If Republicans Repeal Obamacare, Ryan Has Replacement Blueprint

http://www.npr.org/sections/health-shots/2016/11/21/502612264/if-republicans-repeal-obamacare-ryan-has-replacement-blueprint

Donald Trump and Republicans in Congress are vowing to repeal and replace the Affordable Care Act, the signature health care overhaul of President Obama.

Trump has offered a few ideas of where he’d like to see a health care overhaul go, such as a greater reliance on health savings accounts, but he hasn’t provided a detailed proposal.

The absence of specifics on health care from the president-elect makes the 37-page plan that Speaker of the House Paul Ryan has released the fullest outline of what Republicans would like to replace Obamacare. Some health policy analysts say it looks a bit like Obamacare light.

“Republicans through this plan have embraced, I think rightfully so, the basic idea that everybody in the U.S. should have health insurance,” says Jim Capretta, a health policy fellow at the American Enterprise Institute. “And people who are outside the employer system should get some level of financial help through a tax credit, because, frankly, that’s similar to the tax break that is available through employer coverage.”

Republicans had been criticized for years for promising to repeal the ACA and offering nothing as a replacement. Ryan unveiled the proposal at AEI in June.

Trump’s path on health care law intersects with a lawsuit

http://www.seattletimes.com/business/trumps-path-on-health-care-law-intersects-with-a-lawsuit/

FILE – In this Oct. 24, 2016, file photo, the HealthCare.gov 2017 web site home page as seen in Washington. (AP Photo/Pablo Martinez Monsivais, File)

President-elect Donald Trump says he wants to preserve health insurance coverage even as he pursues repeal of the Obama-era overhaul that provided it to millions of uninsured people.

How his administration handles a pending lawsuit over billions of dollars in insurance subsidies will reveal whether Trump wants an orderly transition to a Republican-designed system or if he’d push “Obamacare” over a cliff. Stripping away the subsidies at issue in the case would put the program into a free-fall.

The question in the House v. Burwell case couldn’t be more technical: whether the Affordable Care Act specifically states in its hundreds of pages that the government can pay money to help reduce out-of-pocket costs for low-income consumers on HealthCare.gov and state insurance markets.

Those subsidies for deductibles and copayments are paid directly to insurers, on top of the law’s tax credits that reduce premiums for consumers. Since the ACA’s basic coverage is fairly skimpy, the cost-sharing subsidies make it work for millions of people when they seek treatment. For example, subsidies can bring a $1,500 hospital copayment down to $100.

House Republicans have taken the Obama administration to court. They argue that the law lacks a specific congressional “appropriation” for the subsidies, estimated to total $9 billion next year. A federal district judge in Washington, D.C., agreed with the House and the case is now on appeal.

The Health Care Industry Is in a Panic Over Obamacare Repeal

http://www.thefiscaltimes.com/2016/11/22/Health-Care-Industry-Panic-Over-Obamacare-Repeal

The pledge by President-elect Donald Trump and congressional Republicans to swiftly repeal the Affordable Care Act — followed by months or even years of deliberation over a replacement – is no doubt troubling news to many of the roughly 20 million Obamacare beneficiaries.

House Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) have vowed to jam through legislation as early as January to dismantle the heart of President Obama’s signature 2010 health insurance program, while leaving the question of precisely how they would replace it and when that new system would be put in place unanswered.

California healthcare advocates rally against Trump

http://www.sacbee.com/news/politics-government/capitol-alert/article116320043.html

California Secretary of State Alex Padilla the Democratic National Convention in Philadelphia on Wednesday, July 27, 2016.

They backed Obamacare, and they’re not letting it go without a fight.

The federal healthcare overhaul could be one of the first casualties of President-Elect Donald Trump, who has joined the Republicans controlling Congress in vowing to dismantle the law. Since winning the presidency Trump has softened his stance somewhat, speaking favorably about popular provisions that prohibit insurers from turning away people with pre-existing conditions and allow people to stay on their parents’ plans until they turn 26.

Still, Trump’s election has California healthcare advocates on high alert, not to mention the state’s new U.S. senator. California could forfeit billions of federal dollars that support Medi-Cal, the insurance program for poor Californians, and subsidize private insurance purchases. They’re worried about the fate of Medicare, a program that Speaker Paul Ryan, R-Wisconsin, said has “serious problems because of Obamacare” and is “going broke.”

 A rally today in Los Angeles offers the latest example of a policy rift between California and Washington, D.C., with elected officials joining healthcare workers and patients for an event billed as a push to “protect our health care.” Among the expected speakers are Senate Health Committee chair Ed Hernandez, D-West Covina, Los Angeles County Health Agency Director Mitch Katz, and California Secretary of State Alex Padilla, whose public denunciations of Trump have become a recurring feature.

BY THE NUMBERS: 13.6 million is the number of Californians enrolled in Medi-Cal as of June 2016, the most recent data available, a net increase of about 800,000 from a year earlier and about double Medi-Cal enrollment a decade ago. The total includes almost 3.4 million people who became eligible for Medi-Cal under the state’s optional Obamacare expansion. The Legislative Analyst’s Office last week reported that Medi-Cal caseload should grow by about 100,000 annually through mid-2021 among families, children and people covered by ACA expansion. Enrollment among senior citizens and people with disabilities will grow by an estimated 50,000.

Pence says Trump plans to repeal ACA right ‘out of the gate’

http://www.beckershospitalreview.com/hospital-management-administration/pence-says-trump-plans-to-repeal-aca-right-out-of-the-gate.html

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President-elect Donald Trump has decided repealing the ACA will officially be among his top priorities when he takes office, Vice President-elect Mike Pence told Chris Wallace on Fox News Sunday.

“Decisions have been made by the President-elect that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free market solutions that he campaigned on,” Mr. Pence said on Fox News.

The Trump-Pence transition team has been working with congressional leaders from both political parties to move Mr. Trump’s “aggressive policy agenda” forward, Mr. Pence said. This weekend Mr. Pence met with Senate Minority Leader Chuck Schumer, D-N.Y., Senate Majority Leader Mitch McConnell, R-Ky., House Minority Leader Nancy Pelosi, D-Calif., and House Speaker Paul Ryan, R-Wis., according to the interview.

Later on the show, Fox News spoke with Sen. Schumer, who said the ACA is one of the issues on which Democrats plan to “oppose [Mr. Trump] tooth and nail.” Sen. Schumer said Mr. Trump would not be successful in his efforts to repeal the healthcare reform law.

“He won’t be able to do it, because now even he, after his meeting with President Obama, said, ‘Oh, I want to keep the good things.’ Well, you can’t keep the good things without keeping [the] ACA,” Sen. Schumer told Fox News.

Scott Becker, publisher of Becker’s Hospital Review, says it is still unclear if Mr. Trump can or will be able to push through an ACA repeal. “It’s a fascinating statement because it’s not clear Republicans have the votes to repeal this without making complicated accommodations on a few levels, particularly for preexisting conditions and some funding issues,” Mr. Becker says.

Keeping tabs on a potential ACA repeal: Three questions to watch

https://www.brookings.edu/blog/fixgov/2016/11/15/keeping-tabs-on-a-potential-aca-repeal-three-questions-to-watch/?utm_campaign=Brookings+Brief&utm_source=hs_email&utm_medium=email&utm_content=37671114

 

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In the days since the surprise election of Donald Trump to the presidency, substantial attention has been paid to the possibility that congressional Republicans will take advantage of a Republican president’s pen to repeal all or part of the Affordable Care Act, possibly as soon as January. Doing so will almost certainly involve a special budgetary process known as budget reconciliation, which, thanks to a limit on time for debate, eliminates the possibility of a filibuster. Reconciliation and other similar procedures for limiting debate in the Senate (which I’ve written on elsewhere) are often described as “arcane,” and certainly, the coming weeks are likely to bring several procedural twists, likely with big policy implications, worth watching. Given the centrality of the law’s repeal to Republican messaging—the House has voted on repeal more than 60 times—the political implications of the foregoing debate are large as well. Here are three key questions I’ll be watching for the answers to as the debate unfolds, as they’ll tell us much about the both the policy and political implications of Republicans’ repeal efforts.

Clinton vs. Trump: 5 critical election issues

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/hillary-vs-trump-5-critical-election-issues?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=25102016

While Hillary Clinton vows to forge ahead with Obamacare if she is elected president, Donald Trump would scrap it altogether. The end results would be two very different forms of healthcare, and industry leaders have much to consider.

Brill“Many different factors are weighing on managed care executives such as the costs of pharmaceuticals, diagnostics and devices; the impact of consolidation amongst hospitals, physicians, health plans; and the losses in the exchange marketplace,” says Managed Healthcare Executive editorial advisor Joel V. Brill, MD, chief medical officer, Predictive Health, LLC, which partners with stakeholders to improve coverage of value-driven care. “With each of these factors, plans can, at least at a high level, make some educated guesses about the relative risk of each factor and impact to the bottom line.”

The election results, however, are much less certain, which from a risk perspective, weighs heavily on the minds of healthcare executives, Brill says. “How can you plan for business knowing that whatever you are doing currently could be upended in the beginning of November?”

To help provide some clarity, Managed Healthcare Executive identified five of the top industry issues, reviewed the candidates’ platforms for each, and asked industry experts to weigh in.

Healthcare Coverage Reform Proposals

Click to access RyanPlanAnalysis-brief.pdf

 

What can we expect in healthcare with Clinton, Trump?

http://thehill.com/blogs/congress-blog/healthcare/289527-what-can-we-expect-in-healthcare-now-that-clinton-and-trump

Now that our presidential nominees are set and the general election has begun, what do our nation’s hospitals and health systems need to do, whether Secretary Clinton or Mr. Trump is elected in November? They, and their parties, offer stark contrasts, but what will they mean for hospitals?

Seven healthcare questions the candidates aren’t answering

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/seven-healthcare-questions-candidates-aren-t-answering?cfcache=true

Hillary Clinton is quick to tout that she will defend the Affordable Care Act (ACA) and build on it to slow the growth of out-of-pocket healthcare costs while Donald Trump vows to repeal the ACA and have a series of reforms ready for implementation that follow free-market principles.

But when taking a closer look at their proposals, Clinton and Trump are keeping mum about some healthcare issues, and that’s raising some critical questions. Managed Healthcare Executive asked industry experts to comment on what topics presidential candidates are being quiet about, and why they suspect they’re not talking about them.