What does death of bid to repeal Obamacare really mean?
Q: I don’t get it. How could the Republican-led House — which voted more than 50 times to repeal the Affordable Care Act — fail to pass it when they had the chance?
A: The quick answer is it’s easy to vote against something when it stands no chance of becoming law. It’s much harder to gain consensus on new legislation — particularly when it would rescind benefits that millions of Americans have enjoyed for several years.
GOP leaders quickly realized it would be politically more difficult than they expected. They tried to make compromises and retain certain aspects of the law while terminating others. Conservative hardliners affiliated with the tea party wanted no parts of what they felt was a watered-down repeal bill. Rather than compromise, they stood firm and forced Ryan and Trump to cancel the scheduled House vote on the measure.
Q: So what happens to my marketplace coverage now?
A: If you’ve got individual coverage for 2017, sit tight. You’re OK. Your plan benefits are signed, sealed and must be delivered.
Q: What about next year? Will individual coverage cost more?
A: Hard to say. The Obamacare tax credits and subsidies will help most marketplace plan members pay for coverage. The lower a person’s income, the larger tax credit they receive. So most recipients are fairly wellinsulated from any major rate hikes next year. That said, the Trump administration is proposing policy changes for the individual insurance market that don’t require congressional
As the political drama over health care legislation in Washington fades, the rest of the country faces a more immediate concern: Getting insurance for next year. The Republican health plan designed to replace the Obama-era health law known as the Affordable Care Act would not have taken full effect for a few years anyway — and now it’s dead.
“We’re going to be living with Obamacare for the foreseeable future,” House Speaker Paul Ryan said Friday.
That means millions of Americans will have to navigate a current federal health care system that, while not “imploding” as President Donald Trump has said, is at least in flux. approval — and could greatly affect the cost and scope of coverage.
Q: What changes?
A: The proposals allow insurers to cover a lower percentage of medical costs and to redirect current premium payments to a plan member’s previously unpaid premiums. Those provisions could potentially increase out-ofpocket costs for consumers.
In addition, Trump has directed the Internal Revenue Service not to enforce the Affordable Care Act’s individual mandate that requires most people to have health insurance or pay a fine. That’s expected to cause millions of healthy, younger people to drop coverage, which could cause insurers to raise premiums.
Another proposed adjustment would let insurers design cheaper plans tailored to younger people who may not need lots of health care but want to be protected in the event of a big injury or sickness. Insurers say they have struggled to attract younger and healthier customers to the marketplaces to balance out the claims they pay from those who use their coverage.
Q: Will I have plans to choose from?
A: It depends on where you live. Choices are dwindling, but chances are at least one insurer will sell in your market. That company may offer several plans.
Generally, big cities will have more choices than rural areas, where there may not be enough customers to attract insurers.
Customers can try to find coverage outside their exchange, but then they won’t be able to use tax credits to help pay the bills, which may be particularly painful since many markets have seen prices soar.
Q: But didn’t marketplace premiums skyrocket this year anyway?
A: Premiums in states that use the federal HealthCare. gov marketplace did increase an average of 25 percent in 2017, after rising just 2 percent in 2015 and 7.5 percent in 2016. But that was mainly because insurers had underpriced their coverage in 2015 and 2016. After making the cost corrections in 2017, most analysts felt the individual market was on its way to stabilizing in 2018.
Q: What about the Medicaid expansion? Are congressional Republicans going to go after that?
A: The Medicaid expansion is part of the Affordable Care Act and will remain in effect. But Republicans have their sights on cutting Medicaid and could pursue separate legislation that changes the program from an open-ended entitlement to one with capped funding — as the GOP health bill would have done.
Q: What will Republicans do now?
A: In the short term, probably not much. Burned by Friday’s debacle, Republican leaders will be loath to plunge back into a contentious debate. But many are still quite eager to repeal the law, so look for some to float solutions.
“Congress has a responsibility to continue its work to solve this problem,” said Sen. Lamar Alexander, R-Tenn., chairman of the Senate health committee.
Of course, if their constituents don’t make a fuss, lawmakers will turn their sights elsewhere.
“We’re going to be living with Obamacare for the foreseeable future.” House Speaker Paul Ryan, R-Wis.