In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

1. Drowning In A ‘High-Risk Insurance Pool’ — At $18,000 A Year

Minnesota had one of the most successful high-risk insurance pools in the country, and GOP leaders are eyeing this special insurance for sick people as an Obamacare replacement. But analysts say costs were high and many people in need were left out. (Mark Zdechlik, Minnesota Public Radio, 2/27)

3. To Pay Or Not To Pay – That Is The Question

With the future of Obamacare up in the air, many consumers are wondering if they must comply with the tax requirements related to the law, including whether to pay the penalty for being uninsured. (Emily Bazar, 2/27)

4. Political Cartoon: 'Wild Child?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Wild Child?'" by Rick Kirkman and Jerry Scott.

Here's today's health policy haiku:


If you swim in it
You’ve got worries beyond health.
Cash flow could hurt, too.

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:

Health Law

5. GOP Draft Repeal Plan Scraps Subsidies And Individual Mandate, Rolls Back Medicaid

The replacement would be paid for by limiting tax breaks on generous health plans people get at work.

Politico: Leaked GOP Obamacare Replacement Shrinks Subsidies, Medicaid Expansion
A draft House Republican repeal bill would dismantle the Obamacare subsidies and scrap its Medicaid expansion, according to a copy of the proposal obtained by POLITICO. The legislation would take down the foundation of Obamacare, including the unpopular individual mandate, subsidies based on people’s income, and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high risk pools for some people with pre-existing conditions. Some elements would be effective right away; others not until 2020. (Demko, 2/24)

Stat: The GOP Plan To Replace Obamacare: 5 Takeaways
The final version is likely to be different — how much different, it’s hard to say. The draft obtained by Politico is dated two weeks ago, and rumors have been swirling here that Republicans received an unfavorable analysis from the Congressional Budget Office, the official scorekeepers on the cost and coverage implications of legislation. But this is nonetheless an important milestone — real legislative text, prepared with an eye toward the complex parliamentary procedures needed to pass ACA repeal with only Republican votes, and presumably with the endorsement of House leadership. (Scott, 2/24)

The Associated Press: GOP Proposal Aims To End Insurance Mandate In 'Obamacare'
A draft Republican bill replacing President Barack Obama's health care law would end its Medicaid expansion, scrap fines on people not buying insurance and eliminate taxes on the medical industry and higher earners.Instead, it would create tax credits worth up to $4,000, allow bigger contributions to personal health savings accounts and impose a new levy on expensive health coverage some employees get at work. (Fram, 2/25)

The Washington Post: House GOP Plans To Keep Some Medicaid Expansion — And Steer Money To States That Never Bought In
Congressional Republicans have been struggling for months to resolve one of the most vexing problems in their tortuous effort to replace the Affordable Care Act: What to do about the generous federal funding for states that broadened their Medicaid programs under the law, while not shortchanging the 19 states that balked at expansion? Now, as the House begins to hone details of its legislative proposal, a possible compromise has emerged. It would temporarily keep federal dollars flowing to cover almost the entire cost of the roughly 11 million Americans who have gained Medicaid coverage but would block that enhanced funding for any new participants. (Goldstein and Eilperin, 2/24)

The Wall Street Journal: GOP’s New Plan To Repeal Obamacare: Dare Fellow Republicans To Block Effort
Republican leaders are betting that the only way for Congress to repeal the Affordable Care Act is to set a bill in motion and gamble that fellow GOP lawmakers won’t dare to block it. Party leaders are poised to act on the strategy as early as this week, after it has become obvious they can’t craft a proposal that will carry an easy majority in either chamber. Lawmakers return to Washington Monday after a week of raucous town halls in their districts that amplified pressure on Republicans to forge ahead with their health-care plans. (Radnofsky, son and Armour, 2/27)

NPR: Obamacare Rollback Bill Would Replace Subsidies With Tax Credits
The draft bill is consistent with what Republicans have been saying they want to see in place of Obamacare, says Rodney Whitlock, vice president of health policy at ML Strategies. "No surprises here," says Whitlock, who was formerly the Republican health policy director for the Senate Finance Committee. "These are all ideas Republicans have championed. Now the Congressional Budget Office will decide if they agree." (Kodjak, 2/24)

Bloomberg: GOP Obamacare Plan Would Cover Fewer People; Blowback Grows 
At the core of the Republican argument in favor of their plan is that it will expand access to insurance for those who want it, rather than expanding total coverage by forcing people to. The requirements for repealing the ACA mean it’s not possible to keep the same number of people covered, said Representative Trent Franks, an Arizona Republican. (Tracer, House and Edney, 2/24)

Forbes: Hospitals Where Trump Won Face Closure If GOP Repeals Medicaid Expansion
News that Paul Ryan and the Republican-led U.S. House of Representatives want to roll back the Affordable Care Act’s Medicaid expansion has rural hospitals facing a huge financial hit with hundreds of health facilities already facing closure. ... Even without an effort to repeal the Affordable Care Act, more than 670 rural hospitals are at risk for closure, according to The Chartis Group , which released a study earlier this month at the Rural Health Policy Institute. The group examined hospital performance across nine measures, including a population health metric that shows impact on their communities and a loss of 137,000 “community jobs” including 99,000 jobs in healthcare, the Chartis Group report said. (Japsen, 2/26)

Bloomberg: Abortion Spat Imperils GOP Obamacare Repeal And Risks Shutdown 
Republicans in Congress have made cutting off funding to Planned Parenthood one of their top priorities, but the issue could stymie President Donald Trump’s Obamacare repeal plans and even trigger a government shutdown. House Republicans insist that the emerging plan to end Obamacare must cut off an estimated $500 million in annual federal funding for Planned Parenthood over its provision of abortions, aiming to carry out two longtime GOP campaign promises at once. Democrats are equally determined to ensure that won’t happen, and a few Republicans may stand with them. (Kapur, John and House, 2/27)

The Associated Press: Pre-Existing Conditions Complicate Health Care Replacement
As Republicans try to unite around a replacement for the Affordable Care Act, one of the most popular parts of the law will be among the most difficult to replace: the guarantee of health coverage for people with pre-existing conditions. The challenge of providing insurance for Americans who have no other alternative has some congressional Republicans considering whether to ask the states to reboot high-risk pools, an option with a rocky history. In the past, the pools served as insurers of last resort for people in poor health who could not get an individual policy from a commercial insurer. (Johnson and Alonso-Zaldivar, 2/25)

The New York Times: Key Republican In Health Law’s Fate Hails From A State That Embraced It
When Representative Greg Walden of Oregon visits his expansive district, which swallows two-thirds of a very blue West Coast state, his constituents grouse amiably to their longtime Republican congressman about environmental regulations and federal lands policy. And then the conversation shifts to the Affordable Care Act and what its repeal would mean for the struggling rural workers who have long voted for Mr. Walden, and for children like 11-year-old Rocco Stone. Because of the health law, Rocco has been able to live at home, attend school and have a nearly normal life despite having autism and a rare genetic disorder. (Pear, 2/25)

6. After Governors' Meeting, The Big Question Remains: What To Do With Medicaid?

The state leaders gathered for the National Governors Association winter meeting but were stymied over the problem of how to handle Medicaid. They want to make sure a repeal of the health law doesn't penalize states that took billions of dollars in federal funds to expand the program.

The Wall Street Journal: Talks Between Republican Governors Don’t Yield Agreement On Key Health-Law Issue
Governors gathered Saturday to discuss health-care policy said they didn’t reach a consensus on the future of the Medicaid program, an issue hamstringing Republicans’ bid to alter the Affordable Care Act. The governors’ meeting came at a key moment in the debate over the future of the health law, which Republicans have pledged to overturn. The party controls the White House, the Senate, the House of Representatives and 33 state governorships. (Radnofsky and Hackman, 2/26)

Politico: GOP Governors Split On Obamacare Replacement
The governors are split on whether to ask Congress to preserve the federal funding boost Obamacare made available to cover millions of additional low-income adults and broader structural changes. “We’re working through many different ideas,” said Oklahoma Gov. Mary Fallin, one of about a dozen governors trying to craft a compromise. F

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