Obamacare

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. 

Eight female activists from Jacksonville are calling on state and federal officials to keep the Affordable Care Act intact. That’s as Republicans in Washington are talking about repealing and replacing the health care law.

President Donald Trump and other Republican leaders have been working to repeal and replace the Affordable Care Act. And the millions of Americans who have health insurance through the Obamacare marketplaces aren't the only ones wondering about their fate. Leaders of insurance companies are, too.

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.

Tuesday is the last day of open enrollment for health coverage for 2017 under the Affordable Care Act. And while Republicans in Congress are working to repeal the law, it's not at all clear what might replace it.

During the campaign, President Trump suggested a nationwide insurance market that would allow insurance plans to be sold across state lines.

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.

Short-term health plans have been around for decades, bridging coverage gaps for people who are between jobs or have recently graduated from school, among other things.

After the Affordable Care Act was enacted, some people gravitated toward the short-term plans because they were willing to trade comprehensive coverage for a cheaper sticker price — even if it meant paying a tax penalty for not having the comprehensive coverage required in the law. Sales increased sharply.

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.

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.

Republicans plan to turn control of Medicaid over to the states as part of their replacement for the Affordable Care Act, according to an adviser to President Donald Trump.

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. 

President-elect Donald Trump said he's finishing a plan to replace the Affordable Care Act with a proposal that would provide "insurance for everybody," according to a report by The Washington Post.

As their first major act of the new Congress, Republicans rushed approval of a budget resolution this week that sets up a framework for repealing Obamacare, but what exactly to replace it with is still a puzzle Republicans are piecing together.

And it could take a while.

The Affordable Care Act brought the rate of uninsured Americans to a record low 9 percent in 2015. It's the major achievement of the controversial health care law and one the Obama administration likes to tout whenever it can.

Health and Human Services Secretary Sylvia Burwell did just that in an interview with NPR on Tuesday.