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White House pushes uncertain bid to revive health care bill

21 April 2017, 08:35 | Darin Griffith

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Later in the day, Bloomberg reported that House GOP leaders were balking at a White House push for a quick vote on the legislation when Congress returns from recess on Tuesday.

The original bill ran aground last month after Freedom Caucus members pushed at the last minute to scale back or eliminate these protections, which they argue is the only way to lower premiums. The President tweeted that he blamed the House Freedom caucus for the bill's demise, despite additional opposition from moderates to the bill that House Republican leadership crafted and championed.

The proposed changes would also allow states to waive ObamaCare's requirements that insurers offer certain benefits, including mental healthcare and prescription drugs.

The House legislation would dismantle the Obamacare extensive system for expanding health insurance coverage to millions of Americans, cutting almost $1 trillion in federal aid that has allowed states to expand the Medicaid safety net programs and scaling back tax subsidies that help millions of low- and middle-income Americans buy commercial health plans.

States could request an exemption from the rule meant to ensure that people with pre-existing conditions could not be charged prohibitive premiums, but only if those states establish a high-risk insurance pool.

At the heart of the negotiations are two provisions of Obamacare that have been brought up before: essential health benefits and community ratings.

President Donald Trump touted progress as top House Republicans may be nearing a significant breakthrough on efforts to repeal and replace Obamacare, one month after a Republican health care bill was pulled from the House floor.

Brat said that assuming the outline is translated into legislative text he backs and is added to the health care bill, he would now support the legislation and believes most of Freedom Caucus' three dozen members would also back it. Chris Murphy, D-Conn. "Everybody hated it..." Democratic negotiators are likely to resist providing the down payment that Mulvaney says Trump wants for construction of the wall, but the former GOP congressman from SC adds that "elections have consequences".

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"The Republican health care repeal bill was an unworkable, unpopular piece of garbage a month ago, and it still is today" he said. The credits would taper off for individuals who earn $75,000 or more a year.

About 7 million people now qualify for the subsidies.

The waiver would effectively undermine Obamacare's pre-existing conditions mandate, according to health care experts, because it would nullify the requirement that insurers offer coverage in a given area at the same price, regardless of health status. "So we think we've opened the door for that", Mulvaney said. To get those waivers, states would need to have high-risk pools - government-backed insurance for the most seriously ill people, a mechanism that has often failed for lack of sufficient financing.

The American Health Care Act would penalize those who have lapses in coverage with a 30 percent surcharge on their premiums when they sign up for insurance again. Insurers say the penalty is not high enough.

For instance, states could choose to put people with pre-existing conditions in "high-risk pools". But some insurers say that is not enough. "But I suspect it might get some folks on board that maybe weren't before". "We will be analyzing the impact of specific proposals for how such funding and risk pools would work".

Of greater concern for insurers is the future of an Affordable Care Act provision that helps subsidize co-payments and deductibles for low- and medium-income people.

A one-page description of the plan, dated April 13 and first published by Politico on Thursday, suggests the waivers would be easy to obtain - a key selling point for members of the hardline House Freedom Caucus, which has pushed to deregulate the insurance market for people who don't hold insurance from a job or government program and buy it on their own. Trump has publicly toyed with the idea of withholding the subsidies as a way to force Democrats to negotiate over the House proposal, and Verma told the insurers they should look to Congress to appropriate the money.



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