begin quote from:
Now
that Republicans control both houses of Congress and the presidency,
their threat to repeal the Affordable Care Act no longer is a pipe
dream, but the trick now is to transition to a new system that doesn’t
rip coverage away …
Republicans Finding Repealing Obamacare Complicated
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House
Republicans have voted 60 times to repeal the Affordable Care Act since
it was enacted but now the trick is to transition to something else
without ripping coverage away from 20 million Americans.
Now
that Republicans control both houses of Congress and the presidency,
their threat to repeal the Affordable Care Act no longer is a pipe
dream, but the trick now is to transition to a new system that doesn’t
rip coverage away from the 20 million Americans who have signed up in
recent years.
President
Barack Obama’s signature legislative achievement was signed into law
March 23, 2010, but didn’t come into full force until last year.
Republicans hate the mandate that requires all adults to obtain coverage
or face fines, they hate that the federal government has become the
primary regulator of healthcare, and they hate that the law specifies
what insurance companies need to cover.
Republicans
said Wednesday they intend to repeal the ACA by early next year but
possibly delay the effective date three years to figure out with what
they want to replace it. Part of the balancing act will entail
convincing insurers not to bail on the healthcare marketplaces.
“I
think once it’s repealed, you will have hopefully fewer people playing
politics and [instead] coming together to try to find the best policy,”
House Majority Leader Kevin McCarthy, R-Calif., told Politico, adding once there’s “a date certain that something’s going away … you know you have to have something done.”
House
Republicans have voted 60 times to repeal the ACA since it was enacted.
During the campaign, President-elect Donald Trump repeatedly said the
law would be repealed and replaced with something “much better.”
After the election, however, Trump said
some elements of the ACA should be preserved, like the guarantees of
coverage for people with pre-existing conditions and allowing children
to stay on their parents’ plans until they reach 26 years of age.
Further complicating the Republicans’ path forward is a study released by Kaiser Family Foundation that indicates only about a quarter of Americans want the law repealed entirely.
“The flaws in Obamacare are obvious to me. The solutions are much harder,” Sen. Lindsey Graham, R-S.C., told Politico.
Health
Secretary-designate Rep. Tom Price, R-Ga., is a longtime critic of the
ACA — and a doctor. Among the changes he has proposed, the Fiscal Times reported,
are eliminating the state-run marketplaces, individual mandates and
federal tax credits for low-income participants. Instead, he would like
to see tax credits pegged to a person’s age, ranging from $1,200 to
$3,000 to partially cover premiums and out-of-pocket costs.
For
a pre-existing condition or chronic illness to be covered, consumers
would have to prove they had continuous coverage for the preceding 18
months to prevent people from obtaining coverage only after they become
ill.
Senate
Health Education, Labor and Pension Committee Chairman Lamar Alexander,
R-Tenn., said he’d like to have a replacement plan in hand before the
ACA is repealed, an approach favored by Price.
But House Speaker Paul Ryan said Wednesday he’s in favor of taking care of repealing the law immediately.
One
approach under consideration is to take the law on in pieces rather
than by passing one massive bill, an approach that likely would drag out
the process and possibly produce a backlash from voters who want to see
action after six years of bluster.
Ryan has offered a proposal he says would give patients and doctors more control and foster competition among insurers.
Like
the ACA it would set up state insurance exchanges and protect those
with pre-existing conditions. It also would auto-enroll people at points
of service and give states the power to form multistate high-risk
pools.
The
proposal would provide tax credits for obtaining coverage and improve
Health Savings Accounts by allowing premiums to be paid from them and
increasing the amount of before-tax money that can be contributed to
them.
The plan also calls for improvements to Medicaid and privatizing Medicare.
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