Repeal and Replace

Republican efforts in Congress to “repeal and replace” the federal Affordable Care Act are back from the dead. Again.

There's a chance Republicans wouldn't be so close to repealing and replacing the Affordable Care Act if former GOP Sen. Rick Santorum of Pennsylvania hadn't dropped into the Capitol barbershop this spring.

"I was up on the Hill, I happened to just go by the barbershop to see if I could get a haircut, and Lindsey was in the chair," Santorum said. "And Lindsey asked me what I was doing, and I thought to myself, 'Well, let me just bounce it off Lindsey.' "

With insurance premiums rising and national efforts at health reform in turmoil, a group of 50 state bureaucrats whom many voters probably can’t name have considerable power over consumers’ health plans: state insurance commissioners.

As insurers threaten to exit state markets and voters at town halls complain about unaffordable prices, the state commissioners are central characters in the unfolding drama that is America’s health coverage.

With Republican efforts to "repeal and replace" the Affordable Care Act stalled, tentative bipartisan initiatives are in the works to stabilize the fragile individual insurance market that serves roughly 17 million Americans.

Center on Budget and Policy Priorities

A proposal by two senators to replace Obamacare would be particularly bad for Florida, costing the state billions of dollars over the next 10 years, a new study says.

Betting that thin is in — and might be the only way forward — Senate Republicans are eyeing a "skinny repeal" that would roll back an unpopular portion of the federal health law. But health policy analysts warn that the idea has been tried before, and with little success.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

KELLY MCEVERS, HOST:

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

KELLY MCEVERS, HOST:

The Senate voted Tuesday to begin debating a replacement for the Affordable Care Act. It remains uncertain as to what that replacement might look like. No formal legislation has been drafted. But senators moved to take the procedural first step, known as a "motion to proceed." The vote was 51-50, with Vice President Pence casting the tiebreaking vote.

Debate will now begin, most likely on a measure to fully repeal the law, also known as Obamacare.

Updated July 25, 5:25 PM ET: Tuesday afternoon, the Senate voted to send the original House legislation repealing and replacing the Affordable Care Act to the floor. (Details below on the proposals/bills.)

But the Senate is only using it as a vehicle to add amendments that will change it substantially. The first amendment would phase out many of the Affordable Care Act's provisions over two years.

In Jacksonville Wednesday, Florida Governor Rick Scott said Congress should “do their job” and repeal the Affordable Care Act. But he said lawmakers must first craft something to replace it.


President Trump has summoned all Senate Republicans to the White House on Wednesday for a debrief on the state of health care legislation effort in their chamber. Based on the week so far, the meeting may be more like a post mortem.

Senate Majority Leader Mitch McConnell, R-Ky., plans to release an updated Republican health care bill on Thursday and is delaying the body's annual August recess by two weeks in an effort to generate momentum for the beleaguered legislation.

Crippling Medicaid Cuts Could Upend Rural Health Services

Jul 11, 2017

Each day as Ginger Peebles watches daughter Brenlee grow, she sees the importance of having a hospital close by that delivers babies.

Healthcare.gov

The health care legislation under discussion in the Senate could allow states to remove some of the Affordable Care Act’s consumer protections — including the prohibition that keeps insurers from limiting how much they’ll pay for medically needyexpensive patients. Clara Hardy’s parents worry about the Senate bill for just this reason.

Tax Breaks In GOP Health Plans Will Go To Top 1% In Wealth

Jul 5, 2017

There’s much talk on Capitol Hill about the tax cuts included in the Republican health plans, but unless you are a frequent user of tanning beds or have personal wealth that puts you in the top 1 percent, you might not feel much effect from them.

The Affordable Care Act isn't perfect. Even proponents of the law would agree with that.

In many parts of the country, there is only one insurer in the individual markets — and in a few, there are zero. Premiums have spiked, sending some people on the insurance exchanges hunting for new plans.

WMFE

President Donald Trump promised to make health care more affordable but a government report finds that out-of-pocket costs — deductibles and copayments — would average 61 percent higher under the House Republican bill.

And even though the sticker price for premiums would be lower than under the Obama-era law, what consumers actually pay would edge up on average because government financial assistance would be curtailed.

Republicans in both the House and the Senate are considering big cuts to Medicaid. But those cuts endanger addiction treatment, which many people receive through the government health insurance program.

Several decades ago, Evan Nodvin's life probably would have looked quite different.

Nodvin has his own apartment just outside Atlanta, in Sandy Springs, Ga., which he shares with a roommate, and a job at a local community fitness center. He also has Down syndrome.

"I give out towels, and put weights away, and make sure people are safe," the 38-year-old says.

To get to and from work, Nodvin relies on rides from people who are hired to help him. He also has a counselor to help him do daily chores like grocery shopping, cleaning and cooking.

Republicans are running way behind schedule.

In the dream scenario outlined by party leaders back in January, President Trump would have signed legislation to repeal and replace the Affordable Care Act, also known as Obamacare, months ago. By early June, Republicans were supposed to be in the thick of overhauling the tax code.

More Floridians could lose their health insurance under legislation being considered by the U.S. Senate. That includes the poor, the disabled and military veterans.

Health care groups that represent doctors and patients are warning members of Congress that the House Republicans' plan to overhaul the Affordable Care Act would hurt people who need insurance most.

WMFE

The Republican overhaul of the federal health law passed by the House this month would result in slightly lower premiums and slightly fewer uninsured Americans than an earlier proposal. But it would leave as many as one-sixth of Americans living in states where older and sicker people might have to pay much more for their health care or be unable to purchase insurance at all, the Congressional Budget Office said Wednesday.

The Senate is negotiating its own legislation to repeal and replace much of the Affordable Care Act in secret talks with senators hand-picked by party leaders and with no plans for committee hearings to publicly vet the bill.

"I am encouraged by what we are seeing in the Senate. We're seeing senators leading," said Sen. Ted Cruz, R-Texas, one of the 13 Republicans involved in the private talks. "We're seeing senators working together in good faith. We're not seeing senators throwing rocks at each other, either in private or in the press."

Ryan Lennon Fines seems like a typical 2-year-old. He and his parents, Scott Fines and Brianna Lennon, flip through a picture book of emergency vehicles. Ryan is looking for the motorcycle, but a photo of an airplane catches his dad's eye.

"That's an air ambulance," Fines tells him. "You've been on one of those."

Former President Barack Obama urged Republicans to be guided by a personal standard of ethics and integrity, not political avarice, as they forge ahead with plans to dismantle the Affordable Care Act — his signature legislation.

In the Rose Garden last week President Trump and the House Republican leadership celebrated their vote to repeal and replace the Affordable Care Act as though it had actually repealed and replaced the 2010 law colloquially known as Obamacare.

It had not, of course. Several more giant steps remain in the process. And more than a few of these same Republicans may well be grateful.

Debates about health care are complicated, and it's easy to get overwhelmed when complicated things like premiums, block grants, state waivers, Medicaid and Medicare are the main topics.

But what are the ideas driving this debate? And why do debates get so heated when we're talking about something so technical?

After the GOP-controlled House passed a Republican-drafted health care bill Thursday without waiting for an analysis of the bill's costs and impacts by the nonpartisan Congressional Budget Office, the White House is signaling that Washington's official legislative scorekeeper could be its next political foil.

Sarah Huckabee Sanders, a spokeswoman for President Trump, told reporters Friday the White House feels "very confident in where the plan is, and moving it forward."

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