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Health Law Issues And Implementation

4. Companies Warn Of Mass Marketplace Exodus If Trump Drops 'Insurer Bailout' Lawsuit

The House is suing the Obama administration, saying subsidies the health law provides to insurers are illegal because the legislation is appropriating money without congressional approval. Donald Trump will be able to drop the lawsuit when he's sworn into office, but if he does, it could spell quick disaster for the marketplace.

The Associated Press: Trump's Path On Health Care Law Intersects With A Lawsuit
President-elect Donald Trump says he wants to preserve health insurance coverage even as he pursues repeal of the Obama-era overhaul that provided it to millions of uninsured people. How his administration handles a pending lawsuit over billions of dollars in insurance subsidies will reveal whether Trump wants an orderly transition to a Republican-designed system or if he'd push "Obamacare" over a cliff. Stripping away the subsidies at issue in the case would put the program into a free-fall. (Alonso-Zaldivar, 11/16)

In other news on the health law and Republicans' efforts to dismantle it —

The Wall Street Journal: On Republicans’ Path To Health-Law Repeal, Questions Emerge
Ascendant Republicans who have put a repeal of the Affordable Care Act at the top of their to-do list face a set of early, key decisions that will test the party’s consensus on the issue. Among them: How much of the 2010 health law to strike early on, how soon and how closely to work with Democrats in shaping a replacement, and how much leeway to give consumers who might be caught without coverage in between a repeal and a new law. Lawmakers who weren’t necessarily expecting Donald Trump to win the presidency now see they can move ahead more boldly on the health law than they anticipated. (Radnofsky and Armour, 11/15)

Morning Consult: Murphy Calls For Extensive Process To Reform ACA
Two top House Republicans on health policy reiterated promises Monday to replace the Affordable Care Act after repealing it. Rep. John Shimkus (R-Ill.), who is vying to lead the Energy and Commerce Committee next year, said the House GOP’s “Better Way” health plan will be the starting point for reform efforts. He referenced high-risk pools as the best way to require insurers to cover pre-existing conditions without having a mandate to purchase plans. Tax credits would help people afford coverage, he said. ... Rep. Tim Murphy (R-Pa.) said Republicans won’t repeal the Affordable Care Act without offering a replacement, but he expects that effort could take several months of hearings and legislative work. (McIntire, 11/15)

Kaiser Health News & Lancet: Podcast: The GOP’s Path To ‘Repeal And Replace’ May Not Be So Easy
Starting in January, Republicans will control the white house and both chambers of Congress. After promising to repeal and replace the Affordable Care Act, president-elect Donald Trump has said he’d now like to keep some elements of the law. Republicans who have voted for years to repeal the law now have their chance to enact a replacement. Medicare and Medicaid might also see major changes under a GOP-controlled White House and Congress. (11/16)

The Hill: Doctor's Group Warns GOP: Don't Increase Uninsured 
The nation’s leading doctors group is warning the incoming Trump administration not to strip away a single person’s health coverage as it works to dismantle ObamaCare.  The American Medical Association (AMA) on Tuesday released a two-page document that outlines its top goals for healthcare reform under incoming President Trump. One of the top items is making sure that “any future proposals do not cause individuals covered as a result of [Affordable Care Act] provisions to become uninsured,” the AMA wrote." A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured,” the group said. (Ferris, 11/15)

Morning Consult: AMA Says New Health Policy Must Maintain Coverage For All Currently Covered
The American Medical Association’s House of Delegates vowed Tuesday to work with the incoming Trump administration and Congress on health care reform, but said any new reforms shouldn’t result in people losing coverage. “A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured,” the group said in a statement. “We will also advance recommendations to support the delivery of high quality patient care. Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs.” (McIntire, 11/15)

And, Republican governors meet to discuss, among other issues, health care coverage in their states following the election —

The Associated Press: GOP Governors Hope To Move Fast On Making Promised Changes
Republicans are still celebrating their election victories, but the country's GOP governors warned this week that they need to move fast on many of the changes that have been promised to voters. ... Most of the GOP governors mentioned health care when discussing their top priorities. But it became evident they are not in complete agreement on how to unwind President Barack Obama's health care overhaul that included an expansion of Medicaid, the nation's main safety net health care program for the poor. (Fineout, 11/16)

5. Some States Looking For More Control Of Medicaid Under Trump

The future of the health law's Medicaid expansion is uncertain but parts of it may remain. State officials want to be able to add more requirements for people participating in the programs, however. Meanwhile, South Dakota's governor says his efforts to get the legislature to consider a Medicaid expansion are now dead.

The New York Times: Expect Medicaid To Change, But Not Shrivel, Under Donald Trump
The expansion of Medicaid, a central pillar of the Affordable Care Act, faces immense uncertainty next year, with President-elect Donald J. Trump and top Republicans in Congress embracing proposals that could leave millions of poorer Americans without health insurance and jeopardize a major element of President Obama’s legacy. But influential figures in surprising quarters of the new administration might balk at a broad rollback of Medicaid’s reach, favoring new conditions for access to the government insurance program for the poor but not wholesale cutbacks. (Pear, 11/15)

The Associated Press: Governor Ditches Medicaid Expansion After Mike Pence Meeting
Republican Gov. Dennis Daugaard said Tuesday that he won't pursue an expansion of Medicaid in 2017 after a discussion with Vice President-elect Mike Pence. The South Dakota governor said in a statement that his decision is based on a Monday meeting in which he and Pence talked about the Trump administration's plans for repealing or reforming the Affordable Care Act. (Nord, 11/15)

Sioux Falls (S.D.) Argus Leader: Pence Dashes Daugaard's Hopes Of Medicaid Expansion
Plans to move forward on Medicaid expansion during the 2017 legislative session came to an abrupt halt Tuesday. Gov. Dennis Daugaard, one of the plan's key architects, in a statement said based on the election of Republican Donald Trump and the administration's plans moving forward, he would drop his request that the state Legislature weigh expanding the health insurance program for needy people. (Ferguson, 11/15)

6. Oscar -- The Health Care Startup -- Continues To Lose Millions

Also in the news, a federal judge tosses out a lawsuit by a now-defunct health insurance company that says it is owed more than $70 million by the government.

Bloomberg: Obamacare Startup Oscar Has $45 Million Loss In Three States 
Oscar Insurance Corp., the Silicon Valley-backed health-care startup, continued to lose tens of millions of dollars in the third quarter as the company exits some markets and works to diversify away from of its Obamacare business. The New York-based company sells health insurance to individuals in new markets set up by the Affordable Care Act. Its attempt to reinvent the insurance business has been marked by large losses -- in the third quarter, closely held Oscar lost $45 million in New York, Texas and California, according to filings with regulators. That follows losses of $83 million in those states during the first six months of this year. (Tracer, 11/15)

Chicago Tribune: Court Rejects Land Of Lincoln Lawsuit Seeking More Than $70 Million
A federal judge has tossed out Land of Lincoln's lawsuit seeking more than $70 million that the now-defunct health insurer says it's owed by the federal government. The insurer shut down at the end of September amid financial woes, sending 49,000 Illinoisans scrambling to find new coverage for the last three months of the year. Shortly before the insurer's closure was announced, it sued the federal government in June for more than $70 million. (Schencker, 11/15)

Administration News

7. Who Will Have Trump's Ear On Health Care?

Stat offers a look at the players who are likely to have influence in a Trump presidency. Meanwhile, as Ben Carson passes on Cabinet positions, another name is added to the list for Health and Human Services secretary.