Taking Stock Of The Repeal-And-Replace Effort

Bloomberg: Republicans Start To Get Real On Health Care
Now that Republicans control both the executive and legislative branches, their plans to replace Obamacare -- yes, they exist -- will amount to more than just hot air. One new proposal shows they’re beginning to take their newfound responsibility seriously. (1/25)

The Wall Street Journal: The President Opens The ObamaCare Escape Hatch
The executive order’s language—stopping anything in the law that creates “a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden”—should be music to the ears of congressional Republicans. They have been struggling with Senate procedural rules regarding reconciliation, which likely preclude repealing ObamaCare’s cost-increasing insurance regulations without Democratic support, while still allowing the repeal of the law’s mandates and subsidies. Why does this matter? Insurance companies cannot presently afford to sell the policies people actually want. The law imposes a $100-a-day penalty on insurers for every person to whom they sell a noncompliant policy. That effectively limits the individual market to nothing but ObamaCare-compliant plans, with premiums and deductibles driven sky-high by the law’s regulatory burdens. For many, even ObamaCare subsidies can’t keep up with these increasing costs. (Heather R. Higgins and Phil Kerpen, 1/25)

The Fiscal Times: For The GOP, Failure To Act On Obamacare Is Not An Option
What’s more daunting than creating a massive federal entitlement program? Unwinding it with the least amount of damage to people and providers, as Republicans are learning about the Affordable Care Act. After seven years of opposing the ACA, forever known as Obamacare, the GOP finds itself in a position to finally fulfill their promises to repeal it entirely and replace it with market-based reforms. (Edward Morrissey, 1/26)

RealClear Health: The Republicans' Slippery Slope On Obamacare
The nation is focused on what new leadership in Washington will mean for the Affordable Care Act (ACA), better known as Obamacare. Republicans won partly because of Obamacare’s implosion — including rising premiums, declining coverage quality, and diminished choices — and are expected to deliver fundamental changes to health-care policy. Nevertheless, Obamacare, though unpopular on the whole, contains several popular features. Hence the GOP’s path might seems relatively direct: keep the tolerable parts, repeal the unpopular ones, and move forward with replacement legislation. But the notion that a so-called “repeal and replace” approach can start by cherry-picking a few popular components is wrongheaded. (Tom Haynes, 1/26)

JAMA Forum: What Might An ACA Replacement Plan Look Like?
The US House of Representatives and Senate recently took initial steps towards repealing the Affordable Care Act (ACA), passing budget resolutions that pave the way towards a “budget reconciliation” measure that can repeal major aspects of Obamacare with a 51-vote majority in the Senate. (Larry Levitt, 1/24)

The Columbus Dispatch: Uncertainty Drives Health-Care Stress
Congress is beginning to take a whack at untangling the snarl of mandates, guarantees and requirements in the flawed Affordable Care Act. It's time to stop arguing over the failures and work toward constructive revisions that fix the problems while preserving popular protections. (1/26)

Forbes: What Medicaid Block Grants Would Mean For Seniors
The Trump Administration and congressional Republicans seem to be moving full speed towards capping federal payments for Medicaid. But they may be missing a key piece of the story: Two-thirds of the program’s dollars go to the frail elderly and younger people with disabilities. ... More than four out of every 10 Medicaid dollars are spent on people with disabilities, for both medical care and long-term services and supports (LTSS). One-quarter of program’s funding is used for older adults, mostly for nursing home care or personal assistance at home. In 2014, Medicaid spent as much as $150 billion on LTSS. While they are often ignored, these people would be profoundly affected if the program is redesigned. (Howard Gleckman, 1/25)

Lexington Herald Leader: Has Bevin Swung On Medicaid?
In urging Congress to repeal the Affordable Care Act “in its entirety,” Gov. Matt Bevin has put himself at odds with some of his fellow Republican governors and also with his own former position. House Majority Leader Kevin McCarthy asked governors to share their ideas for achieving the Republican goal of repealing and replacing the ACA. (1/25)

Los Angeles Times: Obamacare Repeal Would Hit California's Central Valley Hard
Last week, I went looking for the real Obamacare. Not the one that’s been vilified by President Trump and House Speaker Paul D. Ryan, but the Obamacare that’s otherwise known as the Affordable Care Act, the one providing health coverage to more than 5 million people in California. (Ed Hernandez, 1/26)

Atlanta Journal Constitution: The Issue With Nixing The Affordable Care Act That No One Is Talking About
One of the first things our new president did Friday was sign an executive order urging his administration to fight the ACA. The executive order has no teeth. It simply states the Trump administration’s position, and, sure, that carries with it all the heft brought to bear by the Oval Office. But what is worrisome for proponents of the ACA is that the executive order follows current legislative efforts in Congress to obliterate the centerpiece of President Barack Obama’s legacy. With a newly installed majority, Republicans are poised to dismantle the historic law that helped 20 million uninsured Americans get affordable healthcare. (Adam Levin, 1/26)

Stat: If Obamacare Is Dismantled, Keep The Physician Payment Sunshine Act
The Physician Payment Sunshine Act has been a valuable tool for revealing industry payments to our nation’s physicians. Nearly $17 billion in payments from drug and device companies have been recorded since the act was passed as part of the Affordable Care Act. The publicly available data it has created lets consumers and other interested parties judge for themselves whether their doctors have important conflicts of interest that might affect their treatment decisions. (James Rickert, 1/25)

Forbes: Massachusetts Governor Hiking Taxes To Rescue Failed Health Reform
The reality is the mandate merely camouflages significant growth of government spending and control over health insurance. This has been the case in Massachusetts since day one: Spending has grown out of control despite many failed efforts to bend the cost curve. (John Graham, 1/25)