Even before the Republican-led Congress acts to repeal the 2010 law, the new administration will move swiftly to unwind as many elements as it can on its own — elements that have changed how 20 million Americans get health coverage and what benefits insurers must offer some of their customers.
.. Robert Laszewski, president of the consulting firm Health Policy and Strategy Associates, called the executive order a “bomb” lobbed into the law’s “already shaky” insurance market. Given the time it will take Republicans to fashion a replacement, he expects that federal and state insurance exchanges will continue to operate at least through 2018.
“Instead of sending a signal that there’s going to be an orderly transition, they’ve sent a signal that it’s going to be a disorderly transition,” said Laszewski, a longtime critic of the law, which is also known as Obamacare. “How does the Trump administration think this is not going to make the situation worse?”.. the president’s decision to sign the order on his first day in office, coupled with his recent comments about moving swiftly on repealing and replacing the law, has applied pressure on GOP lawmakers to act faster than they might have initially planned... Democratic leaders, however, are casting the executive order as evidence that Republicans are in a state of disarray on health care... Chris Jennings, who served as a senior White House adviser on health care in the Clinton and Obama administrations, said that in the health-care arena, “more than any other domestic policy, details matter. Plans, they live off a comma, or an incentive, or a disincentive, or a penalty, or an enforcement mechanism.”
Donald Trump’s Medical Delusions
Some Republicans appear to be realizing that their long con on Obamacare has reached its limit. Chanting “repeal and replace” may have worked as a political strategy, but coming up with a conservative replacement for the Affordable Care Act — one that doesn’t take away coverage from tens of millions of Americans — isn’t easy. In fact, it’s impossible.
But it seems that nobody told Mr. Trump. In Wednesday’s news conference, he asserted that he would submit a replacement plan, “probably the same day” as Obamacare’s repeal — “could be the same hour” — that will be “far less expensive and far better”; also, with much lower deductibles.
.. the anti-Obamacare campaign has always been based on lies that can’t survive actual repeal.
A prime example is the pretense that health reform hasn’t helped anyone. “Things are only getting worse under Obamacare,” declared Paul Ryan,
.. an overwhelming majority of those covered by the new health exchanges are satisfied with their coverage.
.. the percentage of nonelderly white adults without insurance fell by almost half from 2010 to 2016, from 16.4 to 8.7, a gain surely concentrated in the Trump-supporting white working class.
.. Republican ideas about cost control are all about “skin in the game,” requiring people to pay more out of pocket (which somehow doesn’t stop them from complaining about high deductibles).
.. they’ll probably do it because they believe they can find some way to blame Democrats for the ensuing disaster.
GOP feuds over how to kill Obamacare
Some want a quick end, while others fear throwing 20 million people off their coverage virtually overnight.
.. A party rift was already emerging between lawmakers and advocacy groups who want a slow and orderly transition to give notice to the millions now covered — and those who want to repeal the entire law within minutes of Trump’s inauguration.
.. Heritage Action .. is demanding that Congress prepare a repeal bill that Trump could sign on Inauguration Day.
.. “It should crumble immediately because Americans can’t afford it,” said Rep. Andy Harris (R-Md.), a member of the Freedom Caucus who wants to see the individual mandate scrapped right away.
.. “There’s nothing you can do about that,” Roe said. “It’s going to take one to two years to reconstitute a marketplace.”
.. Complicating their discussions is the practical reality that they will have only one shot at passing a health bill using a difficult budget maneuver that prevents a Democratic filibuster.
.. The quickest thing a GOP administration could do is refuse to pay insurance companies the subsidies they make on behalf of low-income people. Insurers would face insurmountable costs and would be allowed to leave the markets almost immediately.
.. If Republicans aggressively attack the law through regulation, the law will quickly crumble because insurers will become unstable and customers would lose coverage with little notice. For some in the GOP, that’s the goal. But others fear that would generate backlash.
.. Some Republicans are worried about appearing reckless by getting rid of Obamacare without a new system in place, opening themselves up to accusations that they’re canceling consumers’ health plans
.. “Certainly in the House, they are running for office constantly, only two years to go again,” .. “Most of them are not going to want campaign ads in two years that say Mr. X or Mrs. X is responsible for throwing 20 million people off health insurance.”