Obamacare: What patients need to know about “repeal and replace”

Repeal and Replace: What Patients Need to Know about Future of Obamacare

With control of the House of Representatives, U.S. Senate and the White House, Republicans are working to deliver on their campaign promise to “repeal and replace” Obamacare.

“On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare,” President-elect Donald Trump writes on his transition website.

So, what do patients need to know about what’s on the table when it comes to repealing and replacing Obamacare?

Before Repeal, There’s A Big Fight over Insurance Risk Corridors

Before Congress debates “repeal and replace,” the courts must decide whether taxpayers must provide a bailout to insurance companies.

Yes, the same insurance companies raising rates and denying treatments want the federal government to provide them with a multi-billion dollar bailout.

The fight centers on the Affordable Care Act’s “risk corridor” program.  A portion of profits from the health insurance marketplace were supposed to be redirected to offset losses from other insurance providers.

“The program was supposed to transfer excess funds from exchange plans with lower-than-expected claims to insurers with higher-than-expected claims to safeguard them against losses,” Sally Pipes, President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute, writes at The Hill. “The risk corridors were never more than a bribe to get insurers into ObamaCare’s marketplaces.”

But, as Pipes explains, that money never materialized. “With so many coverage providers hemorrhaging cash, not many plans have been able to pay into the risk corridor pot.”

The law was unambiguous: risk corridors were to be budget-neutral. Nevertheless, insurance companies are seeking billions of dollars. That’s brought about lawsuits, and will likely be resolved by Congress.

“It’s not yet clear whether Team Obama’s pro- or anti-bailout forces will win out,” Pipes concludes. “But the losers are already clear — the taxpayers who have been forced to underwrite this mess and the patients who are left with limited exchange options and soaring premiums and deductibles.”

Expect Congress to Vote Quickly to Repeal…

The Washington Post’s Mike DeBonis and Kelsey Snell report that “Republicans on Capitol Hill are already laying the groundwork for a rapid repeal of President Obama’s signature health-care law beginning on the first day of the new Congress, before President-elect Donald Trump is even sworn in.”

Many political pundits anticipate that President Trump could sign legislation by the spring.

Sen. Orrin G. Hatch of Utah, who will lead the “repeal and replace” efforts as chairman of the Senate Finance Committee, is expected to work with other high-ranking Republican lawmakers to craft a replacement plan. They have a keen awareness of the need to protect patients during a transition period.

“I don’t want to leave the 84,000 people in Maine who are buying insurance on the exchange uninsured because, all of a sudden, two-thirds of them who have subsidies have lost that subsidy,” said Sen. Susan Collins, R-Maine.

… With Replacement Plan Phased in Over Time

While Congress is expected to move swiftly with repeal, a replacement plan will take time.

“There needs to be a reasonable transition period so people don’t have the rug pulled out from under them,” House Speaker Paul Ryan, said earlier this month, according to NPR.

That sentiment is shared by Republican leadership in the U.S. Senate. According to the Chicago Tribune, “No. 2 Senate Republican, John Cornyn of Texas, said there will likely be a three-year gap between Congress’ votes to repeal Obama’s law and when that would actually kick in.”

“We’re not going to let anybody fall through the cracks,” Cornyn vows.

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