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Thursday, December 8, 2016

The First Glimpses Of A New Healthcare Program Starting To Come To Light

Health Insurers Willing 

to Give Up a Key

 Obamacare Provision


  • Lobby group is open to repeal of individual insurance mandate
  • AHIP wants incentives to buy insurance, continued payments


Trump's Health-Care Vision: The Winners and the Losers
U.S. health insurers signaled Tuesday that they’re willing to give up a
 cornerstone provision of Obamacare that requires all Americans to 
have insurance, replacing it with a different set of incentives less loathed
 by Republicans who have promised to repeal the law.
Known as the “individual mandate,” the rule was a major priority for the
 insurance industry when the Affordable Care Act was legislated, and also 
became a focal point of opposition for Republicans. In a position paper
 released Tuesday -- the first since President-elect Donald Trump’s victory -- 
health insurers laid out changes they’d be willing to accept.
“Replacing the individual mandate with strong, effective incentives, such
 as late enrollment penalties and waiting periods, can help expand coverage
 and lower costs for everyone,” AHIP said.
That also includes openness to Republican ideas such as an expanded role
 for health-savings accounts and using so-called high-risk pools to cover 
sick people. In return, insurers are asking Republicans to create strong 
incentives to buy insurance, and to ensure the government continues to
 make good on payments it owes insurers under the ACA. The paper was 
released by America’s Health Insurance Plans, or AHIP, the main lobby
 for the industry.
“Millions of Americans depend on their current care and coverage,” AHIP 
said in the document outlining its positions. The group called on lawmakers
 to “ensure that people’s coverage -- and lives -- are not disrupted.”

Republican Replacement

Now that they’re set to gain control of the White House, Republican
 lawmakers are working to define their vision for replacing the law after
 years of attempts to repeal it. Obamacare brought insurance coverage to 
about 20 million people via an expansion of Medicaid and new insurance
 markets, and repealing the law without a replacement would leave those
 individuals without coverage.
Trump has said that repealing and then replacing the law will be one of
 his first priorities. Republicans in Congress, however, have signaled that
 they’ll need time to write a replacement -- potentially via a years-long
 delay between passing a repeal and implementing it -- to craft a replacement.
 And AHIP on Thursday said insurers will need at least 18 months to create 
new products and get them approved by state regulators, if Republicans 
change the market. It could take even more time to educate consumers 
and change state laws, AHIP said.
“It’s taken six years to get where we are now and to demonstrate the
 failure of Obamacare, so it’s going to take us a little while to fix it,” said 
Senator John Cornyn of Texas, a member of the Republican leadership 
in the chamber.

Medicaid Changes


Republicans may also make substantial changes
 to Medicaid, by turning the joint state-federal
 program into one where the U.S. sends “block
 grants” to the states, which exert more control.
 Vice President-elect Mike Pence said on CNN
 Tuesday that the Trump administration will “develop a plan to block-grant
 Medicaid back to the states” so they can reform the program. Some Medicaid
 programs are administered in part by private insurers.
AHIP said any such plans should ensure that payments are adequate to meet
 the health needs of individuals in Medicaid coverage. And they should ensure
 that when enrollment increases in an economic downturn, funds are 
available to help states deal with the increased demand, AHIP said.
AHIP is open to working with Congress on replacement plans for the ACA,
 said Kristine Grow, a spokeswoman for the lobby group. The document is 
the first detailed look at AHIP’s priorities.
Big insurers like UnitedHealth Group Inc. and Aetna Inc. are already 
scaling back from the ACA’s markets, because they’re losing money. At the
 same time, remaining insurers are boosting premiums by more than 20
 percent on average for next year.
Trump’s election increased the level of uncertainty in the market, and a
 repeal bill without something to replace the law could destabilize it
 further. To shore up insurance markets, AHIP says lawmakers should
 fund a program, known as reinsurance, designed to help insurers with 
high costs, through the end of 2018, and avoid cutting off cost-sharing
 subsidies for low-income individuals.

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