�鶹Ů��

Although Trump said during the campaign that he wouldn't touch Medicare or Social Security -- he wouldn't have secured enough Electoral College votes if he had -- tearing apart Obamacare will almost certainly raise costs for Medicare beneficiaries and hasten its decline as a guaranteed, fee-for-service system. Embedded in the Affordable Care Act were a raft of pilot projects and provisions to make medical care for retirees less expensive. The drafters of the act wanted to make doctors more accountable, share in cost savings and cut hospital re-admissions. The Act even cracked down on fraud and abuse in Medicare. (John Wasik, 12/5)

The selection of Rep. Tom Price (D-Ga.) to be the Secretary of Health and Human Services (HHS) in the Donald J. Trump administration seems to signal the President-elect is moving well beyond repealing ObamaCare. ... It’s questionable whether the new President really wants to exert the political energy it will take to convince elderly Americans that they are better off with private insurance rather than Medicare. That’s a tough sell. But he and Price will have less resistance on at least one other GOP dream. Medicaid, as we know it, is toast. (Mike King, 12/5)

With Donald Trump headed to the White House, Republicans on Capitol Hill are poised to move quickly on rolling back Obamacare. On "60 Minutes," House Speaker Paul Ryan said that changes to the Affordable Care Act will be "the first bill we're going to be working on" in the next Congress. Trump's headed to the White House thanks to 80,000 voters in Michigan, Wisconsin and Pennsylvania — the margins of victory in three states he flipped from blue to red. He flipped other states, too, including Iowa and Ohio. The counties that moved to the right the most relative to 2012 were heavily (but not exclusively) across Appalachia, the Rust Belt and the upper Midwest. The irony of Trump's victory is that many of those counties also had the biggest increases in insurance rates under Obamacare. (Philip Bump, 12/5)

If there weren’t so much at stake, one would be amused at the spectacle of Republican politicians writhing as they try to make good on their ideological promise to “repeal and replace” Obamacare without ruining the lives of millions of their own constituents. In the few short weeks since the GOP added control of the White House to its existing control of both houses of Congress, the GOP has been grappling with the recognition that taking potshots at the Affordable Care Act and weakening its consumer protection provisions is no longer just a parlor game, but actions that could have genuine consequences. (Michael Hiltzik, 12/5)

Obamacare’s implementation was delayed for almost four years, giving the Obama administration time to build the exchanges (well, almost) and make decisions about the trillion-and-one fiddling operational details that accompany any massive new policy change. Even then, they had a running head start; a national health system had been a major priority of Democratic wonks for decades. ... Unfortunately, repeal and delay has serious problems, for reasons that pundits on both the left and the right have elaborated. The most fundamental issue is what economists call “regime uncertainty”: when businesses don’t know the rules under which they will operate in the future, they are unwilling to invest in that future by taking risks or expanding operations. (Megan McArdle, 12/5)

Republicans tentatively plan to hold a "repeal" vote soon after the new Congress convenes. But they have put off the effective date for carrying it out for up to three years, so they can come up with a workable replacement plan they can all agree on. The problems with the slow-motion "repeal and replace" plan are in part technical, as the experts describe. But the hurdles are also political. Republicans seem to believe that setting a concrete date for when the Affordable Care Act would just disappear would pressure Democrats into some bipartisan deal in 2020. Republicans might need the votes, since it's unclear they will ever come up with something their conference can agree on in both chambers of Congress (and in any case they'll need the cover if they retain the parts of the law that Americans really like). (Jonathan Bernstein, 12/5)

As Republicans barrel headlong towards repealing the Affordable Care Act, new factoids and data are slowly dribbling out to reveal just what a mess they are about to make, including for countless numbers of their own constituents. The latest: The Kaiser Family Foundation today released a new study breaking down how many people in each state are benefiting from the ACA’s subsidies to buy health insurance on the individual market — and how much money people in each state are getting. We’re talking about a lot of people in red states and in states with Republican legislators — and a lot of money. (Greg Sargent, 12/5)

In January, Donald Trump will be sworn in as our next president. At the same time, we will welcome in new and returning legislators at the federal and state levels. With this change, there is promise and opportunity if we all share the same goal of providing access to affordable, high-quality healthcare. As a solutions-oriented company, Florida Blue complied with the Affordable Care Act (ACA) — Obamacare — because it was the law of the land and because it made healthcare coverage available to many more Floridians. ... Now we are ready to work with the new administration to identify the funding, benefits and guidelines through which even more Americans are provided the opportunity to obtain healthcare coverage. (Pat Geraghty, 12/5)

Why aren’t Wisconsin’s millennials signing up for the Affordable Care Act? That’s what the Obama administration is wondering now that open enrollment is underway in Wisconsin and across the nation. My generation is the key to the Affordable Care Act’s success, and yet, so far, we’ve steered clear for three straight years. (David Barnes, 12/5)