Meadows: 'We're Very Close' on Obamacare Repeal, Replace

His promise was based upon a good-faith but faulty belief that Republicans had an alternate health care plan to replace Obamacare. Here's how what's going on in Washington might touch you.

Republicans, insisting that the funds weren't explicitly allocated by Congress, thought they might be able to crash the insurance markets by using the courts to scrap the subsidies, making it vastly more hard for struggling families to pay for their medical care. Only 2 percent of Republicans said the law should not be repealed.

Republicans had long derided ObamaCare's "essential health benefits", which mandate 10 health services that insurance plans must cover. One avenue would involve stopping payments to insurers that lower deductibles and other cost-sharing for 58 percent of those enrolled in ACA coverage. Also, the CBO's analysts said the overall savings for the federal government wouldn't be as large as hoped for, partly because of the medical costs of the millions of people who would lose coverage.

A Trump administration official said that while the lawsuit is being litigated, the cost-sharing subsidies would be funded. They left the market or made consumers pay more out of pocket or through higher premiums. It was partly restored after an outcry.

Trump told Fox Business he did not want to "put deadlines" on either legislative goal, but he insisted that "health care's gonna happen at some point" and said that passing health care legislation could save money and make it easier to pass a tax overhaul afterward. So would health insurance coverage for tens of millions of Americans.

Republicans sued the Obama administration, saying that the spending - in the absence of an appropriations law - was unconstitutional. That would cause more hikes in premiums and exits by insurers.

I am really interested to see the Congressional Budget Office assessment of this try. Even more insurers could withdraw from the public marketplaces where more than 10 million Americans obtained coverage a year ago. Perhapsmore employers could gain religious exemption from providing birth control. Thirty-one states and the District of Columbia expanded Medicaid to most adults who have incomes below about $16,000 for singles and $28,000 for a family of three (although eligibility varies).

Like John Sexton, I'd call it highly unlikely. We can't say the same thing about politicians.

Donald Trump's plan to repeal and replace the Affordable Care Act with a far-right alternative hasn't gone especially well, but if the Republican White House was determined to sabotage the health care system, it has a variety of options available.

At the same time, however, Republican support for the ACA's Medicaid expansion is growing, which might mean overall cutbacks would be less severe or Medicaid coverage could increase among the 19 states that didn't expand the program under the ACA. Both those ideas could lead to less coverage or greater out-of-pocket expense. The survey also found small businesses opposed key components of the replacement plan, and the only specifics of the plan they did support are provisions already available under the ACA. Changing Medicare likely would trigger loud objections from AARP and other powerful lobbies.

The president at first seemed to back the AHCA.

"I don't think. Trump wants to meddle with Medicare or Social Security", White House chief of staff Reince Priebus told the press in January.

Any replacement law signed by Trump might not include those protections.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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