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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 March 24, 2017

News Update as of 4:25 p.m. CST

Obamacare Is Here To Stay

House Speaker Paul Ryan addressed the AHCA’s recent defeat in a press conference held this afternoon. “Obamacare is the law of the land. We’re going to be living with Obamacare for the foreseeable future.

While Ryan does not believe that Obamacare is viable, he has hopes that Tom Price will find ways to make the healthcare law sustainable. In the meantime, Ryan and the White House will move on to other priority issues.

News Update as of 3:12 p.m. CST

White House Pulls AHCA Ahead of House Vote

Republicans have decided to pull the American Health Care Act from the House floor. Despite last-minute concessions to conservative Republicans, the party still lacked the votes to approve the healthcare reform bill. House Speaker Paul Ryan was seen rushing to the White House during the House’s debate to inform President Trump. In a phone interview with The Washington Post, President Trump said, “We just pulled it.” The President did not cast blame on Ryan, telling The Washington Post, “I don’t blame Paul.”

Trump Demands Friday Vote on AHCA

Mick Mulvaney, Office of Management and Budget Director, issued strong words from Trump to lawmakers Thursday. Trump wants the vote on American Health Care Act to happen today (March 24), and if it fails, he will leave Obamacare in place and move on to other priorities.

The House Is Debating the American Health Care Act

Currently, the U.S. House is debating for and against the AHCA. The scheduled 4-hour debate began at 10:20 a.m. central and can be viewed live here. It still is not clear if the bill has gained enough Republican votes to pass.

Kansas Moves Forward With Medicaid Expansion Amid Federal Medicaid Debate

On Thursday, state lawmakers in Kansas moved a Medicaid expansion proposal forward. It is currently headed to the Senate floor, despite healthcare reform debates over Medicaid funding. Supporters of the expansion don’t want national debate to derail Kansas-state needs, but opponents want Kansas lawmakers to wait until federal debates over Medicaid-expansion funding have settled.


News Update for March 23, 2017

Healthcare Reform Vote Postponed

While the House planned to pass the American Healthcare Act tonight (Thursday, March 23), the vote has been postponed. The White House remains confident in its ability to vote quickly on the bill despite the delay. Sarah Huckabee Sanders, White House deputy press secretary, said, “Debate will commence tonight as planned and the vote will be in the morning to avoid voting at 3 a.m. We feel this should be done in the light of day, not in the wee hours of the night and we are confident the bill will pass in the morning.”

Last-Minute Changes to AHCA Aim to Appease Conservatives but Irk Moderates

Recent changes to the American health Care Act (AHCA) have been focused on persuading conservative Republicans, particularly the Freedom Caucus. Unfortunately, these changes might be repelling moderate Republicans.

Late Wednesday, conservatives of the Freedom Caucus added the removal of some essential health benefits (like prescription drugs, maternity care, and substance abuse treatment) and protections for people with pre-existing conditions to their list of things the bill must do before they will vote in favor of it. While even these changes may not guarantee all conservative voters, Randy Weber (R-Texas) of the Freedom Caucus told reporters, “Negotiations are taking place. The president’s moving our way.”

Moderate Republicans seem dissuaded by these potential additions to the AHCA. GOP Rep. Ryan Costello of Pennsylvania stated, “The Freedom Caucus has presented what it will take for them to get some yeses, and I think there are now members who will have to now evaluate things a little bit further.” A more strongly worded disapproval was given by Rep. Charlie Dent of Pennsylvania. Dent said, “After careful deliberation, I cannot support the bill and will oppose it. I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals.”

According to ABC News, at least 30 Republicans still oppose the AHCA.

Biden Speaks Out Against AHCA Before House Vote

On Wednesday, Former Vice President Joe Biden shared his strong opposition to the AHCA. Joined by fellow Democrats, Biden said, “The costs [of an Affordable Care Act repeal] are enormous” and the proposed healthcare bill uses tax benefits for the “transfer of about a trillion dollars” to wealthy households.

Two Non-ACA Healthcare Bills Have Been Passed by the House

On Wednesday, two healthcare bills were passed by the U.S. House:

  • R. 372, the Competitive Health Insurance Reform Act of 2017, means to repeal the McCarran-Ferguson Act. The McCarran-Ferguson Act is an antitrust exemption directed toward health insurance companies.
  • R. 1101, the Small Business Health Fairness Act, “would let a multi-state association health plan sell coverage outside its state of domicile, even if the other states objected. The regulators in the state of domicile would regulate the plan.”

Read more about the passing of these bills here.


News Update for March 22, 2017

The Senate Is Just as Divided Over the AHCA

If as few as 3 Republicans vote against the American Health Care Act (AHCA) in the Senate, it will fail. Factions of the Republican Senate want more from the AHCA, and they may be willing to kill the bill if they don’t see even greater changes. And those refining the bill will have a hard time pleasing these differing factions.

  • More Affordable Care Act (ACA) Repeal: Conservatives (particularly Rand Paul, Ted Cruz, and Mike Lee) have stated strong opposition toward the current draft of the AHCA and want stronger repeals of the ACA.
  • Planned Parenthood: Those defending Planned Parenthood (particularly Susan Collins and Lisa Murkowski) oppose the AHCA’s defunding of the program, but removing the bill’s current provision could upset conservative voters.
  • Medicaid: Those protecting Medicaid expansion (particularly Murkowski, Rob Portman, Shelley Moore Capito, Cory Gardner, Dean Heller, and Brian Sandoval) have expressed shared concerns about the bill’s plans to withdraw Medicaid expansion funding from their represented states. Removing this phase-out would upset conservatives, who want it to happen even sooner than planned in the bill.
  • Loss of Coverage & House Majority: Those concerned over the loss of coverage for people, as well as the loss of the House majority, make up the last two factions (Bill Cassidy and Tom Cotton). Bill Cassidy has grave concerns about the 24 million who will lose coverage based on the Congressional Budget Office (CBO) estimate. Tom Cotton “thinks the bill could endanger the House majority and won’t pass the Senate.”

Can Mitch McConnell Save the AHCA?

Senior United States Senator and Majority Leader Mitch McConnell will be in charge of altering the AHCA before it can be rejected by the Senate. On Tuesday, McConnell said, “We’re not slowing down. We will reach a conclusion on health care next week.”

How Do American Voters Feel About Current Healthcare Reform?

The Morning Consult and Politico recently published a new poll asking nearly 2,000 registered voters how they felt about the AHCA and other healthcare reform. Here are the results:

Reform Speed

  • 43% think the GOP needs to take more time
  • 17% think Republicans are taking the right amount of time

AHCA Effects on Healthcare Costs

  • 39% think healthcare costs will increase
  • 20% think healthcare costs will decrease

AHCA Effects on Quality of Healthcare

  • 32% think quality will decrease
  • 28% think quality will increase

AHCA Effects on the Healthcare System

  • 36% think the healthcare system will be negatively affected
  • 30% think the healthcare system will improve

Around half of the respondents stated that they were more likely to back the bill after the CBO predicted a $337 billion decrease in the federal deficit in 10 years, as well as an eventual 10% decrease in the average premium. However, over half of respondents stated that they were less likely to back the bill after CBO estimates that 24 million people would lose coverage and premiums would increase by 15%-20% for the first two years of the AHCA.

To see if your representative shares your feelings on upcoming healthcare reform, visit this NPR article.


News Update for March 21, 2017

House Freedom Caucus Won’t Vote as a Bloc, But That Doesn’t Mean a Yes Vote

The conservative House Freedom Caucus has around 3 dozen members, enough to kill the healthcare reform bill in the House if they voted against it as a bloc. However, chairman of the Freedom Caucus Rep. Mark Meadows (R-NC) has announced that the group will not be voting in bloc. “We’re not taking any official positions. I’m going to encourage them to vote for their constituents,” Meadows told reporters.

But this doesn’t mean the Freedom Caucus will be voting for the AHCA. Because of ongoing concerns with the bill, many members have expressed that they will vote against it in the House. A co-founder of the Freedom Caucus, Rep. Jim Jordan (R-OH) said after negotiations with the White House, “Nothing’s changed. We’ve still got lots of problems with this bill. … The president’s a good man, and the White House has been great to work with, but opposition is still strong with our group.”

Republicans Changing AHCA to Strengthen Chances of Passing It

While Democrats are set to oppose the AHCA bill, the White House is making changes to try and win more Republican votes.

  • A provision may be added to lower prescription costs with a “competitive bidding process”
  • An amendment may:
    • Remove a provision allowing consumers to move excess tax credit funds into health savings accounts (HSAs). Anti-abortion groups fear the provision allows taxpayers to fund abortions.
    • Accelerate the repeal of around a dozen Affordable Care Act (ACA) taxes.
    • Delay implementing the Cadillac tax again (from 2025 to 2026).
  • In addition to allowing states to choose block grants and requiring enrollees to provide proof of employment, Medicaid enrollees may:
    • Be required to renew their coverage every six months.
    • Lose the ability to request retroactive coverage.

While some have changed their votes based on recent changes to Medicaid, subsidies for older Americans, and ACA taxes, these changes aren’t enough to sway all lawmakers. Justin Amash, Michigan Rep. and strong critic of the bill, tweeted, “They haven’t changed the bill’s general framework. They don’t have the votes to pass it. They have seriously miscalculated.”

Republicans Reintroduce Small Business Healthcare Legislation

A bill passed by the House in 2003, which did not advance, has been reintroduced in help improve small businesses’ health insurance purchasing power. At the time, the bill was criticized because it “would do little to enhance the coverage options or control costs of many small businesses, especially those that employ older, sicker workers, while at the same time weakening consumer protections against plan insolvency and fraud.” “Health policy experts say there’s no reason to change that assessment now.” The bill would:

  • Establish nationwide “association health plans,” allowing small business owners to join associations and purchase health insurance in larger groups. In turn, this would ideally lower costs.
    • These plans have existed, but were not regulated well and neither states nor the federal government had clear authority over them. Fraud and insolvency cases in the ’70s and ’80s lessened the appeal of these plans.
    • Federal law was amended to let states regulate them, and in 2010 the ACA required them to meet qualified health plan standards.
  • Remove state regulations and give the federal Department of Labor oversight of association health plans.
  • Remove ACA group health insurance requirements but maintain individual health insurance ACA requirements for association health plans.
  • Allow association health plans to charge companies with more unhealthy workers higher premiums.

 


News Update for March 20, 2017

Likely Changes for the American Health Care Act (AHCA)

Under strong opposition, House Speaker Paul Ryan and other Republican leaders have opened the door to making changes to the AHCA. Particularly, the bill will likely see changes to states’ flexibility with Medicaid and individual coverage for older Americans. The House is expected vote on the bill this Thursday. Here is more on the proposed changes.

States’ Flexibility With Medicaid

  • States may gain the option to require “able-bodied Medicaid recipients to work” in order to receive coverage. Health & Human Services Secretary Tom Price and Administrator of Centers for Medicare and Medicaid Services Seema Verma have stated in letters to governors that they are open to this option.
  • States may have the option of receiving federal funding in the form of block grants, meaning they would receive a set amount of funding regardless of the state’s number of enrollees. The current legislation calls for per capita funding, meaning a set amount per enrollee.

Individual Coverage for Older Americans

  • Older Americans, those in their 50s and 60s, shopping on the individual market may see enhanced tax credits compared to the AHCA’s original proposal. Sunday, Ryan said, “We believe that we do need to add some additional assistance with people in those older cohorts.”
    • Americans in their 50s would receive $3,500 in refundable tax credits.
    • Americans in their early 60s would receive $4,000 in refundable tax credits.
  • There is no mention of how allowing insurance companies to charge older individuals more may change, but the CBO projection does not bode well, even with the increased subsidy amount. A 64-year-old with an income of $26,500 might end up paying up to $14,600 in 2026 under the AHCA. Compare this to the projected Affordable Care Act (ACA) cost of $1,700 in 2026.

Republican Governors Argue the Current AHCA “Hurts States”

Ohio, Michigan, Nevada, and Arkansas governors sent a joint letter to the House and Senate leaders arguing against the current version of the AHCA. Republican governors John Kasich (OH), Rick Snyder (MI), Brian Sandoval (NV), and Asa Hutchinson (AR) all signed the letter, which states that the AHCA “provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out, and shifts significant new costs to the state.” Each of these states expanded Medicaid under the ACA, and the governors outlined alternative approaches to Medicaid reform.

States Will Take Greater Share of Medicaid Costs Under AHCA

Moody’s Investors Service theorizes that states’ credit ratings could suffer under the AHCA. States would take on a larger share of Medicaid funding, increasing their borrowing costs and lowering the current value of bonds. Any funding decrease from the federal government would force states to reduce spending on their individual Medicaid programs, raise taxes, or do both.

Rand Paul Does Not Believe the AHCA Will Pass

Senator Rand Paul sat down with ABC’s “This Week” on Sunday to voice his feelings about the AHCA and its chances of passing through Congress: It won’t happen. “I think there’s enough conservatives that do not want ‘Obamacare Lite.’ … None of us ran on this plan,” Paul said.


News Update for March 17, 2017

Are You Confused by Terms in the Obamacare Repeal and Replacement Process?

Kaiser Health News has released a new article that helps clear up some of the more confusing terms pertaining to the Obamacare repeal and replacement process going on right now. Here are some of those terms. Check out the article for more details.

  • Budget Reconciliation: An obscure legislative process that permits bills to pass through Congress with just a simple majority. Budget reconciliation bills only deal with budgetary issues and can’t be filibustered.
  • Health Savings Accounts: HSAs allow consumers to save money on a tax-free basis for healthcare expenses.
  • High-Risk Pools: Insurance groups that cover individuals with pre-existing conditions. These individuals tend to have high health insurance costs.
  • Individual Market: The individual market is where people who don’t have health insurance through their employer or the government can get a plan from an insurance company.
  • Medicaid Block Grants: A block grant is when the federal government gives states a “set amount of money to pay for coverage for Medicaid recipients.” Right now, the federal government matches a percentage of a state’s Medicaid spending to help alleviate states’ costs.
  • Per-Capita Caps: With per-capita caps, states would get a fixed amount of money each year, but that fixed amount would be determined by how many people are enrolled in each Medicaid program.

American Health Care Act Narrowly Passes House Budget Committee

The Republican plan to repeal Obamacare passed a key hurdle on Thursday. The House Budget Committee “narrowly voted to move [the bill] to the House floor and recommended a series of changes to the plan reflecting concerns from conservatives and centrists.” The committee voted for two motions supporting more cuts to Medicaid beyond what is currently in the bill, as well as a third motion “endorsing a requirement that ‘able-bodied’ participants in [Medicaid] work in exchange for their benefits.” This is in line with what many conservatives have wanted from this bill. The committee voted 19 to 17 to advance the bill. All the Democrats and three Republicans voted against moving the bill to the House floor. All the dissenting Republicans are members of the conservative House Freedom Caucus. More revisions are expected soon.

Republican Leaders Planning Vote on AHCA Bill Next Thursday

GOP leaders have told reporters at CNN that they are planning on holding a vote on the American Health Care Act in the House of Representatives on Thursday. Thursday also happens to be the 7th anniversary of former President Barack Obama’s signing of the Affordable Care Act. The bill is currently being reworked to include Medicaid work requirements. Other changes “may also include making tax credits for older Americans more generous” in order to appease moderate Republicans.

Many in Disabled Community Worried About Medicaid Cuts

Medicaid covers some in-home and transportation services for disabled people in every state. However, the federal government doesn’t require those things to be covered. It does require that states cover “doctor’s visits, nursing home care and laboratory tests.” In-home and transportation services are important for providing disabled people with a degree of independence throughout their everyday lives. These services aren’t required by the federal government. Many people are worried that if federal Medicaid funding decreases, these services would be the first to go and disabled people will see their quality-of-life and independence greatly decreased.


News Update for March 16, 2017

Speaker Paul Ryan Changes Tune, Says AHCA Must Change In Order to Pass House

In a private meeting on Wednesday, Speaker of the House Paul Ryan told House Republicans the American Health Care Act would have to be modified if Republicans wanted to pass it through the House. The bill had initially been crafted by Republican leadership in the House with little input from rank-and-file Republicans. However, resistance from within Ryan’s own party, coupled with an unfavorable Congressional Budget Office report, made Ryan walk back “from his earlier position that the carefully crafted legislation would fail if substantially altered.” Ryan hasn’t given any details on what changes are currently under consideration. “Now that we have our [CBO] score we can make some necessary improvements and refinements to the bill,” said Ryan.

Republicans Debate Adding and Subtracting Different Provisions from Obamacare Repeal

Some Republican leaders are thinking about getting rid of a provision in the American Health Care Act. As a way of replacing the individual mandate, which requires that eligible Americans sign up for health insurance, the AHCA would institute a provision that would require insurance companies “to charge a 30 percent penalty to customers who go without coverage for at least 63 days.” Like the individual mandate, this 30 percent penalty is also an incentive to encourage young, healthy consumers to buy insurance so that insurance pools will have the finances to cover people with pre-existing conditions. Many conservatives are not onboard with the 30 percent penalty, believing that it is another form of the individual mandate. Senator Ted Cruz (R-TX) called for something that would “scrap the requirement to cover pre-existing conditions along with other [insurance company] regulations.” Cruz believes these regulations to be the “principal driver of skyrocketing premiums.”

Conservative House Republicans are also proposing an amendment to the AHCA that “would institute work or education requirements for Medicaid.” The hope is that this Medicaid work requirement would be enough to persuade conservatives to vote yes on the bill. Some critics believe that work requirements could block Medicaid beneficiaries who aren’t currently working from getting needed medical care. Going without this medical care, say these critics, would in turn prevent the beneficiaries from rejoining the workforce.

American Health Care Act Supporters Stress ‘Three Phases’ Approach, But Critics Are Skeptical

On Wednesday, President Donald Trump told a rally in Tennessee that he was in the midst of negotiations on the American Health Care Act. “We’re going to arbitrate, we’re going to all get together. We’re going to get something done,” said Trump. He reiterated that “the end result … is going to be great” once people consider the fact that the AHCA is only the first phase of the Republican plan to repeal Obamacare. The other two phases include regulatory actions taken by Secretary of Health and Human Services Tom Price and more bills passed by Congress that would undo the core tenets of Obamacare.

However, many GOP leaders and other detractors remain critical. “There is no three-phase process,” said Senator Tom Cotton (R-AK). “There is no three-step plan. That is just political talk, it’s just politicians engaging in spin.” Cotton believes that the third phase of repeal is unrealistic because it would require 60 votes to pass the Senate, meaning 8 Democrats would need to defect. Senator Lindsey Graham (R-SC) also said that passing a second bill was a “fantasy.” Senator Ted Cruz (R-TX) believes that “anything in so-called bucket three will never pass.” Democrats, for their part, are even more critical. Senate Minority Leader Charles Schumer said, “We think this bill is so bad there’s no way to make it better.”

First Decline in Total Obamacare Enrollment Numbers Reported

According to a new report by the Trump administration released on Wednesday, a total of 12.2 million Americans enrolled in the Obamacare marketplaces during the 2017 open enrollment period. This is the first annual period in which enrollment dropped. In 2016, 12.7 million Americans enrolled. The exchanges saw “slow but steady increases in 2015 and 2016.”


News Update for March 15, 2017

New KFF Poll: People Expect Obamacare Repeal to Result in Higher Costs and Less Coverage

A new poll published Wednesday by the Kaiser Family Foundation shows that the public expects that the Obamacare replacement plan to increase costs and decrease coverage. 48 percent of respondents believe that the proposal would decrease the number of people who have health insurance. About 30 percent say that the number would stay the same, and 18 percent believe the number would increase. A plurality of people believe that costs would increase for deductibles and for people who buy their own insurance. Results were mixed based on party-affiliation: “Majorities of Democrats believe the plan will decrease the number of people with insurance and increase costs, [while] Republicans’ views are more mixed.” You can read more about the poll here.

Is Obamacare Repeal Putting Republicans at Risk in 2018?

The contentiousness of the GOP’s Obamacare repeal process has been well-documented, and “Republicans concede they’re growing increasingly concerned about falling into familiar traps.” Some are theorizing that the GOP’s inability to satisfy the American public’s desire for healthcare reform might prove to be the party’s undoing in the 2018 midterm elections. Former Republican House Speaker Newt Gingrich said, “By next spring, they have to have a health solution clear enough — and implemented enough — that people feel comfortable” or else the midterms could go very poorly for them.

Three Strange Effects of the America Health Care Act on the Individual Marketplace

LifeHealthPro just published an article yesterday detailing some strange things that might happen if the American Health Care Act passes.

  1. The rules that force “individual or small-group major medical” insurance plans to maintain coverage for around 60 percent of the predicted value of essential health benefits would be taken away. However, the AHCA would still keep Obamacare’s cap on how much a plan can expect an enrollee to pay out of pocket each year. The CBO predicts “that the typical consumer in the individual market would get a mid-level silver plan in 2026 if current ACA rules continue.”
  2. With the AHCA, the removal of the 60 percent rule, combined with the enforcement of the out-of-pocket cap, would result in “the same consumer [ending] up with a plan that was more like a bronze plan than a silver plan,” meaning that average consumers would have less valuable plans.
  3. Because the AHCA is actually a budget resolution bill, it will only require 50 votes to pass. However, the bill can’t actually repeal core elements of the Obamacare law. Another bill would have to handle that, and that bill would require 60 votes, which means that 8 Democrats would have to defect. This is highly unlikely. As a result, we could live in a world in which an “Obamacare repeal bill” is passed, yet major Obamacare provisions would still be in place.
  4. The percentage of a plan’s predicted value, or actuarial value, of its essential health benefits coverage dictates its placement on Obamacare’s metal tier system. The system goes from bronze to gold to silver to platinum and represents plans that cover between 60 percent and 90 percent of the cost of essential health benefits coverage. Confusing? That’s partially why the metal tier system was implemented.
  5. The AHCA would eliminate this system, which is used as a sort of standard to help consumers compare plans. This could make it a bit harder for people to compare health plans.

Drug Prices Are Too High, Say Novo Nordisk CEO & Many Others

A Kaiser Health News study shows that “with new cancer drugs commonly priced at $100,000 a year or more … hundreds of thousands of cancer patients are delaying care, cutting their pills in half or skipping drug treatment entirely.” Dr. Hagop Kantarjian, a leukemia specialist, believes that high drug costs are “causing more death than necessary.” New medications and their “jaw-dropping costs” have led to much criticism of the pharmaceutical industry.

One such critic comes from within the industry itself. In an interview on Tuesday, Novo Nordisk A/S CEO Lars Fruergaard Jorgensen said, “It was never the intention that individual patients should end up paying the list price. I have a big problem with that.”


News Update for March 14, 2017

CBO Says AHCA Would Result in Millions More Uninsured, Reduction of Budget Deficit

The Congressional Budget Office, a non-partisan Congressional agency, released its analysis of the American Health Care Act on Monday. The analysis projects that, compared to the Affordable Care Act, 24 million more Americans would be uninsured in a decade under the AHCA. However, the bill would also lower the deficit by $337 billion thanks to decreased government spending. Representing the Trump administration, Secretary of Health and Human Services Tom Price said, “We disagree strenuously with the report that was put out. It’s just not believable is what we would suggest.” Price said that the CBO’s job was “virtually impossible,” and that the figures should be taken with skepticism. The White House’s own Office of Management and Budget, however, forecasted an even grimmer prediction: 26 million more Americans would lose coverage in the next decade. However, White House Communications Director Michael Dubke stressed that this figure was designed as a prediction of what the CBO’s prediction would be. Dubke stated that the 26 million figure was not to be taken as “an analysis of the bill in any way whatsoever. This is OMB trying to project what CBO’s score will be using CBO’s methodology.”

Senate Republicans Uneasy Over New CBO Figures on AHCA, Obamacare Supporters Emboldened

The 24 million more uninsured figure released by the CBO is not sitting well with many Republicans in the Senate. “Can’t sugarcoat it. Doesn’t look good,” said Republican Senator Bill Cassidy of Louisiana. “The CBO score was, shall we say, an eye-popper.” The CBO numbers don’t bode well for garnering centrist and conservative Republican votes behind the bill. However, some Republicans are taking the White House’s line of discounting the CBO score. Representative Greg Walden (R-OR) said that the CBO hasn’t evaluated the GOP’s “entire proposal to repeal and replace Obamacare, and today’s score reflects only a portion of the actions we will take to roll back red tape, free markets and empower consumers.”

Some of the Senate’s more conservative members will visit the White House on Tuesday. Senator James Lankford (R-OK) said that he and his fellow Republican Steering Committee members “will offer ways to ‘strengthen’ the bill and make it ‘actually viable.’”

Because of the CBO score, which reduces the amount of insured Americans while lowering the deficit, the AHCA is being accused of “throwing 24 million people off their health care to give billionaires a tax break,” according to prominent Democratic Senator Elizabeth Warren of Massachusetts.

Major Insurance Company Comes Out in Support of AHCA

Anthem, the country’s second biggest health insurance company, has endorsed major parts of the American Health Care Act. This is notable not only for Anthem’s stature, but because major insurance company groups had expressed concerns about the American Health Care Act earlier this week. In a letter from Anthem CEO Joseph Swedish to two House committees, Swedish wrote that the bill “addresses the challenges immediately facing the individual market and will ensure more affordable health plan choices for consumers in the short term.” Anthem expressed further support for provisions in the proposal that “would repeal Obamacare’s health insurance tax, temporarily continue the law’s cost-sharing subsidies, and allow customers to receive tax credits off the Obamacare exchanges.” Swedish wrote, “These provisions are essential and must be finalized quickly to have the intended impact on products and prices to benefit customers.” Anthem is still looking for the federal government’s approval to acquire Cigna, another major insurance company. Anthem is currently the largest insurance company participating in the Obamacare exchanges.

Companies That Manage HSAs Could See Big Earnings Under GOP Proposals

Health savings accounts have been a popular Republican talking point for some time now. They were introduced in 2003 and have seen consistent championing by the GOP since that time. The American Health Care Act “reflects the [GOP’s] broad consensus for giving more Americans access to HSAs, which allow people to put aside money tax-free for medical expenses.” If the GOP is successful, it could mean “millions more customers” and earnings from account management fees for companies that manage HSAs. Read more about HSAs and how quickly they’ve grown in the last decade.


News Update for March 13, 2017

What Is the “Obamacare Nightmare Scenario?”

Axios and researchers at the Robert Wood Johnson Foundation have developed some findings that show what would happen to coverage availability if various insurance companies decided to exit the individual insurance exchanges for 2018.  The findings estimate how many people would be left either without coverage or with only one insurance company as an option for coverage if certain insurance companies were to opt out. The departure of Anthem, for instance, would result in around 250,000 people having no option for coverage through the Obamacare exchanges. Over 550,000 consumers would have only one option for insurance. Compounding this “nightmare scenario” is the fact that each time an insurance company leaves the exchanges “it raises the stakes for the next carrier to leave,” says Katherine Hempstead of the Robert Wood Johnson Foundation.

Speaker Paul Ryan Interviewed on Obamacare Repeal

Speaker of the House Paul Ryan was interviewed on CBS’s “Face the Nation” on Sunday. Here are some highlights:

New Bill Proposed by House Republicans Would Help Employers Find Out How Healthy Their Employees Are

The Preserving Employee Wellness Programs Act has been introduced by Representative Virginia Foxx (R-NC). This bill seeks to strengthen company wellness programs by making it easier for an employer to obtain personal medical and genetic data from employees and their dependents. The bill “would also significantly increase the financial costs faced by someone who does not join a company wellness program.”

The bill is currently under review by House committees, but many consumer and privacy advocacy groups are already voicing passionate opposition to the bill. The bill’s opponents object to the bill on privacy grounds and also believe it could lead to the imposition of “draconian penalties on employees who choose to keep [their] information private. The bill’s supporters believe it would help companies make better decisions to help lower healthcare costs.

How Will the AHCA Cover People with Pre-Existing Conditions?

A new article by the Kaiser Health Foundation examines how the American Health Care Act might attempt to keep coverage available for people with pre-existing conditions. The provision to protect that coverage is one of Obamacare’s more popular provisions. Many insurance companies were worried that if they were required to allow sick people to buy their products, medical costs would get out of hand, and healthy people would leave the insurance pool because of rising premium costs. Obamacare’s individual mandate to require people to pay insurance or be subject to a fine was a way of offsetting this worry. The new bill takes out this mandate and, instead, would put in place a fine for “[p]eople who experience a gap in coverage.” The fine of a 30 percent higher premium for a year would be paid to the insurance company. According to Kaiser, this would make it so that people with pre-existing conditions would be guaranteed that their insurance plans would cover their illnesses, but there wouldn’t be a way to guarantee that they could buy the plan.


News Update for March 10, 2017

Voting on Second Healthcare Bill Early Next Week?

Speaker Paul Ryan, speaking with Sean Hannity on Thursday, said that House Republicans will be voting on a second, currently unrevealed, healthcare bill the same “week they vote to repeal Obamacare.” Republican leaders are tackling Obamacare repeal and replacement in 3 phases: passing the American Health Care Act, cutting down healthcare industry regulations through the Department of Health and Human Services, and passing more healthcare reform bills.

In a private meeting with grassroots conservative leaders recently, President Donald Trump said that the companion healthcare bill to the American Health Care Act would be revealed to the public soon, possibly as early as next week. Republicans are intending for the AHCA to handle budgetary measures related to the Affordable Care Act. By doing so, the bill will only require 50 Senate votes to pass. The second bill will need 60 votes. This second bill will be part of the third phase discussed earlier.

White House Takes on Congressional Budget Office in Fight over AHCA

White House Press Secretary Sean Spicer is asking people not to pay too much attention to the Congressional Budget Office’s upcoming budgetary evaluations next week for the American Health Care Act. The CBO is a bipartisan Congressional agency that helps Congress with economic and budgetary findings.

Many lawmakers, including prominent Republicans, are interested in what effect the AHCA will have on the federal deficit. Some experts predict that “the CBO score of [the AHCA] is almost certain to be less favorable than that of Obamacare.” This could greatly influence whether or not the AHCA will pass. CBO Director Keith Hall, a Republican appointee who favors “free-market economic views” and rejects “the political limelight,” is widely considered by his peers as a staunch non-partisan in terms of assessing the budget. His office is coming under fire for some miscalculations with Obamacare’s budget. Others believe that the White House is preemptively discrediting the CBO in anticipation of a bad review in order to drum up support for the AHCA.

House Majority Whip Is Confident the House Will Pass the AHCA

In the past few weeks, there has been a lot of focus on whether or not conservative and moderate Republicans would fall in line to vote to pass the AHCA through the House. On Thursday, Representative Steve Scalise, the House Majority Whip, told the media that the House was going to get the AHCA passed. The Majority Whip is responsible for rallying and keeping track of votes. “Despite being awake for 33 straight hours, fueled by adrenaline and several cups of chicory coffee from New Orleans,” Scalise appeared to be in a very good mood and, smiling, elatedly told reporters, “We’re gonna get this done.” Scalise also said that the GOP divisions were blown out of proportion by the media.

White House Weighs Supporting Rollback of Medicaid Expansion

According to “two senior [Trump] administration officials and a senior House conservative aide,” the White House is privately considering rolling back Medicaid expansion sooner than the American Health Care Act currently calls for. This is a possible concession to House conservatives who want to rein in spending as soon as possible.

While talking to reporters on Thursday, Representative Mark Walker (R-NC) said if this provision was added he would “lean yes.” Walker said that if the bill instituted work requirements for healthy, childless adults on Medicaid, he would definitely vote yes.

This move has a great capacity to alienate moderates in the Senate, however. Many Republicans are strong supporters of the Medicaid expansion.


News Update for March 9, 2017

AHCA Clears Two House Panels, Even as Democrats Attempt to Stall

Despite some obstructionist tactics from the Democrats, the GOP was able to advance the American Health Care Act through two key committees. The House Ways and Means Committee advanced the bill early in the morning (around 4:30 a.m., Eastern Standard Time) on Thursday. The House Energy and Commerce Committee advanced it Thursday afternoon. “Despite what you hear in the press, healthcare is coming along great,” tweeted President Donald Trump. However, many Democrats and Republicans think that the House bill is advancing too quickly. Senator Tom Cotton (R-AK) tweeted, “Get it right, don’t get it fast.”

Doctors, Hospitals, and Many Insurance Companies Line Up Against AHCA

On Wednesday, the American Medical Association released a letter to Congress saying that it “cannot support the [American Health Care Act] as it is currently written.” The AMA “calls itself the largest physician advocacy group in the country.” It backed the nomination of Tom Price, one of the principal authors of the bill, for the office of Secretary of Health and Human Services. Other major physician groups have also come out to either voice their opposition or major concerns with the bill.

Most hospital associations have come out against the bill as well. The nation’s largest hospital association, the American Hospital Association, joined with 6 other associations to send a letter to Congress voicing their disapproval. The letter stated that the associations feared the proposal would “lead to tremendous instability for those seeking affordable coverage.” According to USA Today, “virtually every type of hospital” is represented among the opposition. The hospital associations are also “deeply concerned” that the law will result in massive cuts in federal funding for their healthcare services.

The health insurance industry’s largest trade association, America’s Health Insurance Plans, also sent a letter on Wednesday. This letter was much more appreciative of some of the proposed changes, but it was concerned that the bill would not give enough money to Medicaid and that the new system of tax credits wouldn’t be enough to keep younger, healthier consumers in the insurance marketplace.

White House Avoiding “Trumpcare” Nickname for New Bill

The Trump Administration will not be using “Trumpcare” as a nickname for the American Health Care Act, the Republicans’ new proposed bill to replace Obamacare. Ryan Williams, a former longtime spokesman for Mitt Romney, told Politico, “Anything with the word ‘care’ in it pretty much sounds bad to people these days.” Many other Republican figures were asked about the name “Trumpcare,” and many of them avoided the question or shot down the suggestion.

On the other hand, Democrats are eager to utilize the nickname, possibly as a way of assigning any perceived faults in the law to the president himself. “What we have after the repeal is Trumpcare. Whatever is left after the dust settles is Trumpcare,” said Senator Claire McCaskill (D-MO).

Only 3% of Americans Affected by Premium Increases

More than 90 percent of Americans have health insurance and get it through an employer or government programs that don’t include the Obamacare exchanges. Eighty-five percent of people who buy insurance through these exchanges receive federal subsidies that protect them from premium increases. According to a new, interactive infographic released by The New York Times, only 3 percent Americans are affected by Obamacare’s premium increases. According to the U.S. Census Bureau though, the population of the U.S. is around 320 million, so this number would still affect about 10 million Americans.


News Update for March 8, 2017

Conservatives Continue to Oppose “Obamacare Lite” while Trump Pushes for Speedy Replacement

Conservatives continue to oppose Paul Ryan’s new healthcare reform draft, giving it several disparaging nicknames: Obamacare Lite, RyanCare, and RINOcare (Republican in Name Only). Michael Cannon from the Cato Institute said, “It is remarkable that they’ve produced a bill that is so out of touch with ACA opponents.”

However, President Trump doesn’t seem to want any more delays in repealing and replacing Obamacare. Trump has been very direct when addressing lawmakers about the proposed bill: He wants it to be approved promptly and delivered “largely intact.” Trump has also committed himself to becoming “personally involved in persuading skeptical lawmakers and warned that failing to pass the legislation would result in trouble at the ballot box for Republicans who pledged to repeal and replace Obamacare.”

GOP Factions Pose a Threat to New Healthcare Bill

Three GOP factions pose a threat to Paul Ryan’s American Health Care Act’s ability to become law over certain healthcare reforms.

  1. Western and Midwestern senators: This faction is opposed to any plan that doesn’t provide stability for Medicaid.
  2. Conservative and Libertarian senators: This faction is opposed to subsidizing individuals’ healthcare expenses.
  3. Moderate Supporters of Planned Parenthood: This faction may oppose the bill because of severely decreased funding for Planned Parenthood, a nonprofit healthcare clinic catering to women.

To see the Senators in each faction and a full explanation of their arguments, read the Washington Post’s article.

Elijah Cummings Continues Attempts to Lower Prescription Drug Costs

After being delayed for a month, House Democrat and Senior Black Caucus Member Elijah Cummings is meeting with President Trump today to discuss potential ways to lower prescription drug prices. Cummings stated that Trump “promised—both during the campaign and after—that he would support efforts to stem the skyrocketing prices of prescription drugs, so I am looking forward to discussing ideas he said he supports.”


News Update for March 7, 2017

House Republicans Unveil Long-Awaited Obamacare Reform Bill: The American Health Care Act

On Monday, House Republicans released a long-awaited proposal to replace Obamacare. Billed as a “more conservative vision” for American healthcare, the bill would be a “remarkable moment” in healthcare legislation because Congress has never before reversed a major program of social benefits that has affected this many people. The House has proposed the legislation, which is designed to ensure the long-term financial stability of the healthcare industry, under two bills.

Here are some of the changes:

  • The individual mandate, which penalizes Americans for not having health insurance, would be removed. Insurance companies would be permitted to “impose a surcharge of 30 percent” to people who discontinue coverage and then resume it later on.
  • The employer mandate, which penalizes large employers when they don’t provide health insurance to their employees, would also be eliminated.
  • Age-based tax credits ranging from $2,000 to $4,000 [would replace] the Affordable Care Act’s income-based subsidies.
  • A major overhaul of Medicaid that phases out the open-ended federal funding system it is currently using with a program with spending caps.
  • Insurance companies would be permitted to charge older enrollees 5 times as much in premiums as compared to the cap of 3 times as much under Obamacare.

American Health Care Act Has Long, Uphill Climb Before Passage

In the House, many conservative Republicans are still voicing their displeasure with the bill. Representative Dave Brat (R-VA), a member of the conservative Freedom Caucus, told Politico that he has “seen no evidence that this bill will bring the cost curve down.” Representative Justin Amash (R-MI) insulted the bill by calling it “Obamacare 2.0.” It’s not known if House conservatives will attempt to vote against the bill though. GOP leaders in the House expect that some conservatives and moderates in their party will vote against it. The bill can only lose 21 Republican votes, assuming that the Democrats stand against it unanimously.

If Democrats vote against it along party lines, the bill would lose if just 3 of the Senate’s 52 Republican senators defected. Four Republican senators have already told Senate Majority Leader Mitch McConnell (R-KY) that they plan to oppose any plan that would cut Medicaid for people in their states. Two conservative Republican senators, Rand Paul (R-KY) and Mike Lee (R-UT), have already come out publicly against the plan as well.

On the other side of the aisle, Senate Minority Leader Charles Schumer (D-NY) sharply criticized the American Health Care Act, calling it a “sham of a replacement.”

American Health Care Act Reforms Obamacare, But Also Leaves Parts of It Unchanged

The American Health Care Act seeks to get rid of almost all of Obamacare’s taxes, except the “Cadillac” tax, which taxes high-cost health plans. There is a lot of bipartisan opposition to this tax, which was originally going to take effect in 2020 under Obamacare. The new bill proposes keeping this provision in order to not add to the deficit.

The law also keeps some of the more popular parts of Obamacare unchanged:

  • Insurance companies “have to offer health plans to people, regardless of” pre-existing conditions.
  • “Plans cannot cap the amount they pay in claims in a year or” in their customers’ lifetime.
  • Adult children can stay on their parents’ plans until age 26.
  • Some of the required benefits of Obamacare’s Essential Health Benefits will stay in place, including “preventive medicine and maternity care.”

Tax Credits Between Affordable Care Act vs. American Health Care Act

The Kaiser Family Foundation has released a new tool that compares estimates of premium tax credits Obamacare Marketplace enrollees would receive under Obamacare in 2020 with what they would receive under the newly proposed American Health Care Act. The map shows county-by-county results for how much more or less enrollees would receive in tax credits depending on age, income, and home county. Both policies include tax credits, but Obamacare “takes family income, local cost of insurance, and age into account,” whereas the new policy focuses “only on age, with a phase out for individuals with incomes above $75,000.”


News Update for March 6, 2017

Newest Version of House Obamacare Replacement Bill Leaked Again

Last Friday, Politico was able to obtain leaked documents outlining the latest version of the House’s Obamacare replacement bill. This is the second Obamacare replacement bill proposal to be leaked in the span of a month.

Some of the key components of the proposal include:

  • Tax credits based on age, but it wouldn’t allow wealthier Americans to qualify for the tax credits. No specific cut-offs have been proposed yet though.
  • Eliminating many of Obamacare’s taxes.
  • Extending the lifetime of health plans that pre-existed Obamacare that don’t meet many of the law’s requirements.
  • Creating a “reinsurance” fund for states to help shore up the individual health insurance market. The bill would grant states the ability to reimburse insurance companies from the fund if medical claims of covered individuals are between $50,000 and $350,000.

Healthcare Executives Worried About Trump Administration’s Changes to Obamacare and Healthcare Industry

Healthcare industry CEOs are, according to a survey by Modern Healthcare, nervous about many things they believe will result in major changes to the healthcare industry. The survey, which contacted 110 CEOs and received 81 responses, shows that more than 75% of the respondents do not support a repeal of the Affordable Care Act “with a phaseout period and a promise of a replacement.” Many CEOs “fervently hope Republicans move deliberately and thoughtfully, and preserve affordable coverage for the 20 million people who obtained insurance under the ACA.” According to Catherine Jacobson, the CEO of Froedtert Health, “Any drop-off in coverage falls 100% on health systems, because we’re the ones who pay in terms of bad debt and charity care.”

The survey shows CEO opinions on a wide variety of healthcare concerns. You can read more here.

Conservative Activist Groups to Launch Campaigns to Pressure Republicans on Obamacare Repeal

Conservative activist groups, many of which can be traced back to the billionaire Koch brothers, are about to launch a campaign called “You Promised.” The campaign seeks to strongly pressure GOP lawmakers into repealing Obamacare, as the GOP has been running on the idea of Obamacare repeal for years. Many Republican lawmakers are worried that they’ll lose their seats in Congress since backing the law’s repeal might prove unpopular to their constituents, particularly, but not exclusively, in swing districts and swing states.

Older Americans Are Continuing to Voice Their Concerns About Obamacare Repeal

AARP and other representatives of America’s elder community “are bombarding congressional offices with objections as two House committees” are planning to vote on Republicans’ Obamacare repeal bill. They are worried over insurance premium increases of 20 to 25 percent or higher. The Affordable Care Act prevents older Americans from being charged more than 3 times what younger insurance enrollees are charged. The House bill could possibly allow premiums to be 5 times higher. Some states could choose to charge even more than that.

The proposal could have “a severe impact on Americans age 50 to 64 who have not yet become eligible for Medicare,” said David M. Certner, the legislative policy director of AARP. In the meantime, Secretary of Health and Human Services Tom Price stated on Sunday that he and the White House would stand firm behind not cutting Medicare.


News Update for March 3, 2017

House Speaker Paul Ryan Plans Vote on Obamacare Replacement Bill for Later This Month

House Speaker Paul Ryan is feeling more and more confident about getting an Obamacare replacement bill passed through the House of Representatives. In a closed-door meeting on Thursday, Ryan said he expects a vote on an Obamacare replacement bill to occur sometime in the next 3 weeks, according to various sources who attended the meeting.

At a press conference on Thursday, Ryan stressed Republican unity on the progress for repeal and replace so far. Despite concerns from conservative Republicans over the GOP leadership’s insistence on refundable tax credits, Ryan said the GOP is “in sync – the House, the Senate and the Trump administration, because this law is collapsing.” Privately, many Republicans are stressing that “they have no problem steamrolling conservatives by daring them to vote against” the bill.

Majority Leader Mitch McConnell (R-KY) is much more apprehensive about the Senate. McConnell told reporters, “The goal is for the administration, the House and the Senate to be in the same place. We’re not there yet.”

Senate Republicans Opting Not to Write Their Own Bill, Taking Up House’s Obamacare Bill Instead

Senator John Cornyn (R-TX) told the media on Thursday that Senate Republicans would wait on the House’s upcoming Obamacare repeal bill rather than creating one on their own. “The goal is for the House to pass a bill that we can then take up and pass here in the Senate,” Cornyn said. If the Senate were to decide to change the House bill, it would have to be sent back to the House for the House to pass again before returning the bill back to the Senate. Although much of the media’s coverage on Obamacare is focused on House Republicans and their difficulties unifying around an Obamacare replacement plan, Senate Republicans themselves might face some difficulty in regard to unity when it comes time for them to vote.

Some Republicans Worried About Tying Obamacare Repeal with Planned Parenthood Defunding

Many Republicans, particularly more conservative ones, have pushed to defund Planned Parenthood for many years. Moderate Republicans are worried that conservatives will include measures to defund Planned Parenthood in an Obamacare replacement bill. “I, for one, do not believe that Planned Parenthood has any place in our deliberations on the Affordable Care Act,” said Senator Lisa Murkowski (R-AK). Murkowski also added that she wouldn’t vote on any measure that would deny her constituents access to healthcare provided by Planned Parenthood. Representative Charlie Dent (R-PA) believes that “healthcare reform is controversial and complex enough without Planned Parenthood. Why put it in? It makes this whole exercise more difficult.”

Trump’s CMS Pick Approved by Senate

On Thursday, the Senate confirmed President Trump’s nominee to run the Centers for Medicare and Medicaid Services (CMS). Seema Verma, who was confirmed on a 13-12 vote, “is the owner of SVC, a healthcare consulting firm” that “has helped redesign Medicaid programs in several states, including Indiana.” In this capacity, she worked closely with Vice President Mike Pence, who was then the governor of Indiana. Some Democrats have expressed concern about possible conflicts of interest that might have come up during her time working with the Indiana state government.


News Update for March 2, 2017

Republicans Are Working on a New, Top Secret Obamacare Replacement Draft

House Republicans are currently working on a new draft of an Obamacare repeal and replacement bill. The Republicans are being extremely secretive with the document, which is currently locked up in a “dedicated reading room” and can only be read by certain members and staff on the House Energy and Commerce panel. No copies are allowed outside of the room.

The heightened security is a response to last week, when a previous draft was leaked and widely panned by conservative House members. Today, Representative Chris Collins (R-NY) told the media, “The [new] draft is going to be available tomorrow for those of us on the health subcommittee to start poring through.”

GOP Infighting Is “How You Come Up With a Good Public Policy”

There has been some recent concern over the GOP’s seeming inability to find a compromise on an Obamacare replacement bill. In light of this, Senator Marco Rubio (R-FL) appeared on Fox & Friends to alleviate this concern. Rubio stated, “This notion that because there’s five different ideas about it, that’s a sign of weakness – is ridiculous.” The senator argued that it was “a good thing that there are a lot of different ideas” because it was a sign of a healthy debate that would result in better public policy.

New Study Indicates More and More Americans Are Having Trouble Paying for Their Insurance

The Kaiser Family Foundation has released a new survey showing that healthcare has become less affordable, even among people who have health insurance.

  • Around 43 percent of adults with health insurance are having difficulty affording their deductible. This is an increase from 34 percent from a comparable survey taken in 2015.
  • Around 37 percent of adults say that they are having trouble affording their premiums. This is an increase of 27 percent.
  • Around 31 percent of adults say they are having trouble paying for prescriptions and copays for doctor visits. This is an increase of 24 percent.

Many Community Clinics Fear Being Shut Down in Face of Obamacare Repeal

Coinciding with the implementation of Obamacare, 950 community health center sites have opened in the last 7 years. Much of the costs to open and maintain these community clinics are paid for through provisions in the Affordable Care Act. Many operators of these clinics are now worried about the futures of their clinics, which often provide healthcare services in parts of the country with large shortages of availability in service. “Between 2011 and 2015, local clinics across the country received $11 billion” through the Community Health Center Fund, one of Obamacare’s provisions, in order to maintain operations.

Congress, with bipartisan support, has extended funding before, most recently in 2015 in order to provide $7.2 billion. However, the funding is set to expire in September of this year, and, with so much of the Affordable Care Act up in the air, many people are worried.


News Update for March 1, 2017

President Outlines Five Major Components for Replacing Obamacare

In President Trump’s address to Congress last night, he laid out some key points in his plan to replace Obamacare. The outline for his plan includes:

  1. Making sure that “people with pre-existing health conditions are guaranteed ‘access’ to health insurance.”
  2. Giving tax credits to “people who buy their own health coverage” and expanding health savings accounts so that people can more easily design their own health insurance plans.
  3. Making sure states have “the resources and flexibility” to use Medicaid programs to help poor people with their healthcare concerns.
  4. Bringing “down the price of high-cost drugs” and lowering insurance costs with various legal reforms.
  5. “Creating a national insurance marketplace” that lets insurance companies sell plans across state lines.

New Study Shows Current ACA Replacement Plans, Compared to ACA, Will Lower Health Insurance Tax Credits for Consumers

The Kaiser Family Foundation has released a new analysis estimating that health insurance tax credits in 2020 would, on average, be at least 36 percent lower under replacement plans proposed by Republicans than under Obamacare. The analysis states that the current tax credit for Obamacare exchange customers would rise from an average of $4,615 in 2020 to $6,648 in 2027. However, at least one ACA replacement plan would see a much slower rise in tax credits: from $2,957 in 2020 to $3,729 in 2027.

GOP Set to Hold Meeting to Discuss Obamacare Repeal Bill

Congressional Republicans are currently far from a consensus about how to repeal and replace Obamacare. The party’s reaction to the President’s speech last night has also highlighted differences between conservative and moderate Republicans, who are in disagreement over tax credits for people who pay for their own health coverage. Trump did not specify if the tax credits he supports will be refundable or nonrefundable, which is at the root of the disagreement among the factions of the GOP.

Other disagreements revolve around the nature of Medicaid expansion. “My concern is that we want to make sure none of these folks gets dropped. And I’m not fully convinced that what the House is working on can give me that assurance,” said Senator Shelley Capito (R-WV). Other Republicans, like Representative Jim Jordan of Ohio, believe that voters “didn’t tell us to repeal [Obamacare] but keep the Medicaid expansion.” Senate Majority Leader Mitch McConnell will hold a special meeting with Republican members of both houses of Congress on Wednesday in order to try to hash out an understanding.

Is Obamacare Tied to Early Retirement?

An article from The New York Times suggests that it might be harder for people to retire early if the Affordable Care Act is repealed. Many of Obamacare’s provisions helped prevent a phenomenon “called job lock — the need to maintain a job to get health insurance.” Many studies have shown that there was “evidence of job lock in the pre-Obamacare” years. Some suggest that if it wasn’t for job lock, there would be more job mobility and growth in business because people would be more likely to take risks and innovate.


News Update for February 28, 2017

Conservative Republicans Are Opposing a Leaked Obamacare Replacement Draft

Many conservative Republicans are now voicing their opposition to the draft of a recently leaked Obamacare replacement bill. Representative Mark Meadows, the conservative House Freedom Caucus chairman, and Representative Mark Walker, the chairman of the Republican Study Committee, went on record Monday to say that they would vote against the bill. They believe the bill would increase government spending and that the bill’s tax credits will needlessly benefit wealthier Americans. Senators Ted Cruz (R-TX), Rand Paul (R-KY), and Mike Lee (R-UT) made a joint statement of opposition to the bill for the same reasons.

House Speaker Paul Ryan Insists He and the President Are United

President Trump’s recent proposal to slash domestic spending while preserving Social Security and Medicare sits at odds with House Speaker Paul Ryan’s life’s work. Ryan has been attempting to reform and cut entitlement spending, such as Social Security and Medicare, for the duration of his career. Many are wondering how the GOP can be reconciled over this fundamental difference in ideology. Ryan himself went on record on Tuesday to say that he and the president are united as they are working on reforming something else he sees as an entitlement: Obamacare.

Governors Believe Trump Administration Is Working on Its Own Obamacare Replacement Proposal

Last week, many congressional Republicans went on record to state that they believed the Trump administration would stand back and let Congress draft Obamacare replacement proposals. After meeting with the president at the White House on Monday, many governors, including Virginia Governor Terry McAuliffe (D) and Nevada Governor Brian Sandoval (R), are now working under the assumption that the Trump administration might be drafting its own plan. Governor McAuliffe said that Secretary of Health and Human Services told the governors that the Trump plan would be ready to be unveiled “within a few weeks.”

Health Insurance Companies More Optimistic About Health Insurance Industry After Meeting with Trump

CEOs from many health insurance companies attended a meeting with the President on Monday morning. The meetings allowed the CEOs to discuss their various concerns about the future of the Affordable Care Act and any of its possible replacements. Previously, insurance companies were hoping that the government could provide some assurance that subsidies to help pay for individual premiums would remain. Few details have emerged, but, after the meeting, many of the CEOs said “they were optimistic about the future of the healthcare landscape.”


News Update for February 27, 2017

President Trump to Talk Healthcare in Public Address to Congress

President Trump will be making a nationally televised address to a joint session of Congress this Tuesday night. He will be discussing healthcare and the repeal and reformation of the Affordable Care Act, as well as many other topics.

Tensions Flare over Obamacare and Medicaid Reform at National Governors’ Association Meeting

At the National Governors’ Association Meeting this weekend, a heated debate arose between Democratic and Republican governors. After hearing a report that a Medicaid overhaul “would result in tens of thousands of people losing their insurance coverage in an average-size state,” Democrats, such as Washington Governor Jay Inslee, called the report “disturbing” and accused Republicans of wanting “to spend less money on people’s healthcare so they can do tax cuts for the rich.”

Some Republicans, including Governor Matt Bevin of Kentucky, believe these results are necessary to fix what they see as a broken Medicaid system. Governor Bevin stated, “The piper has to get paid at some point.” Other Republicans, such as Governor Doug Ducey of Arizona said that none of the governors “want to see any citizen have the rug pulled out from underneath them” and that the governors would work hard to improve healthcare and reform the Medicaid system.

House Republicans Might Present Obamacare Plan Later This Week

A leaked draft of a House Republican bill to repeal the Affordable Care Act was obtained by Politico last week. The draft is most likely undergoing some changes at the moment, possibly because many experts said that the proposal would result in a large increase in the country’s rate of uninsured people. House Speaker Paul Ryan has said that he wants to present a repeal bill later this week.

Execs from Major Insurance Companies to Meet with President Today

Cigna Corp, Humana Inc, and the Blue Cross Blue Shield Association announced that some of their executives would be meeting with President Donald Trump on Monday. Representatives of other insurance companies are also expected to attend. Last week, the Trump administration proposed rules to attempt to alleviate concerns that many of these companies had about the individual insurance marketplace. However, many insurance companies felt that the proposals were inadequate and they are looking for assurances “that the government will continue to provide cost-sharing subsidies” for the individual marketplace.

Vermont, a Blue State, Redesigns Its Healthcare Plan to One Similar to Republican-Approved Plan

Vermont is attempting a statewide experiment to change how its healthcare is delivered and paid for. The new experiment “aims to test new payment systems, prevent unnecessary treatments, constrain overall growth in the cost of services and drugs, and address public health problems such as opioid abuse.”

The Affordable Care Act has a provision that permits state governments to launch experimental healthcare reforms so long as certain coverage expansions and consumer protections remain. Vermont’s experiment, which was approved by the Obama administration in October, is notable because it is being enacted in a blue state, despite the experimental plan’s many similarities to Republican proposals.


News Update for February 24, 2017

Draft of Obamacare Replacement Bill Leaked

Politico has obtained a draft of a House Republican repeal bill. The bill would take apart the Obamacare individual mandate, end subsidies based on income for the individual insurance marketplace, roll back Medicaid expansion funding, and give state governments money to help them create high-risk pools for people with pre-existing conditions.

The replacement would fund itself “by limiting tax breaks on generous health plans people get at work.” Read more.

House Republicans Are Trying to Work With Republican Governors on Obamacare Repeal Compromise Bill

The National Governors Association is meeting in Washington for the next couple of days. President Donald Trump will meet with many Republican leaders over the issue of Medicaid funding. Ohio governor John Kasich, a Republican and key supporter of the Medicaid expansion under Obamacare, is a major critic of defunding Medicaid. He will meet with Trump privately over the next few days. House Republicans have reached out to Kasich and Nevada governor Brian Sandoval, another Republican supportive of Medicaid expansion. Many Republican officials throughout the country are in the same boat as Kasich and Sandoval: having to choose between the party line, or whether or not to defund a program that hundreds of thousands rely on in their own states.

Republicans in the House are hoping that Sandoval and Kasich can work out a compromise with other Republican governors who rejected Medicaid expansion. The GOP is hoping that if the governors can resolve concerns amongst themselves, then the party can use the public support of the president and the governors to help get an Obamacare repeal bill passed.

A current plan from House Republicans would temporarily continue using federal funds to cover people who are already insured through Obamacare’s Medicaid expansion. This would, for a time, alleviate concerns for Republican governors who support Medicaid expansion. This plan would also give funding to the 19 Republican-led states that rejected Medicaid expansion.

Former Speaker of the House Says Obamacare Probably Won’t Be Repealed

Former House Speaker John Boehner, at a healthcare conference in Orlando on Thursday, stated that a complete repeal and replace of the Affordable Care Act is “not what’s going to happen.” Boehner, who left politics in 2015 after being pressured out by conservatives in his own party, said that he “started laughing” when Republicans said that they were going to quickly repeal and replace the law. Boehner believes that the Republicans will probably “fix the flaws and put a more conservative box around it,” but the essential framework of the law would probably stay intact. He added, “In the 25 years that I served in the United States Congress, Republicans never, ever, one time agreed on what a healthcare proposal should look like. Not once.”

Can the GOP Ensure Coverage for Pre-Existing Conditions?

Many experts and veteran healthcare industry officials have gone on record to say they believe House Speaker Paul Ryan’s plan to set up high-risk pools for people with pre-existing conditions won’t work. High-risk pools are devoid of healthier (and less expensive) consumers who would otherwise offset the costs of covering people with pre-existing conditions.

The pools under Speaker Ryan’s plan would be run by state governments and be partially financed by the federal government. Ryan’s “A Better Way” plan would give out $2.5 billion a year for the next decade in order to help fund high-risk pools. High-risk pools operated in 35 states before the Affordable Care Act, but their effectiveness was inconsistent. Before the ACA’s reforms took effect, $5 billion was set aside by the federal government to set up a “temporary national high-risk pool program.” According to Kathleen Sebelius, a former Secretary of Health and Human Services under President Obama, the pools “ran out of money because the costs were far more expensive than anyone could have, would have predicted just given the fact that there’s some really sick folks out there.” Many conservative health policy experts also agree that the plan and its financing are unworkable. “The needed amount is more like $16 billion [a year],” says Dean Clancy, a health policy consultant who worked in the George W. Bush administration.


News Update for February 23, 2017

Polls Indicate Approval for Obamacare Continues to Rise

New polls conducted by Morning Consult/Politico show that the Affordable Care Act has again increased in popularity compared to polls conducted earlier this year, since President Trump first took office. “Fifty-one percent of registered voters said Obamacare should be completely or partially repealed,” which is “down 8 percentage points from the beginning of the year. … Seventy-eight percent of GOP voters want the ACA to be at least partially repealed,” which is down 5 percentage points. Support for whether the law should be completely or partially repealed declined by 9 percent for independent voters and 6 percent for Democrats.

Congressional Republicans Not Expecting Trump to Offer His Own Plans for Obamacare Repeal

In January, President Donald Trump said that he and his allies in Congress would be “filing a plan” for Obamacare’s repeal and replacement as soon as Tom Price was confirmed as Secretary of Health and Human Services. Now, indications from the executive branch and the House suggest that Trump will go for a hands-off approach. Congressional Republicans are expecting Trump to not involve himself in the crafting of the legislation. They are, however, expecting him to provide his public endorsement of later proposed bills in order to get them passed.

GOP Looking to Cut Out Parts of Obamacare’s 10 Essential Benefits

Hoping to cut costs, some Republicans are suggesting a roundabout solution to cutting or weakening Obamacare’s 10 essential health benefits. Because the benefits are explicitly laid out in the Affordable Care Act, the law would have to be changed outright in order to get rid of them. This is unlikely to happen immediately as it would be highly improbable for Republicans to obtain the 60 Senate votes needed to enact this scenario. Instead, Republicans could change regulations that federal officials wrote to enact the law. This would, in effect, weaken or eliminate the enforcement of the 10 essential health benefits. Read this NPR article to learn more.

Small Businesses Are Worried Congress Will Continue Ignoring Their Insurance Complaints in Obamacare Repeal

Many small business owners believe Democrats focused too much on reforming the individual insurance marketplace when they created and passed Obamacare. Small businesses (defined as businesses with fewer than 50 workers) feel that this focus was done at the expense of their own concerns.

Employer-based health insurance is the largest source of coverage in America, and “more than 56 million Americans work for small businesses,” which make up to 90 percent of the country’s employers. The percentage of employers who offer employer-based health benefits has been falling over the last 20 years, led mostly by small businesses who struggle to afford the coverage.

Barbara Otto, the director of Health and Disability Advocates in Chicago, an organization that advocates for increased access to healthcare, said “Small business must have a seat at the table. They were not central to the first round of healthcare reform.” She believes that if the new administration can center small employers as a cornerstone for any new healthcare reform laws, the administration will be able to provide an environment for financial growth and more efficient health insurance coverage.


News Update for February 22, 2017

Protests and Contentious Town Halls Continue for Republican Lawmakers Seeking to Repeal Obamacare

Multiple sources have been reporting over the past week or so a marked increase in rallies, protests, and town hall meetings swarmed by Obamacare supporters. These passionate displays of support stem from constituents’ fear over losing their healthcare coverage. Many of them feel that a rushed repeal process could threaten their lives or livelihoods. This Business Insider article collects footage and recollections of constituents’ grievances from around the country.

Group Tied to Senate Majority Leader to Release Pro-Repeal AND Replace Campaign in Response to Obamacare Hardliners

A group affiliated with Senate Majority Leader Mitch McConnell, One Nation, is announcing a series of TV ads in 9 states to both highlight the failings of the Affordable Care Act as well as to promise that the GOP will repeal AND replace the law. The campaign is expected to cost over $3 million. The campaign will also use polling data to show the Freedom Caucus that its hardline stance is out of touch with public opinion.

The poll’s findings include:

  • Only 17 percent of Americans polled (1,201 likely voters in 12 Senate battleground states) believe the ACA should be repealed immediately. 34 percent believe it should be repealed only when a replacement is available.
  • Only 33 percent of Republicans believe the law should be repealed immediately. 56 percent believe in repeal and replace.
  • If repeal passes, 69 percent of respondents believe that the replacement should be enacted immediately. 10 percent believe repeal should be enacted within 6 months. Another 10 percent believe it should take place within a year.
  • 66 percent of all voters say they would oppose Democrats who would oppose all replacement plans.

Republican Senators Offer Two Proposals for ACA Risk Corridors Program

The Affordable Care Act’s risk corridors program was designed to attract more comprehensive insurance plans onto the ACA exchanges. As these new plans would be covering more benefits, the ACA established the risk corridors program to help keep these plans affordable to consumers while at the same time economically sustainable for the insurance companies. The risk corridors program used cash from exchange plan companies that did well between 2014 to 2016 to help those that did not do as well in the same years. Many Republicans oppose the risk corridors program. They believe that it is a bailout for health insurance companies. The program, according to the Department of Health and Human Services, owes insurance companies about $8 billion for 2014 and 2015. “Risk corridors program managers have collected enough cash to pay only 15 percent of the 2014 program obligations. Managers have not made any payments for 2015.”

  • Senator Marco Rubio (R-FL) has proposed a bill that would prevent the HHS from making any payments to these plans.
  • Senator Bill Cassidy (R-LA) has proposed a bill that “would create an optional grant program for states, using the cash that otherwise would be spent on each state’s Affordable Care Act coverage expansion programs.” This bill would allow state governments more autonomy over their approaches to risk corridors programs.

California Senate Introduces Single-Payer Healthcare Bill

State Senator Ricardo Lara (D-Bell Gardens) has introduced a single-payer healthcare bill in the California State Senate. The bill is a preliminary step and, if passed, would officially designate that it would be the “intent of the [State] Legislature” to create a “comprehensive, single-payer health care program.” Experts agree that, while the plan might appeal to many Californians worried about the status of the Affordable Care Act, the disruption that a single-payer system might cause could prove to be its downfall. No specifics were included in the legislation as Lara has, self-admittedly, “not yet figured out the financing” because it is “still early in the legislative process.” Lara was an instrumental figure in last May’s passage of state legislation, which resulted in coverage for 170,000 undocumented immigrant children.


News Update for February 21, 2017

State Government Officials Speak Out Against Full Obamacare Repeal

As Congress works to dismantle the Affordable