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For Trump and GOP, ‘Obamacare’ repeal is complex and risky

  • ASSOCIATED PRESS

    President-elect Donald Trump speaks during a rally in New York. Here’s the idea: Swiftly pass a repeal of President Barack Obama’s health care law, perhaps so Donald Trump can sign it the day he takes the presidential oath. Then approve new legislation restructuring the nation’s huge and convoluted health care system despite Republican divisions, Democratic opposition and millions of jittery constituents.

WASHINGTON >> Here’s the idea: Swiftly pass a repeal of President Barack Obama’s health care law, perhaps soon enough for Donald Trump to sign it the day he takes the presidential oath. Then approve legislation restructuring the nation’s huge and convoluted health care system — despite Republican divisions, Democratic opposition and millions of jittery constituents.

What could go wrong?

With Republicans controlling the White House and Congress in January, they’re faced with delivering on their long-time promise to repeal and replace “Obamacare.” Here are hurdles they’ll face:

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SPEED VS DELIBERATION

Trump and congressional Republicans will be under intense pressure from their core conservative supporters to repeal Obama’s 2010 health care law — and fast. After all, Congress already sent Obama a repeal bill last January, which he vetoed, and many GOP voters will see no reason for delays this time.

But there probably won’t be anything fast about this process, which is likely to take at least months.

While the replacement effort is underway, Republicans will risk aggravating up to 30 million people who are covered by the law or buy policies with prices affected by its insurance marketplace. Democrats will be sure to accuse the GOP of threatening the health care of millions.

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A SOLUTION

Nothing’s been decided, but here’s one likely scenario:(backslash).

The new Congress, which convenes Jan. 3, tries to quickly approve legislation repealing Obama’s health care law, maybe completing it by Trump’s Jan. 20 inauguration or soon after. But the repeal would not take effect until the future, perhaps a year later, to give lawmakers time to fashion a replacement. The version Obama vetoed had a two-year delay.

Seemingly acknowledging that two-step process, Vice President-elect Mike Pence said Sunday on “Fox News Sunday” that Trump “wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare.”

Because Republicans will control the Senate by just 52-48, Congress will first have to approve special budget procedures to prevent Democrats from stopping repeal legislation by filibuster. Bill-killing filibusters require 60 votes to end.

But those special rules would apply only to items that affect the federal budget. Republicans, for example, would need a simple Senate majority to end IRS penalties against people who don’t buy insurance but would still need 60 votes — requiring Democratic support — for other changes such as raising limits on older people’s premiums.

House Budget Committee Chairman Tom Price, R-Ga., says that will restrain Republicans’ ability to ram a “lock, stock and barrel” repeal through Congress.

———

GOP RISKS

One GOP danger: Congress and Trump might repeal Obama’s law, but while they’re laboring on a replacement, nervous insurance companies begin pulling out of markets and raising premiums. Insurers have been doing that under Obama, but now it would occur under a Republican government.

Another hazard: Congress’ work could spill into the 2018 campaign season, when the entire House and a third of the Senate face re-election. Republicans will grow increasingly timid about anything that might anger voters.

“We want to be the rescue party instead of the party that pushes millions of Americans who are hanging by the edge of their fingernails over the cliff,” says Sen. Lamar Alexander, R-Tenn., who chairs the Senate Health committee.

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GOP PATHWAYS

Virtually all Republicans want to get rid of the health law’s mandates that individuals buy coverage or risk IRS fines, and that large employers insure workers.

They also want to erase taxes on higher-earning people and the health care sector. And they’d like to retain parts of the law guaranteeing coverage for people with pre-existing medical problems and keeping children under age 26 on family plans.

Unifying Republicans much beyond that is a work in progress.

Trump’s health care views have varied and lack detail. His campaign website touts tax deductions for health insurance premiums and permitting policies to be sold across state lines. He’d also revamp Medicaid, which subsidizes health coverage for low-income people, directing fixed amounts of money to states and letting them structure benefits.

House Speaker Paul Ryan, R-Wis., last summer unveiled an outline of the House GOP’s solution, though it lacked cost estimates and details. It would provide tax credits, impose taxes on the most generous employer-provided health care plans, revamp Medicaid and let Medicare beneficiaries pick private plans instead of today’s fee-for-service coverage.

Senate Finance Committee Chairman Orrin Hatch, R-Utah, has also advanced a framework relying heavily on tax credits.

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REMAINING QUESTIONS

Thirty-one states — including Pence’s Indiana, where he is governor — plus the District of Columbia have expanded Medicaid coverage to 9 million additional people under Obama’s law. Curtailing that program will divide Republicans.

Taxing the value of some employer-provided health plans, aimed at curbing the growth of costs, is “a political land mine,” says GOP economist Douglas Holtz-Eakin. Republicans have long resisted tax increases.

Obama’s law mandates coverage for individuals because without that requirement many healthy people would forgo policies, driving up costs for everyone else and destabilizing insurance markets. Ryan has proposed shielding people from higher premiums if they’ve had “continuous coverage,” allowing higher rates for people who have not had policies, but Republicans have yet to decide how to keep insurance markets viable.

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AP reporters Mary Clare Jalonick in Washington and Bill Barrow in Atlanta contributed to this report.

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  • take time to do the proper groundwork on providing health insurance without bankrupting americans.

    doing another pelosi rush just to pass legislation will result in another half baked proposal.

    and to all that lauded brandon dixon’s diatribe at hamilton: turns out he’s tweeted about raping drunk white chicks on st pat’s day, called for ho’s to to their jobs so the brothers wouldn’t be distracted with white chicks and said that he’d be using white women as jump offs (one night stands). that’s the kind of spokesman democrats praise.

    • After years of criticizing Qbamacare the republicans don’t really have a alternate plan to offer. All talk and no action or brainstorming. Well the ball is in their court and everyone is watching.They really have no excuse to screw up because they have the presidency, senate and house. The Chumps victory even took them by suprise and they are scrambling to figure which end is up.

        • Les I think it is obvious that the ship that is listing is yours. The Chump did not have a plan and so does the republican majority of congress. The people are watching and they will have to deliver on their promises. I’ll just observe how they dig themselves out of this circus. Didn’t vote for them so I don’t care but I’m sure that those of you who were so easily swayed by their fairy tales hope that your votes were not cast in vain.

        • “circus kaka? The real “circus” is watching all you Democrap losers whine. Trump wins 2 terms. Get used to it.

        • Has to make good on his promises first. Not to me cause I never believed in him but to the idi-ts who did like you.

        • Because the idi-t too busy on twitter. He is big time pilikia just like you. I think time for you to check in with your parole officer or shrink. Good night.

      • IRT Keaukaha, a plan to replace Obamacare is already in play and presented to the House floor when the legislation to repeal Obamacare is vote on and approved. The media is playing games with you and your believers. The repeal and replace is a signature part of President-elect Trumps economic and jobs plan.

        • Kuroiwaj talk is cheap. Payday is when the plan is delivered. Read the article again. When the profit driven insurers start to get nervous and withdraw as is happening as we speak from the affordable health care act. The Chump and his republican congress will be left holding the bag. My thoughts are that when you promise hard working blue collar workers the world you better be able to deliver or your celebration of victory will be very short lived.

        • “Delivered”,”holding the bag”,”promise”? Odummy and the Democraps “delivered” the so called plan all right. Damaged goods right from the start. “You can keep your doctor” “you can keep your plan”,”rates will go down”, remember that one kaka? The sick part about that is that Odummy and the Democraps KNEW that wasn’t true, yet they passed it anyway. Lie,lie lie. “Holding the bag”, you mean the bag of crap the Democraps left behind. Now you want the Republicans to fix their f–up. “Promise” you like the promise Odummy made to the American people? Really kaka, you better quit the bs while you can.

        • It will take 60 senate votes to repeal Obamacare. There are only 52 republicans in the Senate. How is Trump going to repeal Obamacare?!

    • I see your point about Mr. Dixon and his horrible sexual comments…I agree with you, he might be a great candidate for President in 2020 if Trump doesn’t want to run again. #MAGA

  • Allow the free market to work, and it will go a lot more smoother than they think, but they’ll likely have to tinker with it and that’ll screw it up.

  • Now it’s time for Democrats to do exactly what the Republicans have been doing for the last 8 years. Just say “NO” to ANYTHING that Trump and/or the Republicans suggest, and make it their mission to limit Trump to just one term. If it’s okay for the Republicans to do that, it should be equally okay for the Dems to follow suit.

      • Same way it didn’t help us the last 4 years. The republicans never wanted universal health for all Americans. Problem is now that they have the presidency and congress they won’t have anybody else to blame for their failures. It should be very interesting as to how they handle this dilemma.

        • You think they will pretty much repackage Obamacare and sell it as Trumpcare? And if they do, do you think the America that was against Obamacare will say that Trumpcare is a great thing, you know because of the color change? Or, does Trump eventually pitch a plan that someone else in his posse talks him into, since he doesn’t really seem to have a plan. Will it come down to who ever has his ear wins, an how much different is this from previous versions of Presidents?

        • There you go again kaka. The last 4 years Doctors and Health providers were bailing out Odummycare as fast as they could. Where you been kaka? Sleeping? You losers can take your sorry a–‘s and move Kahoolawe. Does that sound familiar kaka?

        • Meat you probably get free medical or at the funny farm in Kaneohe. You are a mystery to me but like those of you who have emotional baggage the Chump could give a sh-t about you. If you not rich then you no matter. Mark my words because you just dead weight. They only needed you because of your vote and now you are a victim of the worlds greatest con man.

        • You right kaka, I do have FREE Medical. From my employer. Nice employee benefit. Baggage? The only baggage I get is when we fly out. That’s the good kind. And we use it often too. And you right, I not rich, but so what. I still own my house, own 3 cars, and all paid for. And I will “mark” your words, cause after Mr. Trump wins his 2nd term, you will be dead weight. You make this too easy kaka.

        • You full of crap nobody really gets free medical. You either on your spouses plan or she’s on yours if you still working. If you work in the private sector then you usually have to work till you’re 65 when they qualify for Medicare. I am retired and part of my pension includes paid medical for my wife and I. I also own my home and have three cars. 2 SUVS and a imported coupe.

        • @Meat, can’t you make a comment without calling someone a name and being mean? You should really take a tip from keaukaha, instead of wishing she or he would die (“go down with the ship,” “dead weight” — sounds like you want them to be dead). keaukaha makes their points clearly and simply, without ugliness. You could do the same. Instead you lash out in anger. I don’t know why you want to make yourself look so bad.

        • Yes it was and how much better is America for his behavior? Now saying that the Democrats should do same thing to Trump isn’t going to help America. If payback is the goal then Democrats should do it but then the Republicans will do it when a Democrat takes office then the Democrats will do it when a Republican takes back the office then the Republicans will do it when a Democrat takes back the office and so on but we will still be the Greatest Nation on Earth, right? #MAGA

      • What I think doesn’t matter because I never believed that the Chump was what I was looking for to be the POTUS. The question that is most important is why did you vote for him and what are you going to do when he reneges on his promises. The only thing that is going to hold him accountable is the people that supported him period. It is very obvious in this forum that you have a lot of faith in the Chump. I hope that your disappointment will be my comfort to know that common decency will always prevail.

        • Try to tone down your anger, where does it say I voted for Trump? I get it though you just want your voice to be heard and aren’t really listening to others, too bad because some people are actually having a discussion with you.

        • Not angry but you have really toned down your enthusiasm for the Chump since the general election. It’s almost as if you realize that what the Chump said and
          what is really happening has you doubting a Chump presidency. For me it’s too late to be asking the questions that you have. It doesn’t matter who you voted for only that we will have to live with our choice.

        • Not toning it down, I actually just like to imagine what it might be like to be stuck in these bubbles that everyone gets locked in and try to see it from their point of view. I wonder how some of these comments get thought up and put myself in that mindset. I enjoy the intelligence on both sides of the argument that you and some others here share though, thanks again for you and the others continued efforts to #MAGA.

    • Hate to burst your bubble aim, but if you don’t know yet, Republicans hold both House AND Senate. You know what that means right? Democraps have absolutely NO chance at stopping anything the Republicans do. AAWWWWW, so sad for you losers.

    • No this is reality and if you voted for the Chump this is where you need to hold him accountable. Don’t know if that would be possible because I don’t think he understands what accountability is.

      • IRT keaukaha: Do you think the Trump supporter has a better ability or lesser ability to hold Trump accountable than the Obama supporter did with Obama? Do you think the Obama supporter held Obama accountable for his 8 years or did he get a pass like many think the Trump supporter will give Trrump?

        • Your problem is that the Chump doesn’t listen to ANYONE and it is too late to be asking that question. You own him. No going back.

  • The non-partisan Congressional Budget Office estimates that repealing Obamacare would add as much as $353 billion to the U.S. budget deficit through 2025,

    • Is your point that we are to deep into Obamacare and that it would cost too much to pull out now, so we might as well stay with it even though it doesn’t work? Or are you saying that it does work and if we pull out now it would hurt us financially?

  • This isn’t one of the better articles on the possible repeal of Obamacare. It’s written to grab readers’ attention and emotions. Better to read about it on investment related sources than news sources which have become supermarket tabloids. From what I read, portions of Obamacare will remain including continuing to insure those who have subscribed. Etc. Blah, blah. A bit too early to find facts or get too worked up about it.

  • Do away with the Obamacare. He is no longer president. Let Trump do his job. It may not be as bad as everyone thinks. Put everything in the hands of God.

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