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Wednesday, Feb 8 2017

Full Issue

Republicans Detest The Individual Mandate, But Other Options Aren't Any More Palatable

Most health care economists believe lawmakers will be hard-pressed to come up with an effective and politically tolerable alternative to what has become the symbolic heart of the health law. “Carrots are expensive,” says Paul Van de Water, a senior fellow at the left-leaning Center on Budget and Policy Priorities. “Sticks are unpopular.” Meanwhile, Speaker Paul Ryan, R-Wis., reiterates that the plan to dismantle and replace the Affordable Care Act will be completed this year.

The most hated piece of Obamacare is the mandate requiring most Americans to get health insurance. The Republican alternatives on the table may not prove any more popular. As the GOP weighs elements of a repeal-replace plan, one of lawmakers' biggest headaches is finding another way to persuade insurers to cover people with pre-existing health care problems. And all of the options under discussion would either raise the uninsured population or run afoul of GOP principles. (Demko, 2/8)

Ever since Democrats began pushing the Affordable Care Act through Congress more than seven years ago, Republicans have been trying to come up with an alternative. Candid conversations leaked from a conclave of Republican lawmakers in Philadelphia last month, and public comments since, show they are nowhere near agreement. (Pear, 2/7)

The U.S. House of Representatives' Republican leader said on Tuesday that legislation to replace former President Barack Obama's signature healthcare law would be completed this year, trying to dispel the idea that the party is retreating from its campaign promise to dismantle Obamacare quickly. (Cornwell, 2/7)

Speaker Paul Ryan (R-Wis.) said Tuesday that Congress’s work to repeal and replace ObamaCare will be finished “this year.” Ryan was responding to a question about President Trump’s comments on Sunday that “maybe it’ll take till sometime into next year” to roll out a Republican replacement plan. But the Speaker said legislation to repeal and replace ObamaCare will pass this year. When that legislation would go into effect that could possibly extend into future years, he added. (Sullivan, 2/7)

“We are going to be done legislating with respect to health care and Obamacare this year,” Ryan said, though he added that it could take time for the Trump administration to implement the changes. “The question about how long it takes to effectuate the change, how long it takes to put these things in place, that’s a question that the HHS [Department of Health and Human Services] can answer,” he said. (Reid and McIntire, 2/7)

Republicans remain deeply divided about how quickly they'll be able to repeal the 2010 health care law, even as insurance companies demand clarity before the end of next month. Some are pressing ahead with plans for a quick repeal. Senate Majority Whip John Cornyn of Texas said Monday he expects the reconciliation measure that will serve as the initial vehicle for repealing the health care law to be filed within the next 30 days. (Williams and Mershon, 2/7)

Republicans on Capitol Hill and within the Trump administration are scrambling to get Obamacare repeal efforts back on track by stuffing as much of a replacement policy as possible into a repeal bill. Four replacement measures are under consideration, with a goal of beginning work on the legislation in the relevant House committees by the end of February, according to congressional sources familiar with the tentative plans. (Haberkorn, 2/7)

A new ObamaCare replacement plan from Rep. Mark Sanford is viewed favorably by the conservative Freedom Caucus, Rep. David Brat (R-Va.) said Tuesday. While the caucus hasn’t taken a formal position on the bill, Brat said it is widely liked by its members. Brat said Sanford’s bill -- which has not been introduced yet -- is similar to one introduced by Sen. Rand Paul (R-Ky.) in the upper chamber. (Hellmann, 2/7)

House Republicans are discussing how to deal with protesters showing up at their town halls and other events in their home districts after angry confrontations this past weekend. GOP leaders told members at a closed-door meeting on Tuesday to be welcoming and polite while arranging for moderators and security. That's the word from Rep. Richard Hudson of North Carolina. (2/7)

[T]he tactics [House Democrats] plan to explore at the minority party’s issues conference starting Wednesday in Baltimore — aside from their intense opposition to President Donald Trump — will be on how they can amplify concerns from constituents in Republican districts. ... In recent weeks, several GOP lawmakers have faced backlash from people in their districts during town hall events over Republican efforts to repeal the 2010 health care law and over an executive order signed by Trump that temporarily restricted travel from seven Muslim-majority countries. ... Perhaps out of concern to avoid such incidents, and the sort of town hall spectacles that defined the summer of 2009, when Congress was debating the health care law, some Republicans are even refusing to have such constituent events at all. (Rahman, 2/8)

And in other health law news —

The AARP says it would consider suing the Trump administration if it went forward with a regulation that would allow insurers to charge older people more under ObamaCare.  The Department of Health and Human Services is in the process of putting forward a regulation on “stabilization” of the ObamaCare marketplaces, and The Huffington Post reported on Monday that one proposal in the regulation is to change the ratio set out under ObamaCare on how much more insurers can charge older people compared to younger people. (Sullivan, 2/7)

As the battle royale over the repeal of the Affordable Care Act—AKA Obamacare—heats up, access to health care for millions of Americans hangs in the balance. For those who get their health benefits through their employers, the repeal and/or replacement of the healthcare program may not hit as close to home. Yet the ACA does far more than many people realize, including guaranteeing new mothers the time and space to breastfeed at work. Before the Affordable Care Act, women in 28 states, including California, already had this guarantee, according to the National Conference of State Legislatures. The ACA made this requirement consistent nationwide, though state laws that offered greater protections were not preempted. (Landes, 2/7)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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