First Steps To A Repeal Are Under Way In Congress
The quest to repeal and replace the Affordable Care Act began even before Donald Trump was sworn in as president.
More than two weeks before Trump’s inauguration, the Senate made its first move, approving a procedural motion on Jan. 4 to start debate on a budget resolution.
Passing a budget resolution is a key step in repealing President Barack Obama’s signature health care law. It allows the Republican majority in Congress to repeal sweeping portions of the law with just 51 votes in the Senate. This process, known as reconciliation, saves the majority from having to round up the 60 votes required to break a filibuster — a much tougher challenge.
On Jan. 12, the Senate passed the budget resolution itself, 51-48. Every Democrat voted against it . The only Republican to cross party lines to vote with Democrats was Sen. Rand Paul, R-Ky., who had expressed concerns about repealing the law without a replacement ready to go.
The budget resolution includes instructions that provide the tools necessary to repeal the law.
Among other things, it instructs the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee to submit legislation to the Senate Budget Committee by Jan. 27.
Still, using reconciliation to repeal the Affordable Care Act has its challenges. While the ACA has a multitude of provisions, the reconciliation process can only address matters related to federal spending and taxes.
Still, this is enough to rate this promise In the Works.
The Difference Between Obamacare The Senates Trumpcare The Houses Trumpcare Explained
The following table shows the main difference between ObamaCare, the Senates Better Care Reconciliation Act of 2017, and the Houses American HealthCare Act :
TIP: Note, not all the recent changes are reflected in the chart below.
UPDATE: Sine both the BCRA and the AHCA didnt pass, this has historical value, but doesnt reflect what actually happened. That said, youll notice some of these items were passed through other means.
OPINION ON UNIVERSAL HEALTHCARE: The biggest gripe people will have with TrumpCare is that it is not a universal healthcare system . Instead, TrumpCare results in more uninsured than we had before the Affordable Care Act. All TrumpCares good points aside, a plan that results in more uninsured and not less will be hard to spin. Trump recently said , Australias healthcare system is better than ours. To be clear, I think many would agree with that. Australia has universal healthcare, meaning it doesnt leave 15% of its citizens without coverage due to preexisting conditions and costs. Trump at one point promised health care for everybody. Here I must note that the Senate could essentially re-write the house bill to create a system like the Australian one . For more see: ObamaCare and Australias HealthCare Systems Compared.
Trumpcare/american Healthcare Act/better Care And Reconciliation Act Summary
The latest version of TrumpCare, with all the changes to the Better Care Reconciliation Act and provisions from the American HealthCare Act , AKA TrumpCare phase 1 contains provisions that:
First, the American HealthCare Act made the following changes (most of which the BCRA keeps items the BCRA changed are crossed out
- Allows states to charge more based on age or health status via state-based waivers ,
- Allows states the option of creating a taxpayer-funded high-risk pool.
The Senate Bill that is Replacing the House Bill does everything noted above with a few changes, they are:
- There is a 6 month waiting period if you want to reenter the market after not having coverage for more than 63 days ,
- Further reduces Medicaid spending,
- Tax credits are based on age and income from 0% 350% FPL .
- Cost Sharing Reduction subsidies are approved until 2019 on a per-month basis .
Then the latest July 13th update to the Better Care Reconciliation Act makes a few changes that include:
NOTES: Immediately following the July 13th version a few more changes were made. The bill now also includes the Ted Cruz Amendment which allows insurers to sell inexpensive plans to consumers that include basic coverage up to an annual cap . This amendment is likely to bring down average premiums considerably, but it does this by allowing insurers to sell low-benefit, low-cost, plans with annual limits. So there is a trade-off there.
The CBO estimates for uninsured under the BCRA.
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What Changes Have Been Made To The Aca Under The Trump Administration
One of the significant campaign promises Donald Trump made during the course of the 2016 presidential campaign was to repeal and replace the Affordable Care Act. During the early months, rumblings on Capitol Hill in Washington, D.C., occurred about repealing and replacing ACA. However, the ACA was not repealed. There were a number of changes made to the healthcare and health insurance law most often referred to by the public-at-large as Obamacare.
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Administration Attacks On The Aca
Some Trump administration actions have clearly undermined ACA initiatives. A recent Government Accountability Office report, for example, criticizes the administration for greatly scaling back ACA outreach and education programs, including funding for the navigators who help consumers find coverage. The administrations termination of reimbursement payments to insurers for reducing cost-sharing for low-income enrollees threatened to destabilize the ACA markets, although swift reactions by state regulators averted chaos. The Trump administration has also effectively ended the SHOP small business marketplace program.
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After Years Of Promising His Own Health Care Plan Trump Settles For Rebranding Rather Than Repealing Obamacare
President Trump capped his fruitless four-year journey to abolish and replace the Affordable Care Act by signing an executive order Thursday that aims to enshrine the laws most popular feature while pivoting away from a broader effort to overhaul the nations health insurance system.
The order declares it is the policy of the United States for people with preexisting health conditions to be protected, avoiding the thorny details of how to ensure such protections without either leaving the ACA, or Obamacare, in place or crafting new comprehensive legislation.
Trump announced the move during a trip to North Carolina, outlining his vision for revamping parts of the nations health care. During the speech, which came shortly before a campaign swing to Florida, Trump barely veiled the political nature of his intent.
The historic action Im taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions, Trump said, despite the fact such protections are already enshrined in law. Were making that official. Were putting it down in a stamp, because our opponents, the Democrats, like to constantly talk about it.
Health care, long a top issue for voters, has taken on fresh urgency with less than five weeks to go before the November election.
Trump Administration Asks Supreme Court To Strike Down Affordable Care Act
If successful, the move would permanently end the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.
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WASHINGTON The Trump administration asked the Supreme Court late Thursday to overturn the Affordable Care Act a move that, if successful, would bring a permanent end to the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.
In an 82-page brief submitted an hour before a midnight deadline, the administration joined Republican officials in Texas and 17 other states in arguing that in 2017, Congress, then controlled by Republicans, had rendered the law unconstitutional when it zeroed out the tax penalty for not buying insurance the so-called individual mandate.
The administrations argument, coming in the thick of an election season as well as a pandemic that has devastated the economy and left millions of unemployed Americans without health coverage is sure to reignite Washingtons bitter political debate over health care.
In his brief, Solicitor General Noel J. Francisco argued that the health laws two remaining central provisions are now invalid because Congress intended that all three work together.
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Vice President Mike Pence
- On July 10, 2017, Pence said that the Senate should vote to repeal the ACA if they were unable to pass the Better Care Reconciliation Act of 2017 . He said, If they cant pass this carefully crafted repeal and replace bill do those two things simultaneously we ought to just repeal only.
- On June 5, 2017, during a listening session on healthcare with women entrepreneurs, Pence said, “The truth is the American people are struggling under the weight of the failed policies of Obamacare, and it must go. Secretary Price and his team at Health and Human Services released a study just two weeks ago showing that in real numbers premiums have more than doubled under Obamacare since 2013, up 105 percent. Now, I was in the Congress when Obamacare was passed into law, and I remember all the promises — if you like your doctor, you can keep them. Remember? If you like your insurance, you could keep it. But the central promise was the cost of health insurance would go down, and here we are that since 2013 alone premiums across this country have increased by 105 percent. America can’t afford Obamacare any longer. President Trump and our administration are working every day with members of Congress, and we’re not going to rest until we repeal and replace Obamacare with the kind of healthcare reform the American people deserve, healthcare reform built on consumer choice, on free-market principles, on state-based innovation, and a respect for the doctor-patient relationship.”
A Few Problems With Trumpcare Worth Highlighting
The goal here is to try to present honest information and note harp on the TrumpCare sticking points, with that said there are a few problems worth highlighting before moving on.
- It lets insurers charge older Americans more and allows for junk insurance by getting rid of standards like actuarial values.
- It defunds Planned Parenthood.
- Women, seniors, and lower-income Americans get the short end of the stick, while industry and higher-income Americans get a better deal.
- The biggest negative is that it fails to address many sticking points of ObamaCare, and doesnt seek to expand coverage. Instead, it addresses some Republicans issues from a centered standpoint by trading entitlements for low-income people for entitlements for all.
TIP: Want to know what Americans like and dont like about ObamaCare? See the comments of our Tell Trump What You Like or Dont Like About ObamaCare page.
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Trump Administration Republican Attorneys General Ask Supreme Court To Repeal Aca
The Trump administration and Republican state attorneys general called on the Supreme Court to overturn the entire Affordable Care Act . President Trump has endorsed repealing the ACA since his 2016 campaign, while Republican lawmakers have largely opposed the law since its inception in 2010.
This story has been updated.
The Trump administration yesterday asked the Supreme Court to repeal the Affordable Care Act stating“the entire ACA act must fall,” hours after Republican state attorneys general, the coalition challenging the law, filed its briefs in the case. Overturning the ACA was a key campaign rallying point for President Trump in 2016 and Republican lawmakers have largely opposed the law since its inception in 2010.
Despite the economic crisis due to the coronavirus disease 2019 pandemic, Trump in May promised to continue fighting the ACA, stating We want to terminate health care under Obamacare. The case is expected to go before the Supreme Court in the spring of 2021.
In a statement, House Speaker Nancy Pelosi condemned the request. “President Trump and the Republicans campaign to rip away the protections and benefits of the Affordable Care Act in the middle of the coronavirus crisis is an act of unfathomable cruelty,” she stated.
The filing accuses the ACA of inflicting classic pocketbook injuries on the states, in addition to preventing states from enforcing their own laws and policies.
The Costs Of Trumpcare 10
- According to the Congressional Budget Office, the CBO and JCT estimate that enacting the American Health Care Act would reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.
- According to the Congressional Budget Office, the CBO and JCT estimate that enacting the American Health Care Act would reduce federal deficits by $119 billion over the coming decade and increase the number of people who are uninsured by 23 million in 2026 relative to current law.
- MOST RECENT: According to the Congressional Budget Office, the plan in its current form saves $321 billion over the decade. However, it did does by leaving 49 million without coverage by 2026 . The cost and uninsured rate are subject to change based on changes to the bill. See a breakdown of the costs here.
The CBO report done after the Amendment shows 1 million less uninsured and about $200 billion in less in savings. See the Key Facts From the May 2017 CBO Report on TrumpCare . UPDATE: We will do some key facts from the Senate bill soon.
TIP: That CBO scoring is subject to change, the plan has been revised since it was scored. The passed bill was not scored at the time of passing.
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What Does The Existing Law Do
The Patient Protection and Affordable Care Act, known as Obamacare or the ACA, was the largest overhaul of the US healthcare system since the 1960s.
It aimed to eventually slow the growth of US healthcare spending, which is the highest in the world.
Obamacare intended to extend health insurance coverage to the estimated 15% of Americans who lacked it and were not covered by other health programmes for the poor and elderly.
The law created state-run marketplaces – with websites akin to online shopping sites – where individuals can compare prices as they shop for coverage.
Some of the more popular provisions include:
- Children can stay on their parent’s healthcare plan until age 26
- No one who is sick or has a medical condition can be denied insurance
- Companies can no longer charge women more than men
- Businesses with more than 50 full-time employees must offer health insurance
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Opponents argued that without the penalty the health-care plan was unconstitutional.
Chief Justice Roberts pushed the Affordable Care Act beyond its plausible meaning to save the statute, Barrett wrote at the time.
He construed the penalty imposed on those without health insurance as a tax, which permitted him to sustain the statute as a valid exercise of the taxing power.
Trump, who campaigned on repealing and replacing Obamacare during his 2016 campaign, signed a series of executives orders last week to protect pre-existing conditions and introduce a number of affordable health-care options.
Were delivering better care with more choice at a much lower cost and working to ensure Americans have access to the care they need, Trump said of his America First Health Care Plan at an event in Charlotte, NC.
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