Affordable Care Act

Treating people for free or for very little money has been the role of community health centers across the U.S. for decades. In 2015, 1 in 12 Americans sought care at one of these clinics; nearly 6 in 10 were women, and hundreds of thousands were veterans.

Some Republicans looking to scrap the Affordable Care Act say monthly health insurance premiums need to be lower for the individuals who have to buy insurance on their own. One way to do that, GOP leaders say, would be to return to the use of what are called high-risk insurance pools.

House Republicans are debating a plan to replace the Affordable Care Act that would give consumers tax credits to buy insurance, cut back on Medicaid and allow people to save their own money to pay for health care costs.

The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor.

President Trump has promised to repeal and replace the Affordable Care Act without taking insurance away from the millions of people who gained coverage under the law.

On Wednesday his Department of Health and Human Services made its first substantive proposals to change the marketplaces for individual coverage, commonly known as Obamacare.

Spending your own money on health care might mean that you'll be more frugal with it. That's the theory behind health savings accounts, a decades-old GOP concept that's sparking renewed interest on Capitol Hill as Republican lawmakers look for ways to replace the Affordable Care Act.

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As Republicans move to overhaul the health law, should people bother paying the penalty for not having health insurance when they file their taxes this year? Or will they be able to sign up on the exchange for 2018 after their COBRA benefits end?

Here are some answers to recent questions from readers.

I didn't have health insurance for part of last year and thought I'd get stuck paying a penalty. Now the new administration is talking about not enforcing the insurance requirement. Could I really be off the hook at tax time?

Lynn Hatter, WFSU

Florida leads the nation in signups through the Affordable Care Act, and Orlando alone had more signups that 32 entire states.

Everyone expects Congress to change the Affordable Care Act, but no one knows exactly how.

The uncertainty has one group of people, the homeless, especially concerned. Many received health coverage for the first time under Obamacare; now they're worried it will disappear.

Joseph Funn, homeless for almost 20 years, says his body took a beating while he lived on the street.

Now, he sees nurse practitioner Amber Richert fairly regularly at the Health Care for the Homeless clinic in Baltimore.

There's a moment in the Broadway musical Hamilton where George Washington says to an exasperated Alexander Hamilton: "Winning is easy, young man. Governing's harder."

When it comes to health care, it seems that President Trump is learning that same lesson. Trump and Republicans in Congress are struggling with how to keep their double-edged campaign promise — to repeal Obamacare without leaving millions of people without health insurance.

Republican Rep. Gus Bilirakis held a town hall Saturday, to hear ideas about replacing the Affordable Care Act. 

But he was met with opposition as about every one of the 200 people gathered at The Centre of Palm Harbor were in support of Obamacare. Many came to voice their concerns with the law's potential repeal. 

Through years of acrimony over the relative merits of Obamacare, one kind of health insurance has remained steady, widespread and relatively affordable: Employer-sponsored plans.

Job-based medical plans still cover more Americans than any other type, typically with greater benefits and lower out-of-pocket expense. Recent cost increases for this sort of coverage have been a tiny fraction of those for Obamacare plans for individuals.

They are just three little words — "health savings accounts" — but they are generating a lot of buzz as Republicans contemplate plans to repeal and replace the Affordable Care Act.

Expanding the use of these accounts, based on a long-held conservative view that consumers should be more responsible for their health care spending, is a part of almost every GOP replacement plan under consideration on Capitol Hill.

It's the last day to sign up for health insurance under the Affordable Care Act.

And at Whitman-Walker Health, a community health center near downtown Washington, D.C., people have been streaming in looking for help choosing an insurance plan.

Katie Nicol is a senior manager who oversees the five so-called navigators whose sole job is to help people sign up for insurance coverage.

Healthcare.gov

While talk of repeal and replace has dominated the recent conversation about the Affordable Care Act, consumers have quietly been signing up in record numbers.  

Republican lawmakers meeting in Philadelphia this week say they want their replacement of Obamacare to be done by spring. There is no consensus on a plan yet, but several Republicans in Congress have already circulated proposals that could reduce or eliminate features of the federal health law that have benefited older Americans.

Here are some examples:

Prescription drugs

With open enrollment season for buying health coverage under the Affordable Care Act ending Tuesday, it seemed like an apt time to talk with folks in charge of some of the state insurance marketplaces created by the federal health law.

It's the fifth year these marketplaces, also called exchanges, have been running. The marketplaces are the go-to option for people under 65 who don't get health insurance through work or qualify for Medicaid.

Much has been written about the 20 million people who gained health insurance under the Affordable Care Act, and what could happen to these patients if the ACA is repealed without a replacement. But some people don't realize that hospitals nationwide could take a big financial hit on several fronts, too.

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The repeal of the Affordable Care Act appears almost certain. On Monday (1/23) a Tallahassee doctor who also teaches at the Florida State University College of Medicine was speaking on what might happen next.

As promised, President Trump has moved to dismantle the Affordable Care Act. It's a concern for those who might be left without health insurance — and especially for the Department of Veterans Affairs, which may have to pick up some of the slack.

Carrie Farmer, a health policy researcher at the Rand Corp., says 3 million vets who are enrolled in the VA usually get their health care elsewhere — from their employer, or maybe from Obamacare exchanges. If those options go away, she has no idea just how many of those 3 million veterans will move over to the VA.

healthcare.gov

People are still signing up for health insurance through the Affordable Care Act despite its uncertain future.

During an enrollment event at the University of South Florida Tuesday,  people said they were worried about losing their health care.

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President Donald Trump, fulfilling a campaign promise to start to repeal Obamacare on Day 1, signed an order directing federal agencies to waive enforcement of large swaths of the law.

The one-page order allows the head of the Department of Health and Human Services or any other agency with authority under the law, not to enforce regulations that impose a financial burden on a state, company or individual.

As promised, President Trump got to work on Day One, spending some time in the Oval Office in between the inaugural parade and a trio of formal balls.

Trump signed an executive order Friday night directing government agencies to "ease the burdens" of Obamacare while the new administration and Congress work toward repealing and replacing the Affordable Care Act.

White House Chief of Staff Reince Priebus presented Trump with the order, which he described as: "An executive order minimizing the economic burden of the Patient Protection and Affordable Care Act pending repeal."

A partial repeal of Obamacare could leave 18 million people who have insurance today with no coverage one year later, according to an analysis by the nonpartisan Congressional Budget Office.

The report estimates that 32 million people would lose their insurance over 10 years.

Once Donald Trump was elected president, Republicans in Congress realized their chance to repeal and replace the Affordable Care Act had finally arrived. The repeal process has already started. And while there is no replacement in sight for the foreseeable future the ACA’s healthcare exchange is still up and running and enrolling record numbers for health insurance in 2017. 

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