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Zach Cahill and David White

Summertime is vacation time!  This week we are taking a brief field trip from Washington to explore the problems facing state individual healthcare marketplaces around the country.

Improving the number of people covered by insurance was one of the stated goals of the Affordable Care Act (ACA). Today, nearly half (49%) of all Americans receive health insurance from their employer. Government programs like Medicare and Medicaid cover another 36%. Only 7% of Americans are in the individual (also called non-group) marketplace.

Zach Cahill and David White

Senate Republicans today released the Better Care Reconciliation Act, S. 1628, their plan to repeal and replace the Affordable Care Act (ACA), also known as Obamacare.  This is the Senate’s response to the American Health Care Act (AHCA), which the House passed in early May.  Like the House bill, the legislation is designed to repeal or revise portions of Obamacare, a law that congressional Republicans have opposed since its passage seven years ago.

Zach Cahill and David White

Today, the American Society of Nephrology (ASN) voiced its concerns to the leadership of the US Senate that “the Better Care Reconciliation Act (the Senate version of Affordable Care Act repeal) passage would negatively impact millions of patients, particularly those with kidney failure, advanced kidney diseases, and other chronic illnesses.” You can read the letter here and a statement from ASN President Eleanor Lederer here.

Zach Cahill and David White

Déjà Vu

We’ve been here before – a secret bill has been released with a looming timeline to vote, only to be pulled at the last minute.

That is the story of the Better Care Reconciliation Act this week in the Senate and it sounds eerily similar to what happened over the spring with the House’s American Health Care Act.

Both bills are designed to repeal and replace the Affordable Care Act (ACA).  Both bills faced opposition from all sides and had to be suddenly and unceremoniously removed from the voting schedule. Although the House version was resurrected a month later to be passed by a slim majority.

Zach Cahill and David White

As we promised last week in our inaugural “Following the Trail,” we are going to keep you on track with the ACA repeal/repair/replace debate. We’ll review key events and introduce you to a new player, Seema Verma.

Key Events This Week:

Zach Cahill and David White

Congress is out of session this week, and we are taking advantage of the slowdown in Washington to give you a thirty thousand foot view of a few healthcare reform ideas that are common to many Republican plans. Will these policies actually become law?  There is no certainty, but you should know how these reforms might work, and how they might impact you and your patients.

What to do with pre-existing conditions?

Zach Cahill and David White

Two House committees — Energy and Commerce, and Ways and Means — plan to begin voting as early as Wednesday, March 8, or next week at the latest, on portions of their closely guarded legislation to repeal and replace the Affordable Care Act (ACA).  While we have seen start dates come and go, Hill sources believe the horses are loading into the gates.  House and Senate Republican leaders want to push the package through the House this month and hope the Senate can consider it by the early April congressional recess.

Zach Cahill and David White

This week House leadership publicly released the details of the American Health Care Act (AHCA), the foundation of the GOP's efforts to repeal and replace the Affordable Care Act (ACA).

The AHCA was initially released to three committees—Ways and Means, Energy and Commerce, and Education and the Workforce (review only). Ways and Means passed the legislation early on March 9 after a contentious 18-hour debate.  That afternoon, the Energy and Commerce Committee voted passed the bill, after 27 hours of continuous debate. Democrats were especially concerned that the bill had not yet been given a “price tag” by the Congressional Budget Office.

Zach Cahill and David White

Twenty-four million Americans will be left without health coverage if the American Health Care Act (AHCA) is signed into law. The Congressional Budget Office (CBO) reported this sobering number late Monday, March 13 – once again reshaping the landscape of the health care debate in Washington. 

Key Takeaways from CBO report

The CBO is a non-partisan organization whose primary mission is assessing the impact of legislation on the federal budget, debt, and deficits. Though it covered much more, the cost of changes to health insurance coverage was the most anticipated outcome of the report. The CBO estimated that repealing the Affordable Care Act’s (ACA) individual mandate (the requirement that everyone have health insurance) could drop the number of patients in the individual market by 14 million in 2018. 

Zach Cahill and David White

This past week has been a rollercoaster as the effort to repeal the Affordable Care Act (ACA) continues. We expected a vote on the American Health Care Act (AHCA) Thursday night, but at the time of publication, votes were postponed until Friday afternoon. Up until noon on Thursday, both President Donald Trump and Speaker Paul Ryan expected to hold a vote to repeal parts of the ACA and replace it with the AHCA on Thursday night; however, that vote did not materialize and many obstacles are still to be overcome.