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Obamacare (2)

Conservatives to Congress: Deliver on Obamacare Repeal and Replace Promise

Conservatives and business leaders in the health care market have a message to Congress on Obamacare: Deliver on your promise to repeal the health care law and begin the process of returning to a health sector that can be “America’s greatest.”

During a panel at the Conservative Political Action Conference, or CPAC, on Thursday, Grace-Marie Turner, president of the Galen Institute, told attendees to think of Obamacare’s repeal as a “down payment” that will allow Republicans to implement their own health care reforms in the future.

But first, Turner said Republicans need to take action to repeal the law using a fast-track budget tool called reconciliation.

“We have to do this,” she said. “We have to be get this out of here to be able to deliver on the repeal-and-replace pledge to the American people, and then to begin the process of truly returning to a health sector that can be America’s greatest health sector again.”

Rep. Michael Burgess, R-Texas, Scott Flanders of eHealth, and Dale Bellis of Liberty HealthShare joined Turner on the health care panel at the annual event.

While Republicans campaigned since 2010 on repealing Obamacare, efforts to advance the legislation dismantling the law have slowed over the last few weeks.

The GOP-led Congress passed a bill using reconciliation to undo major provisions of the health care law in 2015. But President Barack Obama ultimately vetoed that legislation.

Now, conservatives in Congress are calling on their leaders to bring that same bill before members for another vote.

“It’s going to happen,” Burgess said of Obamacare’s repeal. “What [the 2015 bill] demonstrated to me was that if you got the right president in the White House, you could send that bill back down to the other end of Pennsylvania Avenue, and you could repeal large pieces of the Affordable Care Act.”

The 2015 reconciliation bill repealed Obamacare’s individual and employer mandates, Medicaid expansion, and subsidies. It also stripped the federal government of the authority to run the exchanges, and eliminated federal funding for Planned Parenthood.

Though that legislation passed both chambers of Congress, tensions have emerged among GOP lawmakers over which parts of the health care law to unwind.

Republicans are split over whether to leave the Medicaid expansion in place, while GOP leaders want to include parts of a replacement plan in the same legislation that will repeal the law—a strategy that some conservatives have derided.

But Burgess, who serves on the House Energy and Commerce Committee, said the 2015 reconciliation bill will serve as a “starting point” for Congress this year, with Republicans understanding that the repeal bill will be at least the same as that passed in 2015.

In addition to disagreement over whether to include parts of Obamacare’s replacement in the repeal bill, Republicans also split on whether to provide tax credits or tax deductions to consumers.

But Turner stressed that the process for replacing the law—what she said will become a “once-in-a-generation reform”—will be a lengthy one that requires thought, particularly since Republicans are starting not from a blank slate, but with an already changed health insurance market.

“It’s really what would we want if we were starting from the right kind of policy for the health sector? We are not starting there. We’re starting with Obamacare,” she said. “We’re starting with some number of millions of people … relying on Obamacare. You have to create a lifeboat for them, and structures that provide the kind of resources people need who don’t have means to purchase health insurance on their own so they can continue coverage.”

Like Republicans in Congress, President Donald Trump campaigned on repealing Obamacare.

During his first day in office, Trump signed an executive order addressing Obamacare and giving his federal agencies the discretion to no longer enforce the individual mandate.

And he’s repeatedly said that his new Health and Human Services secretary, Tom Price, will present a replacement plan before Congress.

But so far, no proposal has been presented.

Trump will address a joint session of Congress next week, and Burgess had his own wishes for what he hopes the president will tell Republicans and Democrats in Congress.

“I would like for him to say very directly to us, to my leadership in the House, Republicans and Democrats, that ‘this is your job,’” Burgess said. “‘I want you to get it done.’ Simple as that.”

CPAC, the largest annual national gathering of conservative activists, runs from Wednesday to Saturday at the Gaylord National Resort and Convention Center in National Harbor, Maryland, just outside Washington. (For more from the author of “Conservatives to Congress: Deliver on Obamacare Repeal and Replace Promise” please click HERE)

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Why Is the GOP Just Sitting Around on Repealing Obamacare After Winning the Impossible?

In other news, Congress has said it plans to debate repealing Obamacare, maybe sometime end of February, and “hopes” to have a bill end of March. Maybe not … the GOP could just keep stalling.

How many times have Republicans voted to repeal Obamacare in the last six years? Twenty, 30, 40 times? MSNBC claims it’s around 62. In 2015, Congress actually put a repeal bill on President Obama’s desk.
And now that Republicans control every lever of power in the legislative process, suddenly the task to repeal has become monumental. Not so when the GOP was in the minority.

It is not easy to name a member of Congress — or any GOP elected official — who has not run on repealing Obamacare. Certainly every House Republican worth his or her salt is already on record voting for a full repeal — that is, back when there was no danger of those bills seeing daylight. As one member recently phrased it: “We’re playing with live rounds this time.”

The prospect of making a difference has resulted in schoolboy stage fright. The chance to win has made our guys terrified of facing the other team’s fans in the parking lot.

Campaign pledges to do away with the Affordable Care Act were not always, nor even often, married to specific replacement plans. It was widely acknowledged from the start that repealing the law would leave room for debate over the best market-based solutions. Well, Republicans got their chance. Voters believed them. And within five weeks, the repeal movement has smashed up against barriers erected by the very members who ran and won on the promise of ACTION.

A repeal bill would not pit the country against the party — that is only what the opposition wants us to believe. What is certain to damage the party, perhaps irreparably, is a stalled Congress, an impotent executive, and a surviving health care law that continues to wreak havoc on a country that has stridently rejected it. Leave the law where it is, and the GOP flushes its mandate. There are too many other things to accomplish — and such little time to see them through — for this party to squander its credibility on the one issue it can wipe out with a two-page bill.

In the age of Trevor Noah, Lena Dunham, and John Oliver, elected Republicans have my sympathies. Liberal elites control the levers of culture, and as such, it is hard not to believe that after the non-stop bombardment from liberal media, even when in power, that one is governing in direct opposition to the wishes of a hostile electorate. But it is an illusion. Trump won because he saw the illusion for what it was. He ignored the ache of bad press, shaking off the weight on his shoulders intensified by a media-biased bubble. He proved that if you simply press on and do what you told the voters you would do, the voters will keep up their end. They will show their appreciation by showing up for you.

Republicans must learn this lesson, if no other. (For more from the author of “Why Is the GOP Just Sitting Around on Repealing Obamacare After Winning the Impossible?” please click HERE)

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GOP Leaders Release Details of Plan to Replace Obamacare

House Republican leaders mapped out their proposal for how Obamacare will be repealed and replaced in a closed-door meeting Thursday, outlining plans for Medicaid reforms and refundable tax credits for Americans.

Joined briefly by newly confirmed Health and Human Services Secretary Tom Price, House Speaker Paul Ryan, Ways and Means Committee Chairman Kevin Brady, and Energy and Commerce Committee Chairman Greg Walden presented the details to members.

The plan comes amid mounting frustration from the chamber’s conservative wing, who want to see their leaders move faster on repealing Obamacare and decided to coalesce around their own replacement plan Wednesday after discussions over potential changes to the health care system slowed.

GOP lawmakers said repeatedly they would unwind Obamacare—a promise repeated by President Donald Trump on the campaign trail—but the conference has yet to come together on which parts of the law would be repealed and how.

And members are likely to face questions on Obamacare’s future from constituents on both sides of the aisle when they head home for the Presidents Day recess.

Ryan told reporters on Thursday that upon returning to Washington at the end of the month, lawmakers would introduce the repeal and replace legislation.

However, he noted that GOP lawmakers are waiting on cost estimates from the Congressional Budget Office and Joint Committee on Taxation

“What we’re proposing is a patient-centered system where the patient designs their plan. The patient gets to decide what they want to do,” Ryan said. “The nucleus is the patient and her doctor versus the nucleus of the system being the government in Obamacare’s sake.”

According to a copy of the presentation leaders gave to Republicans that was obtained by The Daily Signal, the plan calls for Congress to pass legislation that repeals Obamacare’s taxes, individual and employer mandates, and subsidies. It also stresses that the Medicaid expansion, which loosened program eligibility requirements, would also be changed.

Then, it maps out four key components of a replacement: modernize Medicaid, use State Innovation Grants, expand health savings accounts, and provide portable, monthly tax credits.

Specifically, Americans purchasing coverage on the individual market would receive an advanceable, refundable tax credit based on age.

The plan also expands the use of health savings accounts, a policy that is the hallmark of nearly every proposal Republicans have presented over the last six years.

Brady and Walden’s replacement plan calls for an increase in the maximum contribution Americans can make to their health savings accounts. Currently, individuals can contribute $3,400 each year to a health savings account, but the Republicans’ plan would raise that limit to $6,500.

Republicans are generally in agreement on the expansion of health savings accounts and even on providing Americans some form of financial assistance, but GOP members are more divided on how to handle changes to Medicaid.

Thirty-one states and the District of Columbia expanded Medicaid, and had 100 percent of Medicaid costs for those who are newly eligible covered by the federal government from 2014 to 2016. Now, GOP senators representing some of those states have pushed for the expansion to remain in place.

The plan put forth by House Republican leaders would pare down the match rates for the expanded Medicaid population over time, but allow states to continue enrolling new beneficiaries under the expansion’s eligibility. Republicans then propose changing it to either a per-capita allotment or block grant program.

The proposal provides a transition period, though not defined, for states that did expand Medicaid.

To ease the concerns of leaders from expansion states, Ryan said Walden and Sen. Orrin Hatch, a Republican from Utah who chairs the Senate Finance Committee, have been working with Republican governors to discuss potential changes to the program.

The last item in the GOP’s replacement plan calls for the creation of high-risk pools, which would be funded by federal dollars allocated to the states and can be used to help those with pre-existing conditions.

Republicans plan to repeal Obamacare using a budget tool called reconciliation, which fast-tracks legislation in the Senate and allows it to pass with 51 votes.

Their plan is to start with a repeal bill that passed both chambers in 2015, but was ultimately vetoed by President Barack Obama.

GOP leaders are planning to build on the 2015 bill by including parts of Obamacare’s replacement.

Late last month, Ryan mapped out a timeline for Obamacare’s repeal, telling GOP colleagues the House would dismantle the bill in March or April.

But House conservatives are becoming frustrated with the speed leaders are moving and want to see action before then.

On Monday, the approximately 40 members of the conservative House Freedom Caucus voted unanimously to back the 2015 Obamacare repeal bill, and on Wednesday, they endorsed an Obamacare replacement plan released by Sen. Rand Paul. (For more from the author of “GOP Leaders Release Details of Plan to Replace Obamacare” please click HERE)

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We Hear You: From Obamacare to Affordability and Choice for Consumers

Dear Daily Signal: Thank you for Elizabeth Fender’s data-filled article on the Obamacare approval ratings over time. I appreciate your truthful reporting of the facts, and your citing the specific data and your sources (“Obamacare May Soon Be Over. Here’s What Americans Have Thought of the Law Since 2010”).

In addition to the reasons you cite for Obamacare’s low approval ratings (narrow networks, high and rising health care premiums), there are several others.

These include religious liberty violations: the contraceptives mandate on employers by the Department of Health and Human Services (source of two Supreme Court challenges and hundreds of lawsuits); abortion and Planned Parenthood funding; Independent Payment Advisory Board “death panels” (someone wouldn’t be able to use his own money to save his own life); and the government’s definition of “religious entity.” Last but not least is the Supreme Court ruling on gay marriage, which affects administration of health care benefits.

The Obamacare regulations seem to have completely ignored the serious comments advising the government to stop, slow down, make major changes. The contraceptives mandate and transgender mandate are huge mistakes, ignoring the science that shows that the premises upon which these mandates are based are faulty.

I am hopeful the Trump administration will work more collaboratively with key stakeholders in our health care system, including Catholic health care providers. The larger Judeo-Christian health care delivery system deserves to be treated as the large stakeholder that it is.

As the new administration moves into office and into power, we still can attempt to be peacemakers. We can honor the goal of the Affordable Care Act—to create a health care system that provides affordable care and expands access. This is a worthy goal.

People who have preexisting conditions need to have some form of health care insurance. Theoretically, there should not be an “uninsurable” person. These are some of the areas where insurance companies can focus to create new products and services. I believe they would respond appropriately. My experience with the industry supports the fact that they have far more goodness than they are given credit for.

We can honor one administration for their work as we move forward with the next administration’s agenda—as determined by the voters who put them there. —Kathleen Goryl

Making News Personal

Dear Daily Signal: I just read your piece about Obamacare and its effect on an owner of an International House of Pancakes franchise (“Obamacare a Factor in IHOP Owner’s Decision to Sell His 16 Restaurants”). Your mentioning Utica, New York, jumped out at me. I live just north of Utica in Remsen, home of Olympic luger Erin Hamlin.

I loved your piece because it made the news very personal. So much of the debate on health care is numbers about “millions of people covered.” This showed what happened to an employer who was trying to do right by his employees, not to a number of people.

Thank you for mentioning Utica. —Jane White

Sorting Out Plans to Replace Obamacare

Dear Daily Signal
: I think that there is merit to each of the Obamacare replacement plans, and lawmakers need to sort it out and commit to one (“A Look at 4 of the GOP’s Obamacare Replacement Plans”).

However, I have never favored health care support for grown people age 21 and up. Why should taxpayers support these adults and/or subsidize their parents who choose to do so? —David Cromer

Choosing Between Mortgage and Health Premiums

Dear Daily Signal: I’m writing about the repeal of Obamacare and its consequences (“What Happens for Consumers After Congress Repeals Obamacare”). My son is paying over $1,200 per month for a family health insurance plan, and he has lost his primary job.

His family can’t qualify for subsidies because they still make too much with part-time jobs. But they will have trouble between choosing to pay the mortgage or health premiums. He’s no congressman! —Susan Peed

Obamacare Doesn’t Protect Patients

Dear Daily Signal
: I know from personal experience that the Affordable Care and Patient Protection Act doesn’t contain enough to protect patients. Obamacare should have included where to file comments, suggestions, and complaints about your care. This would help pinpoint what and where the problems are. I find filing with the state to be useless.

My five-day nightmare stay at a hospital revealed what I consider serious problems. I had requested my hospital records three different times within a half-year, but the hospital claimed the records were not complete. After the two-year limitation to sue them, they finally gave me my “records.”

The records were not what I expected. There was no timeline of services provided, treatments, doctors’ assessments, medications, or the amounts. Being sued by the hospital for unpaid bills (some for services I didn’t request), I requested my records from the hospital lawyers. They sent me a list of the charges instead.

I was shocked at the number of drugs I was given—over 40, eight of which were for pain. I was given eight doses of morphine in a four-day period. All of those drugs and the amounts should have been in my records in a timeline, along with things like blood pressure and temperature checks.

Medical records in a timeline would help keep communications open between doctors and nurses, reduce unnecessary treatments and services, help keep the patient from being overmedicated, and give patients and health insurance companies better oversight. Do you know what’s in your medical records? —Gary Kujat

(For more from the author of “We Hear You: From Obamacare to Affordability and Choice for Consumers” please click HERE)

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How Tom Price Can Begin to Unravel Obamacare From Inside the Agency That Implemented It

Tom Price took the helm of the Department of Health and Human Services on Friday, capping a lengthy confirmation process that ended in the wee hours of the morning.

Now, as the health and human services chief, Price can begin fulfilling a yearslong goal of unwinding Obamacare. But instead of dismantling the health care law from the halls of Congress, he’ll be acting from inside the agency that oversaw its implementation.

The Senate confirmed Price 52-47, and the former House Budget Committee chairman is taking over the Department of Health and Human Services as the White House and Congress prepare to follow through on their campaign promises to repeal Obamacare.

An orthopedic surgeon who served more than a decade in the House, Price has spent the last seven years in Congress opposing the Affordable Care Act. The new HHS secretary introduced his own health care plan in 2009—he’s reintroduced that same proposal, the Empowering Patients First Act, in every Congress since then.

The Georgia Republican will take the helm of the agency at a crucial time. GOP lawmakers are debating how to dismantle the law, with a vote to repeal the Affordable Care Act expected to take place by March or April.

Unwinding Obamacare

But even as congressional Republicans finalize their course for unwinding the law, Price can now use his executive power to begin chipping away at Obamacare’s framework.

The Affordable Care Act gave the federal government the power to write and implement many of the law’s regulations through the federal rule-making process—like the exemptions from the individual mandate that are available to consumers who encounter hardships and the mandate that requires insurance plans to cover contraception and abortifacients.

And already, President Donald Trump is using that authority to make changes to the law.

“You live by the administrative state, you die by the administrative state,” Ed Haislmaier, a senior fellow at The Heritage Foundation who worked on health policy for Trump’s transition team, told The Daily Signal.

During a confirmation hearing in January, Price told a Senate committee he believed insurers needed some assistance from the Trump administration before 2018.

“What they need to hear from all of us, I believe, is a level of support and stability in the market,” the Georgia Republican said.

And as the new health and human services secretary, Price can begin providing them with that relief by tightening the monitoring of consumers purchasing coverage on Obamacare’s exchanges—changes insurers asked the Obama administration to make long before Trump took office.

That includes making changes to special enrollment periods, or the time outside the standard enrollment window a person can purchase health insurance, and verifying the eligibility of consumers purchasing coverage during open enrollment and special enrollment periods.

The Obama administration created several special enrollment periods, which a consumer can qualify for if they lose their health insurance, get married, or move to a new state.

But insurance companies warned last year that Americans were taking advantage of the special enrollment periods and purchasing coverage only when it was needed.

That led to an increase in costs for plans and higher costs for consumers, insurers said.

“The Trump administration you would expect to go in and say, ‘We’re going to prioritize minimizing costs and disruption, and we’re not going to let people enroll at the drop of a hat,’” Haislmaier said.

The new health and human services secretary can also eliminate federal regulations that already exist at the state level, such as oversight over proposed rate increases and network adequacy.

Under the current system, insurance companies looking to raise their rates must receive approval from state regulators and the federal government, which review the plans insurers want to sell for the upcoming benefit year.

“If you’re approaching it from the Obamacare mindset, then you make insurers go through all of that at the federal level after they’ve done it at the state level,” Haislmaier said. “If you come in at the Trump administration, they’re saying, ‘We’re not interested in nationalizing insurance. If it’s OK with the state, it’s OK with us.’”

According to draft documents obtained by Politico, the Trump administration is also weighing whether to make changes to a provision of Obamacare that dictates how much more insurers can charge older Americans than younger Americans.

The provision prohibits insurance companies from charging their older customers more than three times what they charge younger customers. According to the documents, the Trump administration proposes changing the ratio to 3.49-to-1.

Health policy experts, though, worry that such a change may not be legal, since the Affordable Care Act specifically set the ratio for insurance companies. Changing the ratio from 3 to 3.49 would require action from Congress.

Still, Trump administration officials believe that since 3.49 “rounds down” to 3, the changes can be made without a change in statute, according to The Huffington Post.

Eliminating Mandates

In addition to enhancing the monitoring of consumers who sign up for coverage, Price can take aim at one of Obamacare’s most controversial provisions: the contraception mandate, which requires plans to cover contraceptives and abortifacients without cost-sharing.

Price, an opponent of abortion, has criticized the contraception mandate in the past for infringing on religious liberty.

As the leader of the Department of Health and Human Services, the Georgia Republican could have his agency rewrite the regulations tied to the mandate or choose not to enforce it.

Price could also revise the list of services insurers are required to cover—called the essential health benefits requirement—to amend or exclude preventive health.

The White House set the stage for the new Health and Human Services secretary to begin making changes to Obamacare just hours after the president took the oath of office.

On Inauguration Day, Trump signed an executive order to “ease the burden of Obamacare as we transition to repeal and replace.”

The order was light on specifics, but health policy experts said it gave the executive branch the authority to begin addressing the thousands of regulations tied to Obamacare.

And some wondered if the individual mandate was on the chopping block.

Price could decide not to enforce the individual mandate, the part of Obamacare that requires consumers purchase insurance or face a fine, or extend hardship exemptions to all enrollees.

But Haislmaier said that for Price, the decision regarding enforcement of the mandate would need to involve the White House, since such a move would require coordination between multiple agencies.

For the executive branch, deciding whether to enforce the individual mandate also is a game of timing.

Republicans are considering passing a repeal bill that gets rid of the individual mandate, among other major provisions of Obamacare.

Turning to Congress

Haislmaier questioned whether it would be necessary for the Trump administration to take action on a part of the law Congress may get rid of on its own.

“If the mandate is going to be repealed in repeal legislation, is it worth the bother of the administration doing it?” Haislmaier asked.

Like with the executive order on Obamacare, the White House began the process for making changes to the health care law through the rule-making procedure before the Senate confirmed Price.

Last week, the Trump administration submitted a proposed rule to the Office of Management and Budget. The details haven’t yet been released to the public, but the rule aims to stabilize the Obamacare markets, likely through the changes reference above.

Once the details are released, it’s Price who will oversee the efforts to provide relief for insurers. (For more from the author of “How Trump’s Executive Orders Line up With Past Presidents” please click HERE)

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Why Delaying Obamacare Repeal Is Hurting the American People

When President Donald Trump took office, repeal of Obamacare seemed like a guarantee—and then the timeline started slipping.

All the elements are in place: A Republican-controlled Congress and a Republican president, all elected after promising to repeal Obamacare. But once the celebration and ceremonies died away, Congress started to do what it does best. Nothing.

“Nothing” may be a bit strong given the historic levels of obstruction from Democrats in the Senate, but House Republicans have no such excuse. In fact, they even have a blueprint.

Last year, the House and Senate passed an Obamacare repeal using the budget reconciliation process. That measure was ultimately vetoed by then-President Barack Obama, but that same legislation can be reintroduced and sent to Trump’s desk to be signed into law.

There is no reason to delay. The slipping of the Obamacare repeal timeline is creating cascading problems for the American people.

Delaying Repeal Prolongs the Current Health Care Crisis

No one needs reminding that Obamacare takes away choice, erodes the value of health care, and puts additional burden on the pockets of the American taxpayer. The unsustainable nature of Obamacare is creating massive uncertainty and causing insurers to leave the marketplace, causing individual premiums to increase.

Additionally, once repeal is signed into law and real health care reforms begin moving forward, private insurers will need time to adjust to the new market. Continuing to delay repeal shortens the time insurers will be able to adjust and provide the best solution for the insured.

Most importantly, we don’t want Americans living under the current failing health care system any longer.

Obamacare is bad, and only getting worse. Average premiums are going up by 25 percent this year, deductibles are blowing past $10,000 for a family, and 70 percent of U.S. counties have no insurer choice, or a choice between only two insurers.

What good is a health care plan that you can’t choose and can’t afford to use? Congress must repeal it as soon as possible to put better health care choices back in the hands of the American people.

Delaying Repeal Hurts Public Support for Congress

Nearly every single congressional Republican campaigned on the promise to repeal Obamacare. The unfortunate consequence of the delay is that the American people are losing faith in the people whose job it is to represent them.

Recent Heritage Foundation research shows 72 percent of Americans will take the promises of Congress less seriously if they wait to fulfill their promise to repeal Obamacare. And 70 percent of Americans believe the longer Congress waits to fulfill their promises to repeal Obamacare, the less likely they will be successful.

There is no doubt that lawmakers will be held accountable to their promises.

Delaying Repeal Keeps the Focus Off Other Priorities

The surest way to repeal Obamacare is through the reconciliation process. However, that option has an expiration date. The reconciliation package is part of the budget process for fiscal year 2017 and it has to be completed before the fiscal year 2018 budget process begins.

In addition to creating a time crunch, the fight over when and how to repeal Obamacare is delaying action on other critical fights.

There is no doubt that Obamacare repeal is and should be the first priority, but Trump and congressional Republicans have made major promises to Americans that must also be considered.

Tax reform. Border security. Regulatory reform. Those priorities cannot move forward until Obamacare repeal is finalized.

What’s Next?

Republicans campaigned on repealing Obamacare in 2010, 2014, and 2016. Now it is time to step up to the plate and use the budget reconciliation process to deliver on those promises.

Congress needs to send a full repeal of Obamacare to the president for his signature. Americans cannot afford any further delays. (For more from the author of “Why Delaying Obamacare Repeal Is Hurting the American People” please click HERE)

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White House Says Trump Won’t Rush Obamacare Replacement

President Donald Trump will use his business skills to negotiate lower prices and foster more competition in the health care market—but he doesn’t want to rush things, White House press secretary Sean Spicer said Tuesday.

Spicer declined to give a specific timeline for seeing Congress repeal and replace the law, saying that Democrats rushed the passing of Obamacare and Republicans should not rush the replacement.

“I think we can have this done legislatively sooner rather than later. But I think the implementation is going to be a little bit longer. It was a big, big bill that the Democrats had,” Spicer told reporters during a press briefing Tuesday. “As you recall, they told us they could read it after they passed it. We are now going through this to make sure we can do this in a very responsible way.”

The Daily Signal asked if the president agreed with House Speaker Paul Ryan, R-Wis., that the Obamacare law cannot be tinkered with or repaired but must be scrapped for something fundamentally different.

“What we’re focused on is the end solution,” Spicer told The Daily Signal. “We’ve been very clear over and over again that the president is going to repeal and replace [Obamacare], and that what Americans will get at the end of this is a health care solution, as I’ve said before over and over again, is going to give them a lower cost solution with more options.”

Spicer said that Trump’s vision is what was “promised in the first place,” but not delivered by Obamacare.

“The president being able to approach this in the businesslike manner that he’s done so successfully in the past is going to ensure that he negotiates prices and that we look at those businesslike practices, force competition among and other things that will help lower costs,” Spicer continued.

Ryan has previously said Congress can repeal and replace Obamacare in March or April. However, during an interview on Fox News with Bill O’Reilly aired before the Super Bowl, Trump said, “I would like to say, by the end of the year, at least the rudiments, but we should have something within the year and the following year.”

And Ryan on Tuesday talked about repealing the law this year.

Other reporters Tuesday pressed Spicer on the timeline for Congress repealing and replacing the law.

Spicer said the president and Republican congressional leaders are on the same page. But he stressed it would be a mistake to rush a repeal bill, as Democrats did in passing the Affordable Care Act in 2010.

“It’s a mammoth bill what they passed,” Spicer said. “We’ve got to make sure we do this right. We don’t want to end up with the same results the Democrats did. They rushed it through, no one was able to read the bill, premiums have skyrocketed, access and options have gone down. We need to make sure we understand we don’t do this in a way that ends up with the same result.” (For more from the author of “White House Says Trump Won’t Rush Obamacare Replacement” please click HERE)

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They Lied All Along: Republicans Plan to ‘Repair’ Not Repeal Obamacare

Is it possible to repair a house on fire without extinguishing the raging inferno in it?

Republicans think we are stupid enough to believe so.

First they promised to repeal Obamacare “root and branch.” Then they promised to “repeal and replace” without explaining its meaning — other than to legitimize the premise of Obamacare as a partial force for good. Now, they are on to “repair.”

The Hill has the relevant quotes from two of the most important committee chairmen (Senator Walden, R-Ore. (F, 36%) and Senator Alexander, R-Tenn. (F, 15%)) drafting the repeal bill … which will not repeal Obamacare:

“I’m trying to be accurate on this that there are some of these provisions in the law that probably will stay, or we may modify them, but we’re going to fix things, we’re going to repair things,” House Energy and Commerce Committee Chairman Greg Walden (R-Ore.), a key player on healthcare, told reporters Tuesday.

“There are things we can build on and repair, there are things we can completely repeal,” he said.

Senate Health Committee Chairman Lamar Alexander (R-Tenn.) is sounding a similar note. […]

“I think it is more accurate to say repair ObamaCare because, for example, in the reconciliation procedure that we have in the Senate, we can’t repeal all of ObamaCare,” Alexander said. “ObamaCare wasn’t passed by reconciliation, it can’t be repealed by reconciliation. So we can repair the individual market, which is a good place to start.”

As we noted before, every word of this premise is false because the price-hiking coverage regulations are inextricably linked to the subsidies, as noted by the courts and CBO. Therefore, the regulations can be repealed through budget reconciliation. Moreover, the Senate parliamentarian doesn’t have the final say on addressing Senate precedent.

However, there is a more important point to bring out from this story. These people lied to all of us. They told a bald-faced lie. Absolutely nothing changed structurally about Obamacare from the time they made these promises during the past three elections until now. If anything, premiums went up even more than expected and there are even fewer insurers than previously predicted, making the case for repeal an easier political sell.

Likewise, nothing changed procedurally from the time they promised to use budget reconciliation to repeal at least most of the main elements of the law. Republicans always knew that they would need to get rid of the actuarially crippling regulations, which would then unfreeze the insurance market, lower costs, bring back choice and competition, and engender much less of a need for subsidies. All the while, everyone always planned to maintain the subsidies and Medicaid expansion for a one to two-year transition period while other free market health care and health insurance reforms were put in place.

Yet, Republicans, particularly those in the Senate, never had any intention of repealing it because they don’t believe or understand free markets, are owned by the big pharma/big government complex, and have no desire or ability to articulate a winning issue to the public without shooting themselves in the foot.

This day was predicted long ago

In 2012 and 2014, conservatives worked against Mitch McConnell, R-Ky. (F, 40%) and his sitting RINO Senators (such as Thad Cochran, R-Miss. (F, 22%), Pat Roberts, R-Kan. (F, 51%) Lisa Murkowski, R-Ala. (F, 20%) and Lamar Alexander, R-Tenn. (F, 15%)) and his chosen challengers in open seats (such as Sens. Tillis, R-N.C. (F, 35%) and Cassidy, R-La. (F, 47%)). Voters were warned that they had no intention of repealing Obamacare. Conservatives cautioned that if Ted Cruz’s, R-Texas (A, 97%) plan to defund Obamacare at its inception was not followed, the law would never be repealed. That if we failed to build a Senate majority upon a solid foundation and stronger leadership, Obamacare would never be repealed even if we were so fortunate to control all three branches. [See my op-ed at Fox News Opinion on October 25, 2013, “Building a GOP Majority on Quicksand”]

Groups like Senate Conservatives Fund were maligned as pursuing “purity for profit” and undermining the creation of a GOP majority that would truly repeal Obamacare. Establishment voices accused the grassroots activists of needlessly creating a civil war over disagreements on strategy. Yet, we knew all along it was a disagreement over beliefs and courage, not strategy. Unfortunately, the establishment used their superior funding (from groups like the Chamber of Commerce that wanted to keep Obamacare all along) to run on repealing the law “root and branch,” as McConnell famously said. Now, some of these very senators are leading the charge to repair the law, which is not feasible.

Trump must intervene

Obviously, President Trump is having a busy week with his immigration policies and the Supreme Court pick, among many other issues. He can’t address everything in the first month of his presidency. But there is no way to ignore Obamacare. Unless it is FULLY repealed, within a few years no middle-income American will be able to live in freedom and dignity without permanent government support and intervention in healthcare. We will have no freedom in one sixth of our economy. Moreover, the crushing job loss, debt, and diminished wages from the Obamacare regulations are weighing down the economy and will undermine the president’s ability to grow the economy with some of his other plans. It will limit his ability to secure a legacy as a jobs president.

The plan forward

Trump should dispatch Vice President Pence to work with the House Freedom Caucus as well as Speaker Paul Ryan, R-Wisc. (F, 52%) and ensure that the House passes the full repeal bill — along with the regulations. They should make it clear that there are no excuses for the Senate to not overrule the parliamentarian, but at the same time they should not wait around for the lords of the Senate to do the right thing. The reconciliation bill should be structured as follows:

An 18-month transition for retaining the subsidies and the Medicaid expansion. However, immediately freeze both programs from new registrations.

Repeal Obamacare’s taxes immediately and the regulations by mid-year so that insurance companies can have certainty to offer cheaper, competitive plans in 2018

On the administrative end, have Tom Price, R-Ga. (D, 62%) get rid of any cost-sharing subsidies and risk corridor bailouts for insurance companies. This will force them to utilize the lifting of regulations to lower prices and actually compete for business rather than relying on subsidies.

Meanwhile, individual states should work on reducing their own onerous health care and health insurance regulations in order to maximize the market effect of reducing federal insurance regulations.

At that point, Trump should relentlessly use his bully pulpit to name and shame the Senate into fulfilling their promise. It can be done if we actually got the momentum rolling in the House. As Reps. Mark Meadows, R-N.C. (A 94%) and Jim Jordan, R-Ohio (A, 96%) said in a statement today, “We committed to the American people to repeal every tax, every mandate, the regulations, and to defund Planned Parenthood. That’s what the American people expect us to do — and they expect us to do it quickly.”

In the meantime, conservatives should put the pressure on the Senate by launching a new round of primaries. Members like Jeff Flake, R-Ariz. (F, 50%), Bob Corker, R-Tenn. (F, 45%), Roger Wicker, R-Miss. (F, 28%), and Orrin Hatch, R-Utah (F, 33%) could be prime targets in states won by Trump.

As Bobby Jindal said, “Republicans who want to retreat from repeal to repair should be replaced.” (For more from the author of “They Lied All Along: Republicans Plan to ‘Repair’ Not Repeal Obamacare” please click HERE)

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New Obamacare Report Shows Rising Costs and Fewer Options for 2017

A new report shows that Obamacare enrollees could pay more money and end up with fewer options in 2017.

The study from Avalere Health, a health care consulting firm, showed rising premiums, deductibles, and out-of-pocket costs for many customers, a shrinking amount of insurance options in the exchange market, and a drastically lower number of Obamacare enrollees than projected.

Premiums for the silver-level plan, Obamacare’s most popular option, increased by an average of 12 percent in 2017. Specifically, the Avalere report showed that 71 percent of Obamacare enrollees covered under the silver plan have seen their average costs rise from $496 per month last year to $554 per month this year. The average cost for the first and second cheapest silver-level plans have also gone up by 25 percent.

Even for Obamacare’s bronze-level plan—the cheapest, lowest quality option—the monthly, average premiums rose from $408 in 2016 to $475 this year.

“Part of the reason why these premiums are rising is because there are fewer people enrolled than I expected, and the people who are enrolled are sicker than expected,” said Chris Sloan, a senior manager at Avalere, in a phone interview with The Daily Signal.

However, according to Sloan, with government subsidies and tax credits, lower-income earners enrolled in Obamacare may not be affected by the rising costs of these cheaper plans.

“While many consumers will experience significant premium increases this year, most will receive subsidies to help offset the costs of the increases and make premiums more affordable,” Sloan said in a statement.

Obamacare premiums are going up, but due to government financial assistance, real costs for many enrollees are remaining relatively the same. These costs will fall on taxpayers, according to a health care expert.

“If subsidies are going up through premium tax credits and cautionary reduction subsidies, the federal taxpayer ends up paying for that increase, so the burden of that is on all us federal taxpayers,” said Alyene Senger, a health care policy analyst at The Heritage Foundation.

Senger added, “When supporters of the [Affordable Care Act] say, ‘Well, these figures don’t really matter, because we’re subsidizing [Obamacare enrollees] so they aren’t feeling the brunt of their premium increases because the federal taxpayer is picking up the tab,’ that doesn’t apply to all the people who are purchasing in the individual market that get no subsidy.”

However, even with many Obamacare enrollees being assisted by subsidies or tax credits, they may still find themselves paying more out of pocket for their health care, as deductibles for services and drugs jumped by about 20 percent for silver-level plans in 2017. The number of silver-level plans charging coinsurance—an out-of-pocket payment charged after a consumer’s deductible is paid—for specialty drugs went up by 10 percent.

Issuer participation is also a problem highlighted by the Avalere report, as approximately 1 in 3 regions in America now only have one health insurance issuer. In 2016, just 4 percent of the country was limited to one issuer in their region. After several national and regional insurers exited the exchange markets, 36 percent of the country is now stuck with one issuer in their region.

“What this means is that people who have purchased insurance for 2017 have a lot less choice, so if there’s only one issuer offering health plans in your area and their network doesn’t include your doctor, then that’s it, you don’t really have another option,” Sloan told The Daily Signal.

“People in this market just won’t have as much choice as they had in 2016, or 2015, or 2014,” Sloan said.

This Avalere report, titled “2017 Health Insurance Exchange Snapshot,” was published on Jan 18. (For more from the author of “New Obamacare Report Shows Rising Costs and Fewer Options for 2017” please click HERE)

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Nebraska Woman Loses Health Insurance for Fourth Time Under Obamacare

Pamela Weldin’s experiences with Obamacare can be boiled down to just a few numbers.

Since the health care law’s implementation three years ago, Weldin, 60, has lost her insurance four different times.

And the Nebraska woman is currently enrolled in her fifth new insurance policy in four years.

“Yet again, and through no fault of my own,” Weldin told The Daily Signal. “I’m just sitting here minding my own business, and here we go again.”

A former dental hygienist, Weldin has all the hallmarks of a consumer intended to benefit from the Affordable Care Act.

She has been denied coverage in the past because of a pre-existing condition related to her career as a dental hygienist.

Additionally, Weldin qualifies for a tax credit, which she has received every year since 2014.

As a result, her premiums are low when compared to consumers who don’t qualify for financial assistance: In early 2015, Weldin purchased a plan through Blue Cross and Blue Shield of Nebraska that cost her $232 each month.

This year, premiums for her silver-level plan with Medica are $161 per month after her tax credit. Without the financial assistance, her premiums would total more than $1,300 per month.

But though Weldin has benefited from aspects of the law, she hasn’t been immune to the changes in the health insurance market that have occurred in last few years.

“I’m a person who has been denied because of pre-existing conditions,” Weldin, a Pampered Chef director, said. “I’m on Obamacare and have lost my insurance four times in three years. I understand the challenges, but it’s not sustainable.”

Weldin’s Journey

Since HealthCare.gov opened for business in the fall of 2013, four policies sold by three different insurance companies—Humana, CoOportunity Health, and Blue Cross and Blue Shield of Nebraska—that Weldin purchased were ultimately terminated.

The Daily Signal previously covered her experiences with Obamacare in a February 2015 article.

But since then—when Weldin lost her insurance for a third time—she’s logged another cancellation.

First, Weldin’s initial policy with Humana, which she held for several years, was canceled in the lead-up to Obamacare’s implementation in January 2014.

The Nebraska woman then purchased a platinum-level plan for 2014 through CoOportunity Health, a consumer operated and oriented plan, or co-op. But CoOportunity Health terminated her platinum-level policy for 2015 after the co-op decided it would no longer offer those policies.

Weldin, though, decided to stick with CoOportunity Health and selected a silver-level plan for 2015.

On Jan. 23, 2015, Weldin received a notice from the co-op notifying her that it was going out of business. CoOportunity far outpaced its initial enrollment projections, and its customers racked up medical expenses that far outpaced what they paid in premiums.

Weldin had no choice but to select a new insurer and policy, and purchased coverage through Blue Cross and Blue Shield of Nebraska for the remainder of 2015 and 2016—a plan that, though a bit more expensive, allowed her to see her original doctor.

Late last year, though, Blue Cross and Blue Shield of Nebraska announced it would no longer sell coverage on the exchange in the state.

“This system is collapsing under its own weight,” Weldin said, “like the co-ops and basic companies like Blue Cross pulling out of Nebraska.”

To ensure she would be covered for 2017, Weldin went to HealthCare.gov to select a plan that allowed her to see her current doctor in Colorado.

In Nebraska, consumers on the exchange had just two insurance companies to choose from: Aetna and Medica.

A policy through Aetna was more expensive than its competitor, but because Weldin thought her doctor was considered in-network, she selected a plan through that insurer.

It wasn’t until after she paid her first month’s premium, however, that Weldin learned from the insurance company that any doctor located more than 100 miles from her rural Nebraska home wasn’t in her network.

If she wanted to see her doctor in Colorado—considered out-of-network now—Weldin had to meet a $20,000 out-of-network deductible before Aetna would start covering her medical expenses.

That information, she said, wasn’t listed on HealthCare.gov when she was shopping for plans.

“$20,000 for a deductible? Are you kidding me?” Weldin said. “How is that affordable?”

Speaking Volumes

Across the country, millions of Americans faced higher premiums heading into 2017.

And premium hikes have been well documented by The Daily Signal and others.

Less attention, however, has been paid to the number of insurers and plans available to consumers.

According to an October report from the Department of Health and Human Services, insurer participation in Nebraska decreased from four insurers in 2016 to two in 2017.

And consumers nationwide aren’t just seeing a decline in the number of insurance companies selling coverage on the exchange in their states.

The federal government reported that Americans would also see a decrease in the number of plans insurers offered in 2017.

In Nebraska, there was an average of 18 fewer plans per county available on the exchange to consumers this year. Nebraskans purchasing plans on HealthCare.gov in 2017 had 13 plans to choose from, down from 31 last year.

“That speaks volumes in terms of ultimate consumer benefits,” Rep. Adrian Smith, R-Neb., told The Daily Signal of the change in insurers selling plans in his state. “Fewer choices most often means higher prices and less quality.”

In 2015, Smith introduced a bill to exempt consumers like Weldin who purchased coverage from a failed co-op from the individual mandate. The legislation passed the House, but stalled in the Senate.

Now, Smith and other Republicans—who have spent six years talking about repealing Obamacare—are looking to check the box on a major campaign promise.

Republicans have taken the initial step toward dismantling the health care law after passing a budget resolution earlier this month, and often cite the experiences of Americans like Weldin to bolster their arguments that Obamacare needs to be repealed and replaced.

But despite their control over Congress and the White House, Republican lawmakers differ on their approaches to unwinding Obamacare.

Conservatives are urging GOP leadership to move forward with repeal as soon as possible and say they’re frustrated with the speed at which their leaders are moving to dismantle the health care law.

House Speaker Paul Ryan said last week repeal would be slated for March or April.

“I’d like to see an acceleration of the front-end repeal side,” Rep. Jim Jordan, R-Ohio, said Wednesday at a monthly gathering with reporters. “Let’s get rid of [Obamacare]. That’s what we told the voters that we were going to do.”

Jordan was joined by other Republicans who said they want to see GOP leadership move faster on Obamacare repeal.

“I, too, am frustrated with the pace,” Rep. Scott Perry, R-Pa., said Wednesday. “We need to not only be against the [Affordable Care Act] or Obamacare, which I am for a myriad of reasons … but we also, if not for political reasons, but for the reason that our constituents and America needs to know what we stand for. We should vote on something.”

But during a gathering last week of House and Senate lawmakers in Philadelphia, other Republicans showed tepid support for dismantling the law and even expressed doubts over their party’s plans to repeal and replace Obamacare.

Though the GOP agrees that the law needs to be scrapped, members haven’t yet concurred on whether to repeal major parts of Obamacare like its taxes. Many also want to see Congress move a replacement at the same time they repeal the law.

Still, Smith, the Nebraska congressman, points to Americans like Weldin as a reason why Congress needs to act.

“When you look at the overall picture, [Obamacare] has failed miserably and will continue to cause great damage,” Smith said. “That’s why we need to step in.”

“We want to prevent further pain that we know will happen if we just let Obamacare sit the way it is,” he continued.

‘Not Sustainable’

After learning about her $20,000 out-of-pocket deductible, Weldin contacted HealthCare.gov to seek assistance with purchasing another plan.

A representative there was able to enroll her in a new policy with Medica, and Weldin learned that her doctor was, in fact, included in the new plan’s network.

This year, the Nebraska woman will pay $161 per month in premiums after a tax credit.

Weldin is one of the more than 9 million Americans who receives a tax credit and has been relatively immune to the increased costs of health insurance, but she still wants to see changes made to the health care system.

“Allow us the choice of what kind of policy and coverage suits our needs,” she said. “Allow us the choice of deductible and to cross state lines for provider care so we can choose and keep our own doctors. Allow insurance companies to compete across state lines so we have more options and have more choice of providers.”

And Weldin said she recognizes that any action Republicans take on Obamacare could very well lead to further changes with her insurance and the health insurance market.

Still, she said she wants to have additional choices, even it means more coming out of her pocketbook.

“Something has to be done because this is not sustainable,” Weldin said. “I’m fine paying a little bit more if it’s what I need. But let me choose a policy that’s appropriate for my needs. Let me have a policy that’s appropriate to my medical needs. Let me choose a deductible that’s appropriate for my budget.” (For more from the author of “Nebraska Woman Loses Health Insurance for Fourth Time Under Obamacare” please click HERE)

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