Latest news on Repeal and Replace ACA Healthcare (aka Obamacare)

What does Repeal and Replace mean looking forward to 2017 and a Republican-controlled Executive Branch, House and Senate? What might change for group health plans/employers, for expatriates and for government subsidies?

This topic was the focus on the Diane Rehm Show on NPR Radio (with Guest Host Susan Page) today, November 14, 2016 –

Listen to the discussion at http://thedianerehmshow.org/shows/2016-11-14/the-future-of-the-affordable-care-act-in-a-trump-administration.

Or look for today’s show on
“The Future Of The Affordable Care Act In A Trump Administration” http://thedianerehmshow.org/shows :: Mon. Nov 14, 2016

 

UPDATE: As of January 5,2017:

http://www.npr.org/sections/health-shots/2017/01/03/508074966/republicans-take-the-first-step-to-repeal-obamacare

Some background on Repeal and Replace:

While 60 votes are required to veto and completely repeal Obamacare, as the speakers on today’s show clearly stated, most likely a Republican House and Senate will use “Budget Reconciliation” to repeal large portions of the bill, including federal subsidies.

Of course, these are just the first days of President-Elect Trump’s selection of his cabinet and he has yet to fully map out his plan for his first 100 days (http://www.pbs.org/newshour/rundown/president-elect-donald-trumps-plan-first-100-days/#document/p1), and Vice President-Elect Mike Pence is just now forming his transition team. The President-Elect has indicated recently his desire to change sections of Obamacare versus repealing the entire bill. Time will tell.

Obamacare originally passed as a two-part solution in order to use “Budget Reconciliation” to get a 51-vote majority, since they didn’t have 60 votes to approve it all at once. The second “reconciliation bill,” was passed after March 23, 2010 to make a series of discrete budgetary changes in the ACA (Public Law 111-148). That act, “The Health Care and Education Reconciliation Act of 2010,” was signed by the President on March 30, 2010, and became Public Law 111-152.

Will Republicans use budget reconciliation to repeal Obamacare?

This same path (budget reconciliation) is assuredly what Republicans (who won’t have 60 votes) will use in order to repeal portions of the ACA Healthcare bill.

Republicans used this multiple times under Obam’s administration. They demonstrated after five years of effort that they could rescind Obamacare with a Republican president.

“We have now shown that there is a clear path to repealing Obamacare,” House Speaker Paul Ryan (R-WI), said in a statement. “So, next year, if we’re sending this bill to a Republican president, it will get signed into law.” This bill (which was vetoed by President Obama was called H.R. 3762. http://www.nationalreview.com/article/442161/obamacare-repeal-lessons-learned-advice

“Reconciliation” legislation may only consider provisions that are primarily budgetary in nature (i.e. cost the government money such as subsidies). Policy changes with only incidental fiscal impact get stripped from the bill. (In addition, reconciliation legislation must not increase our budget deficit.) “Budget Reconciliation” is a procedure that allows legislation to be created or repealed with just 51 votes in the Senate, instead of a filibuster-proof 60 votes.

Read more at: http://www.nationalreview.com/article/442161/obamacare-repeal-lessons-learned-advice

Originally having passed two different ACA bills, the House and Senate needed to find a solution that would pass in both chambers. The politics were extremely complicated at the time because Nevada Senator and Senate Majority Leader, Harry Reid, could not afford to lose a single vote, and House Speaker Pelosi could afford to lose only two votes.

Some of the key provisions of the ACA Healthcare law – including the individual mandate to purchase health insurance, the creation of insurance exchanges where low-income families can buy subsidized policies, and Medicare and Medicaid-funding measures, probably meet reconciliation requirements.

Financial and economic problems have forced nearly half of its non-profit co-ops to go out of business, and prompted insurance giants United Healthcare Humana to pull out of some of the markets. See http://www.thefiscaltimes.com/2016/08/12/How-Donald-Trump-Just-Single-Handedly-Saved-Obamacare. (Additional ACA Health Resources for you to download below image.)

Additional ACA Health Insurance Resources

As mentioned previously at https://www.gninsurance.com/resources/aca-impact-international-insurance/
the ACA-mandate does not apply to those residing overseas (expatriates) and currently no short-term international travel insurance is “ACA-Compliant,” nor do they need to be.
The ONLY medical insurance plans required to meet the ACA requirements are:

   1. Insurance plans intended for U.S. domestic health coverage AND…
   2. Insurance plans intended to cover someone 12 months or longer in duration

IMPORTANT: Please note that if you come home and reside in the USA for more than 31 days in any 12 month period, you may be subject to an IRS fine however even if you have overseas insurance coverage that will cover you during your time in the USA. That is due to the “Individual Shared Responsibility Payment.” We have a free white paper on this subject at: https://www.gninsurance.com/documents/ACA-Individual-Mandate-and-Expatriates.pdf

“Repeal and Replace Obamacare” became the mantra of a large field of Republican presidential candidates throughout the 2016 GOP primary. Dr. Ben Carson is supposedly helping Donald Trump craft portions of any new bill in order that hundreds of thousands of Americans will not lose their healthcare.

Possible “high-risk pools” may be employed to protect insurance companies from major losses. It is still unclear how those with pre-existing conditions will secure insurance.

According to the discussion (listen by clicking on the image on the left), “It’s more than likely that everything will stay in place for 2017 in a ‘phase-out’ period. And the law is still in place that you must have insurance or face penalties.”

The “Replace” portion is more fuzzy, and is the portion that concerns most experts following this story. It was recommended in the discussion that you might keep checking http://www.greatagain.gov
for statements as they become available (before Jan. 1, 2017).

Medicare may also be facing changes based on comments by Rep. House Speaker, Paul Ryan, to FOX’s Special Report program. More about Paul Ryan’s Medicare proposals at http://paulryan.house.gov/issues/issue/?IssueID=9969 and http://talkingpointsmemo.com/edblog/ryan-plans-to-phase-out-medicare-in-2017

What about prescription drugs? Are there going to be changes? – The subject is addressed at the 31:45 minutes mark in the discussion. Will there be bi-partisan support to help solve this increasingly important issue?

Will anything change for group health insurance clients? Or group benefits? – See the 44:00 minute mark for some answers to this question.

Good Neighbor Insurance also recently hosted an insurance panel on ACA Healthcare especially as it addresses group health insurance and international businesses and expatriates. You can get a copy of the transcript by simply emailing group@gninsurance.com and requesting it.