Republicans eyeing Medicaid overhaul as part of ACA repeal bill

Republicans eyeing Medicaid overhaul as part of ACA repeal bill

There's more of that in the Politico article, and it shows that Republicans have reckoned with few of the questions Congress and the White House need to answer in order to repeal the Affordable Care Act without completely blowing up the health care system.

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But as a physician, I also know the underlying system is still broken, and simply repealing won't fix it by itself. That is why President Obama's promise that if you like your health insurance, you could keep your health insurance, turned out to be something very different: If he liked your health insurance, you could keep it.

States could still offer Medicaid to those who became eligible under expansion, but the states' share of the costs would be higher than it is under the Affordable Care Act, likely making it too expensive for many states to do so.

Attendees will be given the opportunity to sign petitions regarding the possible repeal and handouts to support future discussions with their representatives in Lansing and Washington.

That's right: There are Republicans who aren't sure whether they want to get rid of a literal government-run entitlement program that redistributes wealth to the poor in the form of health coverage. That means it may be necessary to prop up Obamacare for an additional year even after it is repealed. "I don't think "Obamacare-lite" is what we should do", Paul said.

"This is not my bill", Sanford said.

One of the issues with cost-sharing reductions is that if they aren't paid, insurers can leave the Obamacare marketplace. But as all would-be health reformers eventually discover, the majority of Americans who have insurance now get it through employers - and they're distinctly uninterested in changes to their tax treatment. "I can't tell you how many families, how many small businesses, how many patients have been hurt by the Affordable Care Act", Ways and Means Committee Chairman Kevin Brady said, adding that the "working to provide relief to the families that have been damaged by Obamacare".

In fact, as I pointed out to him, numerous ideas in my plan came from bills he has offered in the past as a member of Congress.

"They're doing a great job of trying to keep members informed - I think it becomes more of a strategical or tactical question on how you handle a very hard issue, so I'd say there's at least a willingness to explore a number of options", he told reporters.

The elements of the plan include replacing the subsidies that help people buy insurance through Obamacare exchanges with fixed tax credits to buy coverage on the open market.

While they are figuring out how to replace Obamacare, Republicans are also struggling with how to first repeal it. They either vote for repeal or against it. That would be a nice lead in to the 2018 elections, giving them a ready made argument that the GOP is incapable of governing. President Donald Trump said Price would release a plan after his confirmation, which hasn't happened yet.

"We have to get it done because we can't start tax reform until we deal with this", he said. "Instead of simply expanding a broken program, Republicans instead want to put states in charge of their Medicaid programs and give them the tools, resources, and flexibility to address their unique needs". Sixteen states that have expanded Medicaid have Republican governors, including Arizona, Arkansas, Indiana, Iowa, Kentucky, Michigan, Nevada, and Ohio.

Everybody understands these dynamics, so it's likely the real objective of the House conservative gambit in pushing a politically disastrous repeal-without-replace plan - aside from signaling impatience about inaction - is to keep GOP leaders from going too far in the direction of continuing the very Obamacare policies the public (and presumably fearful Republican senators) would like them to continue.