{"id":14692,"date":"2016-11-10T11:29:21","date_gmt":"2016-11-10T11:29:21","guid":{"rendered":"http:\/\/www.biphoo.com\/bipnews\/?p=14692"},"modified":"2016-11-10T11:29:21","modified_gmt":"2016-11-10T11:29:21","slug":"obamacare-defenders-vow-total-war","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/health\/obamacare-defenders-vow-total-war.html","title":{"rendered":"Obamacare defenders vow ‘total war’"},"content":{"rendered":"

Obamacare defenders vow ‘total war’<\/span><\/strong><\/span><\/h2>\n

Obamacare defenders vow ‘total war’:-<\/strong> 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 \u201ctotal war\u201d to defend President Barack Obama\u2019s universal health care program and his domestic policy legacy.<\/span><\/p>\n

“We’ve got the battle of our lifetime ahead of us,\u201d 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. \u201cWe’re going to have a huge number of organizations from all across the country that will participate in this effort.”<\/span><\/p>\n

But their options are limited. They have enough votes to block a total repeal of the law on Day One of a Trump administration. But they can\u2019t block Republicans from passing targeted legislation in the coming months, and Trump \u2014 like Obama before him \u2014 can pick up a pen as early as Jan. 20 and use executive powers to block, change, or put on hold key elements of the massive six-year-old legislation.<\/span><\/p>\n

The road to repeal is more complex than Trump acknowledged on the campaign trail. The law is baked into the health care system, touching every American\u2019s life and a fifth of the economy.<\/span><\/p>\n

But with the Republican sweep of both the executive and legislative branches, expectations for big and bold action are high.<\/span><\/p>\n

“It’s pretty high on our agenda as you know,” Senate Majority Leader Mitch McConnell said on Wednesday. “I would be shocked if we didn’t move forward and keep our commitment to the American people.”<\/span><\/p>\n

Democratic aides on Capitol Hill said it was too early to have concrete plans but that defending Obamacare was a top goal. The law brought uninsurance rates to record lows, and many people have gotten financial help to get covered.<\/span><\/p>\n

\u201cSen. Schumer and Senate Democrats are interested in ways to improve the Affordable Care Act. But we will fight tooth and nail against any attempt to repeal it,\u201d a senior Senate Democratic aide told POLITICO, referring to incoming Minority Leader Chuck Schumer.<\/span><\/p>\n

But Trump, if he chooses, could make his mark immediately. He could loosen requirements, for instance by exempting more people from the individual mandate to buy insurance. The new administration could also cut off funds for outreach and enrollment assistance for Obamacare plans, just at the peak busy days at the end of the 2017 sign-up season.<\/span><\/p>\n

The Trump Justice Department could also stop fighting the lawsuit the Republican House brought against the Obama administration, seeking to shut off subsidies that help pay low-income people\u2019s doctors\u2019 bills. If the House wins, those payments would dry up \u2014 sticking the insurance plans with the bills. If the subsidies stop, insurance companies would have the right to drop out of the Obamacare markets almost immediately, which could lead to the collapse of the exchanges.<\/span><\/p>\n

Or Trump could work with GOP lawmakers to siphon funding that was supposed to help insurers get through the first difficult years of Obamacare \u2014 funds that Congressional Republicans have already limited.<\/span><\/p>\n

\u201cYou can change regulations almost immediately to give the power back to states to give them choice,\u201d said Sen. John Barrasso (R-Wyo.), an orthopedic surgeon, who is likely to be a key Senate leader on Obamacare repeal. He was one of several lawmakers and Trump advisers who called for some kind of transition or phase-out period to help people who would be losing coverage.<\/span><\/p>\n

Using both regulation and legislation, meanwhile, congressional Republicans have a clear path to undermine Obamacare as early as Jan. 20 and to repeal Obamacare within months, although the road is fraught with landmines. Democrats, in turn, may have few options besides trying to convince voters to pressure the GOP to keep that scuttling the law will hurt the vulnerable \u2014 the same voters who just elected Trump. the Republicans who pledged to repeal it.<\/span><\/p>\n

Republicans can\u2019t repeal the law straight away because Democrats will still hold enough Senate seats to mount a filibuster. But over the longer term, Republicans can kill enough of the measure to make it essentially moot. And Trump could undermine the ACA in multiple ways upon taking office because the law gave so much discretion to the HHS secretary.<\/span><\/p>\n

A Republican Congress could also siphon Obamacare funding to insurers too. Lawmakers already blocked some payments meant to offset their financial risk the health plans took on in the uncertain new markets. That\u2019s one reason the insurers raised premiums this year, to make up for anticipated payments that never materialized.<\/span><\/p>\n

All that has rattled health care industry groups, who did not expect Trump\u2019s triumph and who have spent the last six years adjusting to Obamacare.<\/span><\/p>\n

\u201cI\u2019ve got clients freaking out a little bit. It\u2019s just the unknown,\u201d said one veteran health care lobbyist, noting that pre-Election Day briefings were typically dominated by gaming out a Clinton administration.<\/span><\/p>\n

Whether through regulation or legislation, there are risks to taking down Obamacare.<\/span><\/p>\n

Dismantling an exceedingly complex law that has become baked into the health care system is going to be much more complex than Trump acknowledged on the campaign trail. It would add uncertainty and frustration to the insurance companies running Obamacare plans.<\/span><\/p>\n

\u201cFor the last four years every problem of the health care system has been blamed on Obamacare,\u201d said Tim Jost, a legal expert and strong supporter of the law. \u201cFrom here on out it\u2019s going to be blamed on Trumpcare \u2014 and we\u2019ll see how that works out.\u201d<\/span><\/p>\n

Trump has provided few details about his health care replacement proposals. He has used some of the same phrases and big picture concepts as congressional Republicans, but with so little detail, it\u2019s difficult to say how his ideas meld with those on the Hill.<\/span><\/p>\n

\u201cAnybody that says they know what\u2019s going to happen now is smoking something excluded from Part D coverage,\u201d said John Gorman, an insurance consultant. (Part D covers legal prescription drugs.)<\/span><\/p>\n

Republicans may try to thread the needle between voter demands and massive health industry disruption by taking an early vote on Obamacare repeal \u2013 symbolic, given the Democratic filibuster \u2014 to show voters they will live up to their promise, and then build in time for a transition.<\/span><\/p>\n

“I think the replacement obviously must come first and it must be something that is very appealing and easy to understand,\u201d Ben Carson, the retired neurosurgeon and top Trump ally, told POLITICO. \u201cAnd then, only then, would you dismantle what’s in place.”<\/span><\/p>\n

Republicans also have a longer-term path to permanently repeal several huge parts of the law through legislation.<\/span><\/p>\n

Republicans did a test run of their legislative plan to repeal several huge parts of the law last year when the Senate passed repeal legislation through the complex budget reconciliation process, which requires only 51 votes and can\u2019t be filibustered. That bill would have eliminated the ACA\u2019s subsidies that help consumers buy insurance, Medicaid expansion and the medical device and Cadillac taxes. It would also eliminate the fines for the individual and employer mandates, rendering them moot. Obama vetoed the bill.<\/span><\/p>\n

House Speaker Paul Ryan happily acknowledged that a similar bill would face a different fate next year.<\/span><\/p>\n

“This Congress, this House majority, this Senate majority has already demonstrated and proven we’re able to pass that legislation and put it on the president’s desk. Problem is, President Obama vetoed it,” Ryan said. “Now we have a President Trump who has promised to fix this.”<\/span><\/p>\n

Source:-\u00a0http:\/\/www.politico.com\/story\/2016\/11\/obamacare-defenders-vow-total-war-231164<\/span><\/p>\n

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