In This Edition:
From Kaiser Health News:
Republicans want to jettison the health law, but some features are already hardwired into the system. (Jay Hancock and Shefali Luthra, 11/9)
But block grants face likely resistance from states, poised to lose many millions. (Phil Galewitz, 11/9)
Republicans will likely chip away at the ACA piecemeal and say they will try to provide a soft exit. (Julie Rovner, 11/9)
A plan to test the effectiveness of so-called “Frankenflies” is being closely watched by nearby Miami-Dade County as a possible way to combat the spread of Zika. (Rachel Bluth and Emily Kopp, 11/10)
The number of states with laws permitting marijuana use underscores a national cultural shift toward wider acceptance of the drug, despite the federal ban and limited evidence on the public health impacts of legalization. (Anna Gorman, 11/9)
Older adults who hope to spend the end of their lives at home need to take key steps to make that possible. (Judith Graham, 11/10)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Stuck'" by Nick Anderson.
Here's today's health policy haiku:
REPEAL, REPLACE … AND THEN WHAT?
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Summaries Of The News:
Republican leaders say they are going to "hit the ground running" to start dismantling what they can of the Affordable Care Act. But after six years, there are aspects of the law now baked into the industry that won't be easy to upend.
The New York Times: Obama Calls For Unity, But Signature Acts Remain In Jeopardy
The White House acknowledged that Mr. Obama’s signature legislation, the Affordable Care Act, was in genuine jeopardy. Mr. Trump has vowed to repeal it as one of his first acts in office, and a Republican-controlled Congress will prod him to do so. Josh Earnest, the White House press secretary, said Mr. Obama would lobby Mr. Trump to keep it in place — an effort that suggests Mr. Obama believes that Mr. Trump can be persuaded on certain issues. (Landler and Davis, 11/9)
The New York Times: Republicans In Congress Plan Swift Action On Agenda With Donald Trump
Congressional Republicans, stunned by their own good, if complicated, fortune, said on Wednesday that they would move quickly next year on an agenda that merges with President-elect Donald J. Trump’s, repealing the Affordable Care Act, cutting taxes, confirming conservative judges, shrinking government programs and rolling back regulations. (Steinhauer, 11/9)
Kaiser Health News: Obamacare ‘Replacement’ Might Look Familiar
The Affordable Care Act transformed the medical system, expanding coverage to millions, injecting billions in tax revenue, changing insurance rules and launching ambitious experiments in quality and efficiency. Less of that might disappear under President-elect Donald Trump’s pledge to “repeal and replace Obamacare” than many believe, say policy analysts. Republicans promising change might not quickly admit it, but in some respects Obamacare’s replacement may look something like the original. (Hancock and Luthra, 11/9)
The New York Times: Change Ahead: Shifts On Immigration, Climate, Health And Taxes
Republicans will not have the 60 votes in the Senate needed to pass most major legislation, but through a parliamentary procedure called budget “reconciliation,” they have already done a dry run to gut the existing law without facing a Democratic filibuster. ... Uprooting them would be a complex political and logistical challenge. Insurers now accept the idea that they cannot deny insurance, or charge higher prices, to people who have been ill. (Weisman, 11/9)
The Wall Street Journal: Donald Trump And GOP Lawmakers Turn To Health-Law Overhaul
Without 60 votes in the Senate to get around procedural hurdles, Republicans couldn’t repeal the whole law in one shot but could take out pillars of it using a budget maneuver that requires only a simple majority. One target would be subsidies that blunt the cost of premiums for people who get coverage on the health law’s exchanges, said Timothy Jost, a professor at Washington and Lee University School of Law. Without a transition plan, 85% of exchange consumers who get subsidies would face the full cost of their premiums, prompting a major drop-off in participation. The employer mandate that requires many companies with 50 or more full-time workers to provide health insurance also would likely go. (Armour and Radnofsky, 11/9)
The Wall Street Journal: Donald Trump’s Pledge To Repeal Health Law Carries Risks
After six years, the health overhaul is largely implemented. The fourth open-enrollment period is currently under way and due to conclude Jan. 31. Many conservative health policy experts haven’t hid their disdain for Mr. Trump’s campaign, leaving open the question of who would provide the technical support for a dismantling effort. In particular, Mr. Trump’s repeal could face opposition from Republicans in states that expanded Medicaid, the federal-state health coverage for low-income people, and industry groups that heavily profit from the law. (Armour and Radnofsky, 11/9)
Politico: Obamacare Defenders Vow 'Total War'
Shell-shocked Democrats on Capitol Hill are preparing to make a fight for Obamacare their top priority in the opening days of the Trump administration, with leading advocacy groups ready to wage “total war” to defend President Barack Obama’s universal health care program and his domestic policy legacy. "We've got the battle of our lifetime ahead of us,” Ron Pollack, executive director of advocacy group Families USA, said the day after Donald Trump was elected on a pledge to repeal the Affordable Care Act, which now the law that covers 22 million people. “We're going to have a huge number of organizations from all across the country that will participate in this effort." (Haberkorn and Demko, 11/10)
The Washington Post: Obamacare’s Future In Critical Condition After Trump’s Victory
“The clock is ticking, because Republicans appear to be saying health care is going to be the first item on their list with repeal of the ACA being the banner for that,” said Ron Pollack, Families USA’s executive director for three decades. “This will be the most intense fight I remember. . . . One should never underestimate an extraordinary backlash that occurs when people have something that they really value and it is taken away.” (Goldstein, 11/9)
Politico Pro: Pulse Check: Obamacare Is Now Endangered, But It's Not Dead Yet
Families USA's Ron Pollack is vowing "total war" to save Obamacare. AEI's Jim Capretta helped shepherd House Speaker Paul Ryan's proposal to replace it. (Diamond, 11/9)
Stat: Can Trump Kill Obamacare?
Promising to repeal the most sweeping overhaul of the US health care system in a generation is one thing. But how? Here are three questions Republicans will have to answer. (Scott, 11/9)
Kaiser Health News: Repealing The Affordable Care Act Could Be More Complicated Than It Looks
After six controversial years, the Affordable Care Act, aka Obamacare, may be on the way out, thanks to the GOP sweep of the presidency and both houses of Congress Tuesday. “There’s no question Obamacare is dead,” said insurance industry consultant Robert Laszewski. “The only question is whether it will be cremated or buried.” Senate Majority Leader Mitch McConnell (R-Ky.) confirmed Wednesday that repealing the law is something that’s “pretty high on our agenda. (Rovner, 11/9)
NPR: What Lies Ahead For Obamacare In Donald Trump's Administration
During his campaign, Trump proposed a series of measures that he said will allow people to buy affordable health insurance policies outside of the Obamacare exchanges. Those measures include promoting tax-free health savings accounts that might help individuals save money to pay for health care costs and allowing people to deduct the cost of their premiums on their personal income tax returns. Trump has said he also wants to allow insurers to sell policies across state lines to boost competition. Trump could alter the Obamacare exchanges to promote high-deductible health plans and health savings accounts to get a result similar to what he's looking for. (Kodjak, 11/9)
Modern Healthcare: Policy Experts Say Quick Repeal And Replace Of Obamacare Unlikely
Trump clamped onto the party line on healthcare early in his candidacy and has called the ACA a “catastrophe.” He has been less clear, however, on what he would put in place of the ACA, citing vague conservative stalwart ideas such as creating high-risk pools, allowing insurance to be sold across state lines and expanding health savings accounts. There is little evidence any of these efforts would show success in improving quality or reducing healthcare costs. (Aguilar and Muchmore, 11/9)