Morning Briefing
Summaries of health policy coverage from major news organizations
Health Policy Perspectives: McConnell Says Voters 'Spoke Loudly' On Repeal; Medicare's Stake
Americans continue to call for ObamaCare鈥檚 repeal. They spoke loudly again this November, and about 8 out of 10 favor changing ObamaCare significantly or replacing it altogether. We in Congress hear you, and we have already begun to act. ... We鈥檙e acting quickly because ObamaCare is collapsing under its own weight, and things will continue to get worse otherwise. That doesn鈥檛 mean the law will end overnight. There will be a stable transition period .... We plan to take on this challenge in manageable pieces, not another 2,700-page bill like ObamaCare. Some Democratic Senators have mused publicly about their role in that process. I hope they鈥檒l work with us. We want their ideas to improve our health care system. (Senate Majority Leader Mitch McConnell, 1/9)
Republicans are gearing up to repeal Obamacare 鈥 what House Speaker Paul Ryan calls "the first order of business" for the new Congress and the Trump administration. House and Senate committees will be under intense deadline pressure to write legislation before the end of the month that would undercut major pillars of Obamacare as part of a budget bill. Yes, the GOP is in a hurry to rid the nation of Obamacare. (1/9)
For Julie Ross, the looming repeal of the Affordable Care Act isn鈥檛 an abstract political issue. It鈥檚 a life-or-death matter for her 4 1/2-year-old daughter, who was born with Down syndrome and a congenital heart condition and spent her first month in the neonatal intensive care unit. In the pre-Affordable聽Care Act era, when insurers could impose lifetime limits on benefits, hers was $500,000. 鈥淪he would have reached that in her first two weeks,鈥 Ross says. (Michael Hiltzik, 1/9)
Many right-wingers 鈥 some who decided to champion the ideologically nihilistic President-elect Donald Trump 鈥 claim their anger at the GOP鈥檚 鈥渆stablishment鈥 has been fueled by its 鈥渂etrayal鈥 of the base. 聽In the right-wingers鈥 telling, they were led to believe that electing a GOP House and Senate majorities would get rid of Obamacare. Aside from a failure to identify any such definitive promise, their narrative makes no sense. Did they really think President Obama would ever sign such a thing? (They could only be betrayed if they had no clue how the legislative process works.) (Jennifer Rubin, 1/9)
Now it鈥檚 the left鈥檚 turn to use public opinion, and the stakes in the next fight are bigger than the House ethics office. Even before Trump becomes president, Congress is taking steps to deprive millions of people of health insurance. Democrats in Congress should do everything they can to thwart the effort. And if you鈥檙e one of those people who despaired after last year鈥檚 election 鈥 who wondered whether facts still mattered and whether there was anything you could do 鈥 you should get involved, too. How? I鈥檒l get to that in a moment. (David Leonhardt, 1/10)
In the current drive to 鈥渞epeal and replace鈥 the ACA, designers must be careful not to add to the burden of hospitals and clinics by ignoring the significant cuts to Medicare Democrats issued to make the ACA budget numbers work. The challenging economics of hospitals and physicians are being made even more difficult by the changes to Medicare mandated by the ACA. According to the National Center for Health Policy Analysis in a 2015 article, 鈥21 percent [of physicians] are not accepting new Medicare patients.鈥 But while a physician can opt out of Medicare or private insurance plans, a hospital cannot. (Rich Galen, 1/10)
Georgia Congressman Tom Price, President-elect Donald Trump鈥檚 nominee to run the Department of Health and Human Services, is a bundle of contradictions when it comes to Medicare. ... Here is where Price鈥檚 views start to fight with themselves. While he鈥檇 change Medicare in ways that would increase consumer demand for managed care, he seems to oppose many of the consequences of that change. For instance, has been an outspoken critic of many of Medicare鈥檚 efforts to control health care costs. ... He has strenuously opposed efforts by Medicare to shift from fee-for-service medicine to a system that pays for quality, low-cost outcomes rather than volume. (Howard Gleckman, 1/9)
One month ago, as the surprise of the election wore off and the reality of a Republican-controlled Washington sunk in, I would have predicted that Obamacare repeal was a foregone conclusion. Republicans have spent six years promising to repeal the Affordable Care Act. They have maintained incredible party unity on the issue, not wavering even as millions of people gained coverage. Legislators quickly moved to make it their first agenda item in Congress. The matter felt settled. Except today, a month later, it doesn鈥檛 feel settled at all. (Sarah Kliff, 1/9)
As they try to stop Republicans from repealing the Affordable Care Act, Democrats have a few central arguments they鈥檙e making to explain why repeal would be so catastrophic, none more vivid than the simple fact that Republicans plan to kick somewhere between 20 million and 30 million Americans off their health coverage. This argument has the benefit of being true, and unlike many of the details of health reform, relatively easy to understand. So how are Republicans responding? With two arguments, both of which are meant to prey on people鈥檚 confusion and the complexity of this issue. Once you strip away the deception, both those arguments also reveal just how disastrous it will be if they succeed in their plans for the American health care system. (Paul Waldman, 1/9)
Donald Trump likes to say he鈥檚 going to repeal Obamacare and replace it with 鈥渟omething terrific.鈥 Sadly for everyone, that鈥檚 probably not possible. What is possible is repealing Obamacare and replacing it with something that makes a different set of equally painful trade-offs. Price鈥檚 plan, to its credit, is clear about its trade-offs. It costs less than the Affordable Care Act but covers far fewer people, and the people it does cover get much stingier insurance. (Ezra Klein, 1/9)
Trump promised to guarantee coverage to all, not cut Medicaid and preserve protections for those who have pre-existing conditions. If he does all of that, he will be repealing Obamacare and replacing it with something that changes the name but not the program. That may be what he has in mind, but it鈥檚 not what his closest allies and advisers have said they intend to enact. (Daniel Weintraub, 1/9)
As the Republican Party鈥檚 debate over repealing and replacing Obamacare focuses on the Senate, the views of Republican governors have received little attention and will be important to watch. This group doesn鈥檛 like the Affordable Care Act, President Barack Obama鈥檚 signature health law, and will want to support the Republican effort to repeal and replace it. But for many of the governors the interests of their states could run counter to two central elements of the repeal and replace plans. (Drew Altman, 1/10)
Under Obamacare, many have learned that having health insurance isn鈥檛 the same as actually having health care. Many Kentuckians have been forced into plans their doctors won鈥檛 accept with the cost of premiums and deductibles so high that they fear they can鈥檛 afford to get sick. These aren鈥檛 the results Kentuckians wanted.聽These aren鈥檛 the results Obamacare promised. (Senate Majority Leader Mitch McConnell, 1/9)
Gov. Roy Cooper鈥檚 push during his first week in office to expand Medicaid raises at least two pressing questions: Should North Carolina expand Medicaid? And: Is Cooper going about it the right way? The answers: Yes and no. (1/6)