Debate on Obamacare Repeal Centers on Medicaid. Here’s How States That Expanded It Are Doing.

As lawmakers begin to debate a GOP bill to replace Obamacare, both Republicans and Democrats say they worry that Americans who gained health insurance under the health care law will lose the coverage once Congress repeals it.

For many, that worry stems from potential changes to Medicaid proposed by Republicans in their plan to replace the health care law.

Under Obamacare, millions of low-income Americans gained health coverage through Medicaid. The federal government footed the bill for the costs of the newly eligible enrollees through 2016.

But health policy experts point to the exploding population of Medicaid beneficiaries and rising costs as proof that the situation is not sustainable.

“People are paying taxes and [Medicaid expansion states] are adding all these people to the Medicaid rolls, and they’re having to pay little to nothing for medical care,” Doug Badger, a senior fellow at the Galen Institute and former adviser to President George W. Bush, told The Daily Signal. “It’s being paid out of somewhere, and much of that burden is being paid by people in other states.”

Traditionally, the program was restricted to certain groups of low-income Americans, such as those who are disabled, blind, or pregnant.

But Obamacare expanded Medicaid to allow Americans to enroll if their incomes are less than 138 percent of the federal poverty line (currently $16,643 for an individual, $33,948 for a family of four).

In the three years since Obamacare’s implementation, 31 states and the District of Columbia expanded Medicaid. Two more, Kansas and Maine, are considering whether to do so.

But with Republicans slowly moving closer to repealing the Affordable Care Act, the Medicaid expansion is one of many aspects of the health care law on the chopping block.

And this issue, in particular, has caused a split among Republicans in both chambers.

Conservatives want to see the Medicaid expansion repealed in full and the program reformed for the future.

But Republican lawmakers and governors who represent states where Medicaid expanded have asked GOP leaders for assurances that those who were newly eligible for Medicaid wouldn’t lose their coverage when Obamacare is repealed.

“We cannot turn our backs on the most vulnerable,” Ohio Gov. John Kasich, a Republican who expanded Medicaid, told CNN last month. “We can give them the coverage, reform the program, save some money, and make sure that we live in a country where people are going to say, ‘At least somebody’s looking out for me.’”

“It’s not a giveaway program,” Kasich said. “It’s one that addresses the basic needs of the people in our country.”

The House GOP’s Obamacare replacement plan released Monday, called the American Health Care Act, leaves Medicaid expansion untouched until 2020.

Under the bill, states that expanded Medicaid coverage still would be able to enroll low-income Americans until then.

Enrollment in Medicaid expansion would freeze by 2020, though. So while those who gained coverage wouldn’t be affected, states wouldn’t be permitted to enroll any more low-income Americans.

Many states have enrolled millions of newly eligible residents.

But health policy experts say the Medicaid expansion has been detrimental to the budgets of states that embraced it and the resources available to populations the Medicaid program initially was designed to help.

“We see this as a moral issue, because what states have done is create this new category within the Medicaid program, which is a program that was originally intended to serve [the] aged, the blind, the disabled, low-income families, pregnant women—[those] we think about as the truly needy and truly vulnerable,” Nic Horton, a senior research fellow at the Foundation for Government Accountability, told The Daily Signal.

“Obamacare’s Medicaid expansion changed that in states that accepted it,” Horton said.

In a November report, the Foundation for Government Accountability examined enrollment projections for states that expanded Medicaid.

Twenty-four states projected that 5.5 million newly eligibly Americans would sign up.

In reality, the number of able-bodied adults who enrolled in Medicaid was more than double that, nearing 11.5 million, according to the most recent data available.

California, for example, projected 910,000 would enroll under the Medicaid expansion. Enrollment actually topped 3.8 million.

Arkansas expected 215,000 to enroll, and ended up with 324,318.

Horton dubbed this an “enrollment explosion.”

“That means more than twice as many able-bodied adults that the states and federal taxpayers have to pay for,” he said.

Horton warned that in expansion states, where far more low-income Americans enrolled in Medicaid than policymakers expected, services that traditionally went to the disabled and needy are being diverted to pay for the additional costs of the expansion population.

“Every penny that’s spent on this new group of able-bodied adults, that’s a penny that can’t go to the traditional Medicaid program,” he said.

Badger also noted that as the Medicaid population has grown, the number of providers accepting Medicaid patients hasn’t changed.

“We had a surge in the people on Medicaid, but we didn’t have a surge in the doctors accepting Medicaid patients or other institutions to care for them,” he told The Daily Signal. “You add 12 million people to Medicaid, but where’s everyone going to go?”

Studies have suggested that Medicaid patients have had trouble finding providers, and have worse outcomes than those without insurance.

A study from the University of Virginia examining major surgical operations that occurred between 2003 and 2007 found that for eight different procedures, Medicaid patients were more likely to die in the hospital or suffer complications than the uninsured and privately insured.

For conservative lawmakers, the crux of their issue with the Medicaid expansion lies in the money the federal government is sending to participating states.

From 2014 to 2016, the federal government financed 100 percent of the costs of the newly eligible Medicaid population, with federal contributions set to drop to 90 percent by 2020 and beyond.

But as states have enrolled more adults in Medicaid, costs have risen.

A July 2016 report from the Department of Health and Human Services found that Medicaid expansion enrollees cost an average of $6,366 in 2015. The year before, the agency projected enrollees would cost an average of $4,281.

“California is shifting the costs of covering this population to other states, including to states that have chosen not to expand their programs,” Badger said. “California has very little skin in the game. You can enroll someone in this population and shift the cost to Idaho, and Florida, and Texas, the taxpayers in other states.”

Idaho, Florida, and Texas did not expand Medicaid.

Though the federal government financed all of the costs of covering those newly eligible for Medicaid, states that expanded Medicaid are beginning to examine their own budgets since they’re now picking up 5 percent of the tab.

“Before expansion, the traditional Medicaid program was already the largest item in most state budgets,” Horton said, adding:

It’s the home mortgage in the state budget. You pay it first, and figure out what comes next. It’s the biggest piece in most states. Now you’ve taken that and added this expansion on top of it.

Now that we’re into 2017, states are on the hook for 5 percent of those costs. The days of free money from the federal government, that this isn’t costing us anything … we’re living it and seeing that states are having to find that money. That money has to come from somewhere else in the budget—from education, from law enforcement, from infrastructure spending, from the traditional Medicaid program, or tax increases.

While Republicans in Congress debate the future of the Medicaid expansion, some states have begun to take action to curb enrollment in their Medicaid programs.

Last week, the Arkansas House of Representatives voted to freeze enrollment for those newly eligible for Medicaid beginning July 1.

“Currently, we have over 330,000 folks on the program,” state Rep. Josh Miller, a Republican, told the Arkansas Democrat-Gazette. “We are on an unsustainable path, especially with the looming new acts that are going to come out of Washington, D.C.”

Gov. Asa Hutchinson, a Republican, opposes the bill. But if it were to earn his signature, Arkansas would need a waiver from the federal government to proceed.

Badger said that freezing Medicaid enrollment creates inequities.

But Horton said other states should follow the lead of Arkansas.

“Look at what Arkansas is doing. Look at what they’re doing at the federal level, and look at ways to control enrollment,” he said. “The money is not there. The money is not going to be there.”

The post Debate on Obamacare Repeal Centers on Medicaid. Here’s How States That Expanded It Are Doing. appeared first on The Daily Signal.

Debate on Obamacare Repeal Centers on Medicaid. Here’s How States That Expanded It Are Doing.

As lawmakers begin to debate a GOP bill to replace Obamacare, both Republicans and Democrats say they worry that Americans who gained health insurance under the health care law will lose the coverage once Congress repeals it.

For many, that worry stems from potential changes to Medicaid proposed by Republicans in their plan to replace the health care law.

Under Obamacare, millions of low-income Americans gained health coverage through Medicaid. The federal government footed the bill for the costs of the newly eligible enrollees through 2016.

But health policy experts point to the exploding population of Medicaid beneficiaries and rising costs as proof that the situation is not sustainable.

“People are paying taxes and [Medicaid expansion states] are adding all these people to the Medicaid rolls, and they’re having to pay little to nothing for medical care,” Doug Badger, a senior fellow at the Galen Institute and former adviser to President George W. Bush, told The Daily Signal. “It’s being paid out of somewhere, and much of that burden is being paid by people in other states.”

Traditionally, the program was restricted to certain groups of low-income Americans, such as those who are disabled, blind, or pregnant.

But Obamacare expanded Medicaid to allow Americans to enroll if their incomes are less than 138 percent of the federal poverty line (currently $16,643 for an individual, $33,948 for a family of four).

In the three years since Obamacare’s implementation, 31 states and the District of Columbia expanded Medicaid. Two more, Kansas and Maine, are considering whether to do so.

But with Republicans slowly moving closer to repealing the Affordable Care Act, the Medicaid expansion is one of many aspects of the health care law on the chopping block.

And this issue, in particular, has caused a split among Republicans in both chambers.

Conservatives want to see the Medicaid expansion repealed in full and the program reformed for the future.

But Republican lawmakers and governors who represent states where Medicaid expanded have asked GOP leaders for assurances that those who were newly eligible for Medicaid wouldn’t lose their coverage when Obamacare is repealed.

“We cannot turn our backs on the most vulnerable,” Ohio Gov. John Kasich, a Republican who expanded Medicaid, told CNN last month. “We can give them the coverage, reform the program, save some money, and make sure that we live in a country where people are going to say, ‘At least somebody’s looking out for me.’”

“It’s not a giveaway program,” Kasich said. “It’s one that addresses the basic needs of the people in our country.”

The House GOP’s Obamacare replacement plan released Monday, called the American Health Care Act, leaves Medicaid expansion untouched until 2020.

Under the bill, states that expanded Medicaid coverage still would be able to enroll low-income Americans until then.

Enrollment in Medicaid expansion would freeze by 2020, though. So while those who gained coverage wouldn’t be affected, states wouldn’t be permitted to enroll any more low-income Americans.

Many states have enrolled millions of newly eligible residents.

But health policy experts say the Medicaid expansion has been detrimental to the budgets of states that embraced it and the resources available to populations the Medicaid program initially was designed to help.

“We see this as a moral issue, because what states have done is create this new category within the Medicaid program, which is a program that was originally intended to serve [the] aged, the blind, the disabled, low-income families, pregnant women—[those] we think about as the truly needy and truly vulnerable,” Nic Horton, a senior research fellow at the Foundation for Government Accountability, told The Daily Signal.

“Obamacare’s Medicaid expansion changed that in states that accepted it,” Horton said.

In a November report, the Foundation for Government Accountability examined enrollment projections for states that expanded Medicaid.

Twenty-four states projected that 5.5 million newly eligibly Americans would sign up.

In reality, the number of able-bodied adults who enrolled in Medicaid was more than double that, nearing 11.5 million, according to the most recent data available.

California, for example, projected 910,000 would enroll under the Medicaid expansion. Enrollment actually topped 3.8 million.

Arkansas expected 215,000 to enroll, and ended up with 324,318.

Horton dubbed this an “enrollment explosion.”

“That means more than twice as many able-bodied adults that the states and federal taxpayers have to pay for,” he said.

Horton warned that in expansion states, where far more low-income Americans enrolled in Medicaid than policymakers expected, services that traditionally went to the disabled and needy are being diverted to pay for the additional costs of the expansion population.

“Every penny that’s spent on this new group of able-bodied adults, that’s a penny that can’t go to the traditional Medicaid program,” he said.

Badger also noted that as the Medicaid population has grown, the number of providers accepting Medicaid patients hasn’t changed.

“We had a surge in the people on Medicaid, but we didn’t have a surge in the doctors accepting Medicaid patients or other institutions to care for them,” he told The Daily Signal. “You add 12 million people to Medicaid, but where’s everyone going to go?”

Studies have suggested that Medicaid patients have had trouble finding providers, and have worse outcomes than those without insurance.

A study from the University of Virginia examining major surgical operations that occurred between 2003 and 2007 found that for eight different procedures, Medicaid patients were more likely to die in the hospital or suffer complications than the uninsured and privately insured.

For conservative lawmakers, the crux of their issue with the Medicaid expansion lies in the money the federal government is sending to participating states.

From 2014 to 2016, the federal government financed 100 percent of the costs of the newly eligible Medicaid population, with federal contributions set to drop to 90 percent by 2020 and beyond.

But as states have enrolled more adults in Medicaid, costs have risen.

A July 2016 report from the Department of Health and Human Services found that Medicaid expansion enrollees cost an average of $6,366 in 2015. The year before, the agency projected enrollees would cost an average of $4,281.

“California is shifting the costs of covering this population to other states, including to states that have chosen not to expand their programs,” Badger said. “California has very little skin in the game. You can enroll someone in this population and shift the cost to Idaho, and Florida, and Texas, the taxpayers in other states.”

Idaho, Florida, and Texas did not expand Medicaid.

Though the federal government financed all of the costs of covering those newly eligible for Medicaid, states that expanded Medicaid are beginning to examine their own budgets since they’re now picking up 5 percent of the tab.

“Before expansion, the traditional Medicaid program was already the largest item in most state budgets,” Horton said, adding:

It’s the home mortgage in the state budget. You pay it first, and figure out what comes next. It’s the biggest piece in most states. Now you’ve taken that and added this expansion on top of it.

Now that we’re into 2017, states are on the hook for 5 percent of those costs. The days of free money from the federal government, that this isn’t costing us anything … we’re living it and seeing that states are having to find that money. That money has to come from somewhere else in the budget—from education, from law enforcement, from infrastructure spending, from the traditional Medicaid program, or tax increases.

While Republicans in Congress debate the future of the Medicaid expansion, some states have begun to take action to curb enrollment in their Medicaid programs.

Last week, the Arkansas House of Representatives voted to freeze enrollment for those newly eligible for Medicaid beginning July 1.

“Currently, we have over 330,000 folks on the program,” state Rep. Josh Miller, a Republican, told the Arkansas Democrat-Gazette. “We are on an unsustainable path, especially with the looming new acts that are going to come out of Washington, D.C.”

Gov. Asa Hutchinson, a Republican, opposes the bill. But if it were to earn his signature, Arkansas would need a waiver from the federal government to proceed.

Badger said that freezing Medicaid enrollment creates inequities.

But Horton said other states should follow the lead of Arkansas.

“Look at what Arkansas is doing. Look at what they’re doing at the federal level, and look at ways to control enrollment,” he said. “The money is not there. The money is not going to be there.”

The post Debate on Obamacare Repeal Centers on Medicaid. Here’s How States That Expanded It Are Doing. appeared first on The Daily Signal.

Why These 6 Americans Came to DC to Oppose Obamacare

Keeping promises.

That was the theme of a Tuesday anti-Obamacare rally hosted by Americans For Prosperity on a rooftop near Capitol Hill. The title of the event was “You Promised,” a call for Republicans in Congress to keep their word to repeal the Affordable Care Act fully.

Close to 200 activists traveled to the District of Columbia on buses from Virginia, North Carolina, Pennsylvania, New Jersey, and elsewhere to rally for Obamacare’s repeal. The AFP-affiliated activists also came to the nation’s capital to visit the offices of their congressmen and demand action against Obamacare.

Here are six Americans who traveled to Washington to protest against the federal health care law.

1. Lorenz Martinez

Josef Martinez (Photo: The Heritage Foundation/Caleb Ecarma)

Lorenz Martinez. (Photo: Caleb Ecarma/The Daily Signal)

Lorenz Martinez, 31, is a translator and interpreter in the medical industry. A Virginia resident originally from Paraguay, Martinez traveled to the District to oppose Obamacare because he believes in “economic freedom and limited government.”

“I believe that the government shouldn’t be controlling our health care system. The premiums that have increased in many states [are] really terrible and I would really like something that’s affordable for more people,” Martinez said.

2. John Peterson

John Peterson. (Photo: The Heritage Foundation/Caleb Ecarma)

John Peterson. (Photo: Caleb Ecarma/The Daily Signal)

John Peterson, a 49-year-old disabled veteran from Virginia, said, “I’m in D.C. for the total repeal of Obamacare.”

“I’m uninsured now, I can’t afford insurance. I’m a veteran and I can’t get an appointment I’ve been waiting two years on because the Obama administration cared nothing about me, since I lived in a rural community,” he added.

When asked what he thought about the Republicans in Congress delaying the Obamacare repeal, Peterson replied, “we elected them to be bold and to come here and do a job, and if they don’t do it they should get used to retirement because they won’t be in politics anymore.”

3. Rochelle Bird

Rochelle Bird (Photo: The Heritage Foundation/Caleb Ecarma)

Rochelle Bird. (Photo: Caleb Ecarma/The Daily Signal)

Rochelle Bird, 47, a self-employed financial advisor from Kansas, said she traveled to the District so she could provide a voice for the Americans who are suffering from Obamacare, but do not have a platform.

“I wanted to take this opportunity to speak for the millions of Americans who are in the same plight as I am because of Obamacare,” Bird said.

Bird also said that it’s OK that Obamacare was attempted and failed, but now it’s time to move on.

“Let’s be honest about [Obamacare]: we can do better as a country,” Bird said.

“We’re the United States, we’re entrepreneurial, we make rockets go up into the moon, we can deal with this, but we have to have the courage on Capitol Hill to face it and address it in a meaningful way,” she said.

>>> READ MORE ABOUT BIRD: In 3 Years, His Insurance Premiums Double as Options Decline Under Obamacare

4. Julie Boonstra

Julie Boonstra (Photo: The Heritage Foundation/Caleb Ecarma)

Julie Boonstra. (Photo: Caleb Ecarma/The Daily Signal)

Fifty-three-year-old Michigan native Julie Boonstra said she came to oppose Obamacare because she lost her insurance in 2014.

“I’m here because Obamacare has not been repealed yet. [Republicans] need to keep their promise, because I need my doctors and me making these decisions, not the government,” Boonstra said.

5. Jessica Hauyaban

Jessica Hauyaban. (Photo: The Heritage Foundation/Caleb Ecarma)

Jessica Hauyaban. (Photo: Caleb Ecarma/The Daily Signal)

Jessica Hauyaban, a 36-year-old small-business owner from Kansas, said she traveled to the District to protest against Obamacare with the hope that she could get affordable health care for her five children.

“Having five children, our family has struggled to find health care coverage. We even have foregone insurance for awhile and then, before Obamacare came in, I found insurance plan with a low premium and a high deductible. But that policy was canceled last year as it was not compliant with Obamacare,” Hauyaban said.

“I just want to see the broken system repealed and replaced with something that does work for working families like mine,” she added.

6. Tracey Walsh

Tracey Walsh. (Photo: The Heritage Foundation/Caleb Ecarma)

Tracey Walsh. (Photo: TCaleb Ecarma/The Daily Signal)

Tracey Walsh, 52, a mother of five and a real estate agent, is protesting against Obamacare because she believes government involvement in health care is “unconstitutional.”

“The government has no business in health care, it’s unconstitutional, it shouldn’t be involved at any level, whether federal or state,” she said.

“We’re paying higher premiums, we’re getting less service, and we’ve lost access to our normal doctors,” Walsh said.

“If Republicans compromise and don’t repeal Obamacare, they will not be reelected and they’ll lose the majority that they just won,” she said.

The post Why These 6 Americans Came to DC to Oppose Obamacare appeared first on The Daily Signal.

Capitol Hill’s Misleading Claims on Tax Credits for Health Care

Most conservative health care experts are panning House Speaker Paul Ryan’s health care plan, which would keep in place the fundamental architecture of Obamacare.

Rather than listening to constructive feedback from the policy community, however, House Republicans appear to be attempting to throw chaff in the air and ram their flawed proposal through Congress.

Proponents of the American Health Care Act, unveiled Monday evening, argue that their proposal represents the conservative consensus on sound health care policy.  Brendan Buck, counselor to Ryan, points specifically to The Heritage Foundation’s past advocacy of tax credits as a means to address coverage gaps and establish equitable tax treatment between the individual and group insurance markets.

Such arguments distort the conservative critique of Ryan’s proposal by oversimplifying the issues at stake.

Conservative criticism of this bill stems from problems with its structure and sequencing of reforms. Whether and how tax credits should be used to finance the purchase of insurance on the individual market is a complicated question, not a simple yes-or-no exercise.

Among those questions:

Who gets these tax credits? Notably, the 2007 Heritage paper described tax credits aimed at families “between 200 percent and 300 percent of the FPL [federal poverty level],” whereas the American Health Care Act would extend those tax subsidies to those at 850 percent of the poverty level

Who pays for the tax credits? Heritage and others who have acknowledged the potential role for tax credits in health care reform consistently have urged Congress to grapple with the costs of asking taxpayers to shoulder new spending commitments. As Heritage also noted in 2007, proposals such as refundable credits run the risk of expanding the scope of our already massive health care entitlements if not structured to offset new payments to nontaxpayers with other cuts in entitlement spending

Do the tax credits merely provide equity in tax treatment, or are they subsidies meant to serve as a Band-Aid on a broken and overregulated insurance market? The conservative critique of Obamacare always has been that it depends on subsidies to offset the costs to consumers imposed by federal benefit mandates and insurance market rules that encourage people to wait until they are sick to buy coverage. That such a regulatory architecture cannot and should not be propped up by creation of a new entitlement has been the conservative consensus for the past eight years.

In health policy, the complications extend well beyond cost and sources of financing, a fact acknowledged by the bill’s critics on the right.

To suggest that conservatives, in their openness in theory to tax credits, ever endorsed preserving Obamacare’s architecture with a different subsidy delivery vehicle is dishonest. And unfortunately, that’s what the American Health Care Act does.

The post Capitol Hill’s Misleading Claims on Tax Credits for Health Care appeared first on The Daily Signal.

House Republican Health Care Bill Misses the Mark

The key problem with the draft House health care bill is that it fails to correct the features of Obamacare that drove up health insurance costs. Instead, it mainly tweaks Obamacare’s financing and subsidy structure.

Basically, the bill focuses on protecting those who gained subsidized coverage through the law’s exchange subsidies and Medicaid expansion, while failing to correct Obamacare’s misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies.

That is both a policy problem and a political problem.

About 22 million individuals currently receive subsidized health coverage through the exchanges (8 million) and the Medicaid expansion (14 million). For them, Obamacare’s higher insurance costs are offset by the law’s subsidies.

However, that is not the case for another group of about 25 million Americans with unsubsidized individual-market coverage (10 million people) or small-employer plans (at least another 15 million people).

Those 25 million are the ones who most need relief from Obamacare, and have the strongest motivation to politically support repeal and replace. Their lived experience of Obamacare has basically been “all pain, no gain,” as they have been subjected to significant premium increases and coverage dislocations with no offsetting subsidies.

Unfortunately, the draft House bill provides no meaningful relief for that group that is most adversely affected by Obamacare and most supportive of repeal.

Instead, the draft bill leaves Obamacare’s costly insurance regulations in place, and attempts to offset those costs with even more subsidies—a variant of the same basic approach in Obamacare.

New Subsidy Program

In that regard, the draft bill’s new Patient and State Stability Fund is particularly problematic. That program would provide grants to states of up to a total of $100 billion over the nine years, 2018-2026.

There are a several significant problems with this new program.

First, it substitutes new funding for old Obamacare funding without adequately addressing the misguided Obamacare insurance market rules and subsidy design that made the exchanges a magnet for high-cost patients.

Those mistakes in Obamacare created an insupportable burden on the individual insurance market by concentrating expensive patients in only that small portion of the total market.

Second, like Obamacare, it doesn’t actually reduce premiums, but rather masks with subsidies the effects of Obamacare provisions that drove up premiums in the first place.

Third, it creates a new entitlement for states. Furthermore, without a resulting reduction in unsubsidized premium levels, future Congresses will likely face pressure from states and constituents to extend and expand the program.

The Medicaid Problem

The draft bill also fails to wind down the Medicaid expansion and may encourage states to add enrollees.

Under the Medicaid expansion, the federal government reimbursed states 100 percent of the cost of expanding Medicaid to able-bodied adults, with federal support eventually declining to 90 percent.

Yet, states continue to receive significantly less federal assistance (50 percent to 75 percent, depending on the state) for covering the more vulnerable populations (such as poor children and the disabled) that the program was intended for. That policy was both inequitable and unaffordable.

The draft bill does not correct that inequity, but rather reduces the enhanced match rate from 95 percent to 80 percent. The better approach would be to allow states to immediately cap expansion population enrollment, while also setting federal reimbursement for any new expansion enrollees at normal state match rates.

Such changes would likely limit the addition of new individuals to the program, and also substantially reduce the size of the federal revenue loss that expansion states will incur when the program terminates. That is because a significant share of current enrollees can be expected to leave the program for other coverage during the transition period.

Unequitable Tax Treatment

Yet another policy mistake is the failure to take the first step toward providing more equitable tax treatment of health insurance.

The House version drops a proposed cap on the unlimited tax exclusion of employment-based health insurance contained in an earlier version, while retaining the so-called “Cadillac tax”—the 40 percent excise tax on so-called “high-cost plans”—and delaying its implementation until 2025.

Congress should kill that punitive excise tax and replace it with a cap.

While the Cadillac tax would force employers to alter the health benefit plans that they provide their workers, no such effect would result from the cap on the exclusion. It would simply limit the amount of employer health benefits that constitute pre-tax income to workers.

Such a change would make the tax treatment of employer-sponsored health benefits consistent with the tax treatment of other benefits offered by employers, such as retirement savings plans, group life insurance, and dependent care, to name three of the more common ones.

Workers would still be able to use after-tax income to purchase additional coverage, just as they can with other employer benefits, and the employer would still be able to offer a plan whose value exceeds the level of the cap on pre-tax funding.

What a cap on the tax exclusion would do is to encourage both employers and workers to rethink how much of total employee compensation should be devoted to health benefits.

While employers would still have total flexibility to design benefit plans that suit their own circumstances, a cap on the amount of pre-tax funding would encourage both employers and workers to re-evaluate the trade-off between higher health care spending and higher cash wages.

There are numerous other issues with the bill. For example, while allowing insurance companies to charge a markup of 30 percent for delayed enrollment can help address continuity of coverage issues, mandating that penalty is not the way to proceed.

This bill misses the mark primarily because it fails to correct the features of Obamacare that drove up health care costs. Congress should continue to focus on first repealing the failed policy of Obamacare and then act to offer patient-centered, market-based replacement reforms.

The post House Republican Health Care Bill Misses the Mark appeared first on The Daily Signal.

What the House GOP Obamacare Replacement Plan Does and Doesn’t Do

After seven years of promises to repeal and replace Obamacare, House Republicans finally have a bill detailing how they plan to reform the health care system once the Affordable Care Act is dismantled.

The House Ways and Means and Energy and Commerce committees revealed their replacement plan, the American Health Care Act, on Monday evening. The bill repeals key provisions of Obamacare, but also implements parts of a replacement.

The 123-page bill is the culmination of weeks of discussions and negotiations—and years of calls for Obamacare to be repealed and replaced—from House Republicans on the relevant committees who worked through the weekend putting the final touches on the legislation.

The Congressional Budget Office has yet to release cost and coverage estimates for the replacement proposal.

Republicans are using a budget tool called reconciliation to fast-track the replacement plan through the Senate, where it needs 51 votes to pass.

GOP leaders in both chambers have a tough sell—so far, the replacement hasn’t been well received from Congress’s right flank, who have called on their leaders to bring a bill from 2015 unwinding the health care law before members for a vote.

>>> Conservatives Offer Solution to Repeal Obamacare, Defund Planned Parenthood: Pass 2015 Bill Again

In a memo to its members, policy staff for the Republican Study Committee detailed their concerns with the legislation, which included the Medicaid expansion and tax credits.

Additionally, members of the conservative House Freedom Caucus raised concerns about the replacement plan and said changes will need to be made to the legislation before it earns their support.

“We really need to look at some amendments to make sure we get rid of the taxes,” Freedom Caucus Chairman Mark Meadows, R-N.C., told Fox News on Monday night. “We put something on President Obama’s desk just a few months ago, and to suggest that what we put on President Trump’s desk sets a new entitlement, keeps some taxes, doesn’t repeal all of Obamacare, we’ve got to do better.”

“Negotiations start now,” he continued.

Republican leaders in the House and Senate have slim margins for success in getting the replacement plan across the finish line.

In the House, Republicans control 237 seats and cannot lose more than 19 votes.

In the Senate, they control 52 seats and cannot lose more than two votes.

Here is the rundown of the American Health Care Act:

What the Bill Repeals

The penalties for the individual and employer mandates

  • The American Health Care Act lessens the fines for not complying with the mandates to $0, effective Dec. 31, 2015. This provision provides retroactive relief for consumers who didn’t have coverage in 2016 and are filing their taxes now.

Obamacare’s subsidies beginning in 2020

Medicaid expansion beginning in 2020

The “Cadillac Tax” on expensive employer-sponsored plans until 2025

All of Obamacare’s taxes, effective after 2017

Payments to insurers for cost-sharing reductions by 2020

What the Bill Replaces

Advanceable, refundable tax credits based on one’s age

  • Under 30: $2,000
  • Between 30 and 39: $2,500
  • Between 40 and 49: $3,000
  • Between 50 and 59: $3,500
  • Over 60: $4,000
  • The credits are available in full to individuals making up to $75,000 and families making up to $150,000. For every $1,000 in income higher than those thresholds, the credits decrease by $100.

Expanded Health Savings Accounts

  • The American Health Care Act increases the maximum contributions to Health Savings Accounts, or medical savings accounts, to $6,550 for individuals and $13,100 for families beginning in 2018.

Protections for consumers with pre-existing conditions

Continuous coverage requirement

  • Regardless of whether they’re healthy or have a pre-existing condition, Americans must maintain continuous coverage. If there is a lapse in coverage for longer than 63 days, individuals will face a 30-percent surcharge from insurers.

Age ratio of 5-to-1 for how much more insurers can charge elderly customers versus younger customers

Per-capita caps for Medicaid, which depend on each state’s number of enrollees, beginning in 2020

Funds for states to set up high-risk pools, reduce out-of-pocket costs, or stabilize health insurance markets

One-year freeze on government funding to Planned Parenthood

What the Bill Leaves in Place

Essential Health Benefits requirements

Letting adults remain on parents plans until age 26

Tax exclusion for employer-sponsored coverage

The post What the House GOP Obamacare Replacement Plan Does and Doesn’t Do appeared first on The Daily Signal.

Repeal Obamacare ‘Now’ Before Moving to Other Issues, Conservative Leader Says

A key conservative lawmaker is urging Republicans to make good on their promises to repeal and replace Obamacare before they get distracted by other legislative issues.

“We think it is time to repeal it, clean repeal, and replace with market-centered health care [and] patient-centered health care,” Rep. Jim Jordan, R-Ohio, said of Obamacare in a phone interview Monday with The Daily Signal.

When The Daily Signal asked Jordan, former chairman of the House Freedom Caucus, whether he is concerned that repeal of  Obamacare might be sidetracked to address upcoming legislative matters such as the debt limit, the Ohio Republican said: “I hope not.”

“Let’s do Obamacare repeal and replace right now,” Jordan said. “Then we can move on to the other issues and deal with tax reform and deal with the budget issues and deal with the debt ceiling issues and all the other things we gotta get to. It could be so simple.”

A senior Republican aide told The Daily Signal in an email that the text of a “consensus” bill to repeal and replace Obamacare is expected “early this week.”

But Jordan said he is calling for passage of a repeal bill along with “a separate piece of legislation, done at the same time which replaces Obamacare with patient-centered, market-centered, family-centered health care.”

President Donald Trump has pledged to sign legislation to repeal and replace Obamacare as soon as possible, and increasingly has shown a preference for one bill that does both. Office of Management and Budget Director Mick Mulvaney said as much in an interview Monday with radio host Hugh Hewitt.

For procedural reasons amid Democrats’ opposition to undoing Obamacare, however, conservatives such as Jordan see a danger in trying to do both in one bill.

>>> Meet the Doctor Trump Picked to Dismantle Obamacare

Jordan said Obamacare repeal is a “top priority for the American people.” and he will vote for nothing less than the 2015 repeal bill that was passed by both chambers and vetoed in January 2016 by President Barack Obama.

Other pressing matters that could distract from the Obamacare debate include the debt limit deadline March 16, Judiciary Committee hearings for Supreme Court nominee Neil Gorsuch, which commence March 20, and the expiration date for the current continuing resolution funding the government, April 28.

On March 16, the ability of the U.S. Treasury “to borrow on the credit of the U.S. government” will expire and Congress either must balance the budget or raise the debt limit.

On April 28, the continuing resolution adopted in December to fund the government, will expire. A continuing resolution is a type of appropriations or spending bill that sets money aside for government use.

Congress ought to repeal Obamacare before it turns to other items such as the debt limit, argues Thomas Binion, director of policy outreach at The Heritage Foundation.

“I believe they must address [Obamacare] before moving on to other items for several reasons,” Binion said in an email to The Daily Signal. “The first is that they have to pass appropriations to fund the government by April 28 when the current [continuing resolution] expires. If Obamacare is still the law of the land at that time, Congress will face the impossible choice of whether or not to fund Obamacare.”

In 2013, Republican lawmakers’ refusal to fund Obamacare resulted in a 16-day partial shutdown of the government, Binion noted, and a similar funding battle could occur if lawmakers don’t address Obamacare before April 28.

If Republican House leadership releases the text of an Obamacare repeal and replace bill early this week, as the senior aide projected, Congress may be able to get ahead of the game.

“After months – and years – of work, we are quickly approaching the introduction of a consensus Republican plan to repeal and replace Obamacare,” the aide told The Daily Signal in an email.

The aide said several high-level meetings took place Friday and Saturday to finalize the Obamacare legislation, adding:

There was a large staff meeting at the White House Friday led by OMB Director Mulvaney to identify and resolve the few outstanding issues. The health care committees in Congress worked over the weekend with the White House to tie up loose ends and incorporate technical guidance from the administration.

On Saturday, the aide said, House Speaker Paul Ryan had a conference call that included Mulvaney, House Energy and Commerce Chairman Greg Walden, Health and Human Services Secretary Tom Price, and Andrew Bremberg, an assistant to Trump who directs the Domestic Policy Council.

Ashlee Strong, the national press secretary for Ryan told The Daily Signal in an email that Congress is on the cusp of Obamacare repeal.

“We are now at the culmination of a years-long process to keep our promise to the American people,” Strong said.

House and Senate staff worked through Saturday to address unresolved issues. “We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week,” the aide said.

In the House, the Energy and Commerce and Ways and Means committees are tentatively scheduled to vote on the repeal bill this week, followed by a full House vote later this month, The New York Times reported.

Dan Holler, spokesman for Heritage Action for America, the lobbying affiliate of The Heritage Foundation, told The Daily Signal in an email that despite the slowed progress of Obamacare repeal, it remains the highest priority for conservatives.

“President Trump and congressional leaders understand Obamacare repeal is the first major agenda item, and they have said so publicly,” Holler said. “Even though the repeal effort slowed dramatically over the last month, the expectation remains that Obamacare can and will be repealed.”

The post Repeal Obamacare ‘Now’ Before Moving to Other Issues, Conservative Leader Says appeared first on The Daily Signal.

Repeal Obamacare ‘Now’ Before Moving to Other Issues, Conservative Leader Says

A key conservative lawmaker is urging Republicans to make good on their promises to repeal and replace Obamacare before they get distracted by other legislative issues.

“We think it is time to repeal it, clean repeal, and replace with market-centered health care [and] patient-centered health care,” Rep. Jim Jordan, R-Ohio, said of Obamacare in a phone interview Monday with The Daily Signal.

When The Daily Signal asked Jordan, former chairman of the House Freedom Caucus, whether he is concerned that repeal of  Obamacare might be sidetracked to address upcoming legislative matters such as the debt limit, the Ohio Republican said: “I hope not.”

“Let’s do Obamacare repeal and replace right now,” Jordan said. “Then we can move on to the other issues and deal with tax reform and deal with the budget issues and deal with the debt ceiling issues and all the other things we gotta get to. It could be so simple.”

A senior Republican aide told The Daily Signal in an email that the text of a “consensus” bill to repeal and replace Obamacare is expected “early this week.”

But Jordan said he is calling for passage of a repeal bill along with “a separate piece of legislation, done at the same time which replaces Obamacare with patient-centered, market-centered, family-centered health care.”

President Donald Trump has pledged to sign legislation to repeal and replace Obamacare as soon as possible, and increasingly has shown a preference for one bill that does both. Office of Management and Budget Director Mick Mulvaney said as much in an interview Monday with radio host Hugh Hewitt.

For procedural reasons amid Democrats’ opposition to undoing Obamacare, however, conservatives such as Jordan see a danger in trying to do both in one bill.

>>> Meet the Doctor Trump Picked to Dismantle Obamacare

Jordan said Obamacare repeal is a “top priority for the American people.” and he will vote for nothing less than the 2015 repeal bill that was passed by both chambers and vetoed in January 2016 by President Barack Obama.

Other pressing matters that could distract from the Obamacare debate include the debt limit deadline March 16, Judiciary Committee hearings for Supreme Court nominee Neil Gorsuch, which commence March 20, and the expiration date for the current continuing resolution funding the government, April 28.

On March 16, the ability of the U.S. Treasury “to borrow on the credit of the U.S. government” will expire and Congress either must balance the budget or raise the debt limit.

On April 28, the continuing resolution adopted in December to fund the government, will expire. A continuing resolution is a type of appropriations or spending bill that sets money aside for government use.

Congress ought to repeal Obamacare before it turns to other items such as the debt limit, argues Thomas Binion, director of policy outreach at The Heritage Foundation.

“I believe they must address [Obamacare] before moving on to other items for several reasons,” Binion said in an email to The Daily Signal. “The first is that they have to pass appropriations to fund the government by April 28 when the current [continuing resolution] expires. If Obamacare is still the law of the land at that time, Congress will face the impossible choice of whether or not to fund Obamacare.”

In 2013, Republican lawmakers’ refusal to fund Obamacare resulted in a 16-day partial shutdown of the government, Binion noted, and a similar funding battle could occur if lawmakers don’t address Obamacare before April 28.

If Republican House leadership releases the text of an Obamacare repeal and replace bill early this week, as the senior aide projected, Congress may be able to get ahead of the game.

“After months – and years – of work, we are quickly approaching the introduction of a consensus Republican plan to repeal and replace Obamacare,” the aide told The Daily Signal in an email.

The aide said several high-level meetings took place Friday and Saturday to finalize the Obamacare legislation, adding:

There was a large staff meeting at the White House Friday led by OMB Director Mulvaney to identify and resolve the few outstanding issues. The health care committees in Congress worked over the weekend with the White House to tie up loose ends and incorporate technical guidance from the administration.

On Saturday, the aide said, House Speaker Paul Ryan had a conference call that included Mulvaney, House Energy and Commerce Chairman Greg Walden, Health and Human Services Secretary Tom Price, and Andrew Bremberg, an assistant to Trump who directs the Domestic Policy Council.

Ashlee Strong, the national press secretary for Ryan told The Daily Signal in an email that Congress is on the cusp of Obamacare repeal.

“We are now at the culmination of a years-long process to keep our promise to the American people,” Strong said.

House and Senate staff worked through Saturday to address unresolved issues. “We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week,” the aide said.

In the House, the Energy and Commerce and Ways and Means committees are tentatively scheduled to vote on the repeal bill this week, followed by a full House vote later this month, The New York Times reported.

Dan Holler, spokesman for Heritage Action for America, the lobbying affiliate of The Heritage Foundation, told The Daily Signal in an email that despite the slowed progress of Obamacare repeal, it remains the highest priority for conservatives.

“President Trump and congressional leaders understand Obamacare repeal is the first major agenda item, and they have said so publicly,” Holler said. “Even though the repeal effort slowed dramatically over the last month, the expectation remains that Obamacare can and will be repealed.”

The post Repeal Obamacare ‘Now’ Before Moving to Other Issues, Conservative Leader Says appeared first on The Daily Signal.

For One Conservative, 2017 Looks Similar to 2009 Obamacare Debate

For at least one conservative lawmaker, the current process for repealing and replacing Obamacare is beginning to look very similar to that of 2009, when Republicans accused Democrats of writing the Affordable Care Act behind closed doors.

Armed with a portable copy machine, Sen. Rand Paul, R-Ky., went on a crusade through the U.S. Capitol on Thursday to find the legislation that will ultimately repeal and replace the Affordable Care Act.

His goal was to see the elusive Obamacare bill himself, which was available in a reading room only to members of the House Energy and Commerce Committees and their staff, and “demand a copy for the American people.”

“We’ve been talking about it for six years, so we thought we ought to see it,” Paul said of the replacement plan. “We heard it was in a secret room, and that it was under lock and key with guards. And sure enough, when we got there, there were policemen posted at the door, and we were not allowed to see the Obamacare repeal bill.”

Ultimately, the Kentucky senator was unsuccessful. But in his quest, he was joined by some unlikely allies: congressional Democrats like Minority Leader Nancy Pelosi and Rep. Frank Pallone, D-N.J., who wanted to see a copy of the plan, too.

“This is not regular order, and it’s not good order for the American people,” Democratic Whip Steny Hoyer of Maryland told reporters after broadcasting live on Facebook his search for the bill.

The House Ways and Means and Energy and Commerce Committees are expected to take up the Obamacare replacement plan next week, and members of the Ways and Means Committee are planning to work through the weekend to continue hashing out the details.

But while GOP leaders say they haven’t yet finalized the bill, conservatives believe the legislation is being drafted in secret, out-of-view from them and the American people.

For the lawmakers, the process for crafting the bill repealing and replacing Obamacare harkens back to 2009, when Democrats wrote the health care law.

“If you’d recall, when Obamacare was passed in 2009 and 2010, Nancy Pelosi said you’ll know what’s in it after you pass it,” Paul told reporters Thursday, paraphrasing what Pelosi said at the time. “The Republican Party shouldn’t act in the same way.”

Paul and the House Freedom Caucus, a group of approximately 40 conservative lawmakers, are urging Republican leaders to repeal as much of Obamacare as possible and use legislation from 2015 that repealed the major provisions of the health care law as a starting point.

That bill passed the House and Senate, but President Barack Obama vetoed it.

But as Republicans on the Ways and Means and Energy and Commerce Committees continue to work on the bill, it’s unclear whether conservatives will get their way.

Even as Republicans head into the weekend, Paul continued to play hide-and-seek with the replacement bill and solicited his followers on Twitter for tips on where the plan may be hidden.

Conservatives and Democratic lawmakers were given an accidental early glimpse at what Obamacare’s replacement may look like after a draft bill was leaked to the press late last month.

The document, which was reportedly from early February, repealed much of Obamacare and phased out the Medicaid expansion, which would eventually be replaced with a per capita allotment. Under a per capita allotment, states get capped payments based on the number of people enrolled in Medicaid.

It also capped the tax exemption for employer-sponsored coverage, required Americans to maintain continuous coverage or face a 30-percent increase in premiums for a year, and put a new system of refundable, age-based tax credits for purchasing health insurance in place.

But six conservative lawmakers—three in the House and three in the Senate, Paul included—revolted against the draft replacement plan, calling it “Obamacare lite.”

Paul said the draft bill kept elements of the Affordable Care Act like an individual mandate and Cadillac tax on expensive employer-sponsored plans, and the members vowed to oppose any legislation that didn’t repeal the health care law in full.

“These are Democrat ideas dressed up in Republican clothing,” Paul said of the draft document.

After the conservatives vocalized their opposition, House Republican leaders stressed that the proposal released was one from the early stages of discussion.

“That draft is no longer valid,” House Majority Whip Steve Scalise, R-La., told reporters Tuesday.

The opposition from the House and Senate conservatives is the latest setback for GOP leaders, who planned to put the repeal-and-replace measure before lawmakers for a vote in the coming weeks.

Conservatives specifically disagree with the inclusion of the refundable tax credits available to consumers purchasing coverage in the individual market, which they believe creates a new entitlement program.

But the lawmakers aren’t opposed to the notion of a tax credit as a whole.

A replacement plan crafted by Paul calls for a $5,000 tax credit available to individuals who contribute money to a Health Savings Account, or medical savings account.

Despite the opposition from House and Senate conservatives, GOP leaders don’t appear to be backing down from the draft document.

A newer version of the Obamacare repeal bill obtained by Politico contains many of the same provisions as the earlier document, including the refundable, age-based tax credits.

According to Politico, though, there is one change: wealthier Americans would not be able to qualify for the financial assistance.

Republican leaders said this week negotiations are still ongoing and that replacement plan hadn’t yet been finalized. They said that’s the reason a draft wasn’t yet available to Democrats and Paul.

“[Republican] members and staff are continuing to discuss and refine draft legislative language on issues under our committee’s jurisdiction,” Walden said in a statement Thursday.

The post For One Conservative, 2017 Looks Similar to 2009 Obamacare Debate appeared first on The Daily Signal.

Trump’s 5 Health Care Principles, Explained

President Donald Trump didn’t shy away from asking Congress to unwind Obamacare during Tuesday night’s joint address, and he presented lawmakers with a list of five policies to consider as Republicans craft their replacement for the health care law.

During his speech, Trump called on lawmakers to repeal and replace Obamacare, and reform the health care system to “expand choice, increase access, lower costs, and at the same time, provide better health care.”

“Mandating every American to buy government-approved health insurance was never the right solution for our country,” Trump said. “The way to make health insurance available to everyone is to lower the cost of health insurance, and that’s what we are going to do.”

The president offered few specifics on what reforms he would like to see Congress pursue as they work toward a replacement for Obamacare.

But Trump did outline five policies he supports in a proposal that will dismantle the health care law.

Many of the policies are in line with those backed by House Speaker Paul Ryan and Health and Human Services Secretary Tom Price. But some have been met with resistance from the House and Senate’s most conservative members.

The GOP conference hasn’t yet united around a plan to repeal and replace the law, and Trump’s comments seemed to tip the scales in favor of leadership’s suggested reforms.

But, conservatives have said they’ll oppose any legislation that doesn’t fully repeal Obamacare, and their hard line sent Republican leaders back to the drawing board.

Here are the policies Trump said he would like to see in an Obamacare replacement plan, and where they stand in the context of the current debate.

  1. “We should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the health care exchanges.”

Obamacare’s pre-existing conditions provision has become one of the health care law’s more popular measures. Under the Affordable Care Act, insurance companies were prohibited from discriminating against consumers with pre-existing conditions.

Trump, Price, and congressional Republicans have repeatedly said they want to make sure Americans with pre-existing conditions have access to health insurance.

Most replacement plans include a provision barring insurers from discriminating against customers with pre-existing conditions if the person maintained coverage continuously, and a draft proposal—viewed as the leading plan—leaked to the press last week penalized individuals who let their coverage lapse by raising their premiums 30 percent for a year.

  1. “We should help Americans purchase their own coverage through the use of tax credits and expanded health savings accounts—but it must be the plan they want, not the plan forced on them by our government.”

Republicans across the board agree on expanding health savings accounts, or medical savings accounts.

In fact, GOP leaders want to see the expansion of health savings accounts included in the bill that will repeal Obamacare.

But where Republican leadership and conservative lawmakers are at odds is in the financial assistance available to customers buying individual market coverage.

Tax credits were a staple of Obamacare replacement plans rolled out by Price and Ryan, and the leaked repeal document created refundable tax credits based on age—ranging from $2,000 for consumers under 30 to $4,000 for consumers over 60.

But conservatives object to the idea of refundable tax credits and say they’re a form of “Obamacare lite.”

They’re not ruling out all forms of financial assistance for consumers, though. Last month, the House Freedom Caucus, a group of approximately 40 conservatives, backed an Obamacare replacement plan from Sen. Rand Paul, R-Ky., and Rep. Mark Sanford, R-S.C., that created a $5,000 tax credit for those who contribute to their HSAs.

By referencing tax credits explicitly, Trump seemed to side with Ryan and Republican leadership.

However, conservatives after the speech suggested that Trump didn’t explicitly endorse “refundable tax credits,” which leadership’s plan calls for, and which they object to.

  1. “We should give our great state governors the resources and flexibility they need with Medicaid to make sure no one is left out.”

Trump hasn’t offered specifics on which changes to Medicaid he would prefer. However, he seemed swayed by Ohio Gov. John Kasich, a Republican, after a meeting at the White House on Friday—Trump suggested Kasich meet further with Price and chief of staff Reince Priebus to discuss Obamacare’s future more.

Kasich is opposed to repealing the Medicaid expansion, but favors making changes to the Affordable Care Act.

Governors who decided to expand the program, as well as Republican senators representing those states, have opposed a rollback of the Medicaid expansion, which expanded eligibility.

Still, Republican governors are working with congressional leaders to discuss potential changes and come up with a plan for the future of the Medicaid program.

Trump’s call for giving governors “resources and flexibility” with Medicaid seems to go along with Republican plans to block grant the program.

Some Obamacare replacement plans call for Medicaid to be turned into a block grant, or a lump sum of money allocated to the states. Others, though, favor a per-capita allotment.

Like the tax credits, the future of the Medicaid expansion is a point of contention for conservative lawmakers.

House and Senate conservatives are urging Republican leaders to bring a bill from 2015 rolling back key provisions of Obamacare, including Medicaid expansion, before members vote again.

Any proposal that falls short of that legislation won’t earn their support, and Medicaid expansion, specifically, is a sticking point for the conservatives.

  1. “We should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance, and work to bring down the artificially high price of drugs, and bring them down immediately.”

Trump’s fourth policy calls for medical malpractice reform.

The issue hasn’t been prominent in debates over Obamacare’s future, though, Price and Ryan did say in the past they wanted to make tort reform part of their replacement plan.

On drug pricing, though, Trump has criticized the “artificially high price of drugs” before. During the campaign, the president said he was in favor of letting Medicare negotiate prescription drug prices.

Last month, White House press secretary Sean Spicer confirmed Trump hadn’t changed his stance. But the high cost of prescription drugs has largely been left out of discussions surrounding Obamacare’s replacement.

  1. “The time has come to give Americans the freedom to purchase health insurance across state lines—which will create a truly competitive national marketplace that will bring costs way down and provide far better care.”

The ability to purchase health insurance across state lines has been the one health care reform Trump has consistently advocated.

And on this policy, in particular, Republicans are in agreement.

Some Obamacare replacement plans floated by GOP lawmakers over the years would allow consumers to buy coverage across state lines, including Ryan’s “Better Way” plan, Price’s proposal, and the Paul-Sanford replacement bill.

Trump and his fellow Republicans believe allowing insurers to sell across state lines will increase consumers’ access to coverage.

This proposal is beneficial for insurers based in states with strict regulations that can drive up the cost of plans, since they would be able to sell coverage in others with less stringent mandates.

However, it’s not the only thing that needs to be done to lower costs and boost competition, according to Sabrina Corlette, a research professor at Georgetown University.

The post Trump’s 5 Health Care Principles, Explained appeared first on The Daily Signal.