Expanding risk payments to help offset the cost of care for sick enrollees.
• Preventing healthcare providers from steering patients to the individual insurance market when they could qualify for Medicaid.
• Structuring high-risk pools differently from what was in place before Obamacare—high-risk pools for those with preexisting conditions who let their coverage lapse prior to Obamacare lacked proper funding and had waiting lists.

Hospitals Warn Trump and Congress About Repealing Obamacare

The hospital industry issued a letter warning Trump and leaders in Congress that repealing Obamacare “could cost hospitals to lose $165 billion by the middle of the next decade and trigger ‘an unprecedented public health crisis.’” If the Trump administration and Congress repeal Obamacare without a simultaneous replacement, the hospital industry says that government payments to hospital groups that treat Medicare and Medicaid patients should be restored to what they were before the 2010 Affordable Care Act law.

News Update for Dec. 6, 2016

Obamacare Lawsuit

The House Republicans’ lawsuit against Obamacare’s subsidy program has been delayed by the U.S. Court of Appeals for the Washington, D.C. Circuit. A judge previously ruled that Obamacare premium tax credits were unlawful because funding did not come from Congress. And further proceedings have been delayed to give Trump’s Justice Department time to decide on settling or withdrawing the case.

• If House Republicans win the suit to get rid of premium tax credits, also called cost-sharing subsidies, it could cause insurance companies “to sharply raise premiums or exit the ACA exchange markets, since the law requires them to reduce cost-sharing burdens for eligible members in silver plans,” as this Modern Healthcare article
• Without a replacement option for cost-sharing funds, this would also prevent insurance companies from receiving payments, and companies would lose out on money they expected to receive.

ACA Repeal on the Insurance Market

GOP lawmakers are slowly coming to terms with the need to take action to protect the individual insurance market from collapse and prevent plans from exiting the market in 2018. Health plan carriers are watching to see if Republicans will delay the elimination of premium tax credits and Medicaid expansion, both of which insurance companies say are the “key to making the individual insurance business financially viable.”

Obamacare Subsidies and Republican States

Based on a premium tax credit study from the Kaiser Family Foundation (KFF), people in Republican “red” states that Trump won may be impacted the most if subsides are eliminated because of an ACA repeal. Of the $32.8 billion in subsidies the KFF study revealed Americans received, a CNBC article points out that half of the amount went to people in 5 states: Florida, California, Texas, North Carolina, and Georgia. Except for California, Trump won these states.

News Update for Dec. 5, 2016

Selling across state lines

Republicans want insurance companies to sell policies across state lines while only meeting the regulations of their home state. Supporters of President-elect Donald Trump’s healthcare reform say this will boost competition and allow consumers to buy plans that better suit their needs. Insurance executives say it may be costly for insurance companies to enter a new market and arrange contracts with local doctors and hospitals. Some consumer groups argue that:

• Companies may flock to states that have limited regulations for the industry, which could lead to cheaper plans with limited coverage.
• States that sell comprehensive coverage may see healthy people leaving their state marketplace to buy bare-bones plans in other states.
• If more healthy people are leaving states with comprehensive coverage, this will drive up premiums for people with health problems in those states.

You can read more about the impact of selling across state lines here.

ACA tax credits

The Kaiser Family Foundation released a study showing that Marketplace enrollees received about $32.8 billion in tax credits because of the ACA, and that this tax credit will disappear if the ACA is repealed.

Medicare

Despite some Republicans like House Speaker Paul Ryan and Tom Price (R-Ga.) proposing to privatize Medicare, Vice President-elect Mike Pence during an interview said that a Medicare overhaul is not on Trump’s healthcare agenda. Pence also stated that the first thing the Trump team has to do is get the weight of Obamacare off the back of the national economy. “We think that will create tremendous economic growth in businesses large and small, and then setting an orderly transition process in place to capture the power of the free market.”

Repealing Obamacare

• In a 60 Minutes interview, Ryan said that repealing Obamacare will be the congressional Republicans’ first priority once Trump takes office. When asked about the3-year transition plan, Ryan said, “I don’t know the answer to that right now. What we know is we have to make good on this promise. We have to bring relief as fast as possible to people who are struggling under Obamacare.” This article provides more info and a clip of the interview.
• Healthcare associations are launching effortsto save the 20 million people who have gained coverage through Obamacare. CEO of the American Hospital Association Richard Pollack wrote a letter urging Trump that any repeal of the ACA should simultaneously include a replacement plan that continues to provide affordable coverage. The American Medical Association also made similar requests that a Trump healthcare “reform proposal should not cause individuals currently covered to become uninsured.”

News Update for Dec. 2, 2016

• Employers could slow down on hiring and investments because of unclear plans about Trump’s healthcare reform. Potential reforms could mean the loss of about 200,000 jobs in the healthcare industry. A plan to repeal and replace Obamacare could take years to achieve, which may prolong confusion for business owners.
• Americans are divided over repealing Obamacare, according to a Kaiser Family Foundation survey:30 percent want Obamacare to be expanded
• 26 percent want Obamacare to be repealed
• 19 percent want Obamacare to remain as is
• 17 percent want Obamacare to be scaled back
• 3 percent don’t know or want something else
• The GOP’s plan to privatize Medicare is facing resistance from the Senate because some GOP lawmakers say they’re not planning to make big changes—“at least not in the first year of the Trump administration.”

News Update for Dec. 1, 2016

Possible Impact of Repealing Obamacare

• Repealing the Affordable Care Act (ACA) could lead to about 7 million fewer people with health insurance and cause out-of-pocket costs to be as high as $4,700 a year for each individual.
• Without a replacement, repealing the ACA could cause insurance companies to “abandon the individual insurance markets in 2018,” which could affect the exchange, as well as off-exchange markets. Companies may panic because people who are still in the market in 2018 could be sicker, and healthier people could leave the market because of higher premiums.
• A repeal could create a huge domino effect for hospitals, insurance companies, employers, and employees, according to this Fox Business article.

Trump’s Picks for Healthcare Leaders

• Trump picked Congressman Tom Price (R-GA), an Obamacare critic, as secretary of the Department of Health and Human Services (HHS).
• Trump also announced Seema Verma as his pick for administrator of the Centers for Medicare & Medicaid Services. You can get a backstory on Verma here.
• Some healthcare companies, insurers, doctor groups, and hospitals feel encouraged by the appointments. Some insurance companies that sell in both the state and federal markets feel that changes from the GOP will allow them to sell more flexible and cheaper plans.

Medicare

• Price is an advocate of Republican Speaker of the House Paul Ryan’s proposed Medicare changes, such as raising the Medicare-eligible age to 67 and giving vouchers (referred to as premium support) to Medicare beneficiaries so they can buy plans directly from insurance companies.
• Some lawmakers from both political parties feel that Price as head of the HHS could lead to major overhauls and cuts in funding, even though Trump promised to protect Medicare during his campaign.
• The GOP is pushing for major changes and cuts to Medicare to start within the first 6 to 8 months after Trump takes office. This could mean Trump’s healthcare plan would involve raising premiums and the Medicare-eligible age by 2020. The GOP is also in favor of Medicare vouchers.
• Medicare Advantage is expected to be expanded because Republicans are in favor of privatizing Medicare.

Medicaid

• Verma’s proposals for the Medicaid program in some Republican states appeal to conservatives who support things like requiring beneficiaries to pay more and be working or actively looking for work. Some critics feel that with the nominations of Verma and Price, a restructuring of the Medicaid program could be damaging and chaotic.
• Experts predict that Donald Trump’s healthcare plan will involve privatizing Medicaid, and one expert said that doing so shouldn’t be a big threat to insurance companies.
• Price has proposed a full repeal of Medicaid expansion, which would affect millions of low-income Americans. But some Republicans are looking at ways to keep certain parts of Obamacare’s Medicaid expansion. Ryan proposes to continue running the expansion program for states that have already expanded.
• Medicaid reform could reflect Ryan’s proposals to have either a block grant or per-capita allotment option.
• Block grants could cause 25.1 million people to lose coverage, but the grants could also help “balance the increase in the deficit if the states take measures like reducing eligibility or cutting down enrollment outreach,” as an article on 6 ways Trump could impact healthcare reform pointed out.

Preexisting Conditions

Trumpcare involves keeping certain parts of the Obamacare law on preexisting conditions, but Trump hasn’t provided a plan. Vice President-elect Mike Pence and Congressman Ryan have made some proposals on preexisting conditions in this CNN Money article.

Cost-Sharing Subsidies

• House Republicans have asked a federal appellate court to temporarily delay the case that could end ACA cost-sharing subsidies to give Trump time to put together an ACA replacement.
• Stopping subsidies could mean massive losses for insurance companies because those companies would have to pay out-of-pocket costs for each patient and not get any reimbursement from the government. Insurance companies filed a brief with the appeals court warning about “$1,000 premium increases and a market exodus by consumers and [insurance companies].”

Health Savings Accounts (HSAs)

Donald Trump’s healthcare plan includes expanding the use of HSAs. “But experts say HSAs alone can’t make individual insurance coverage affordable. … The accounts work best for those who already have high incomes,” as reported in a MarketWatch article. Without cost assistance, health insurance would be out of reach, especially for those with low incomes. Experts suggest that HSAs could be a way to replace the ACA subsidies if they’re going to be funded by the government.

Prescription Drugs

• A survey from the Kaiser Family Foundation found that many Americans want the Trump administration to tackle high-cost drugs for chronic conditions as a top priority. Trump’s healthcare goals don’t currently align with this priority.
• Trump’s healthcare reform does include a proposal to “remove barriers to entry in free markets for drug providers that offer safe, reliable, and cheaper products,” but this goal is near the bottom of Trump’s top 8 healthcare agenda.

Women’s Health

Under Trump’s proposed healthcare plan, women could see the return of paying more for health insurance than men. Women may also lose benefits, including free contraceptives, free preventive services, and guaranteed coverage for maternity services in the individual market.

As a licensed agent with HealthMarkets, I (Robert Morgen) am sharing this article with my LinkedIn community. I serve Nevada, California, Arizona, Texas, & South Carolina as a Health Benefits Adviser.