The Latest on the Future of the Affordable Care Act

Armchair Quarterbacking - What Will ACA Repeal and Replace Look Like?

5/19/17Sabotage and Uncertainty Jeopardizing ACA Marketplaces, Insurers and Regulators Confirm - Statements from insurers and regulators, including Maryland's CareFirst CEO, and Evergreen Health. Center on Budget Policies and Priorities

5/8/17Health Act Repeal Could Threaten U.S. Job Engine - NYT

5/6/17Maryland faces potential budget emergency under federal health overhaul - We stand to lose $2 billion in Medicaid funding alone. - WBAL

5/5/17Senate GOP vows big changes for ObamaCare bill - The Hill

5/4/17 - GOP House passes the American Health Care Act to repeal and replace the Affordable Care Act with narrowest of margins - Politico

5/1/17 Amendment to ACA Repeal-and-Replace Bill Likely to Increase Premiums and Decrease Covered Services for Many - The Commonwealth Fund’s David Blumenthal, M.D., and Sara Collins write that the amended American Health Care Act is still likely to significantly increase the numbers of uninsured Americans, raise the cost of insurance for many of the nation’s most vulnerable citizens, and cut and reconfigure the Medicaid program. The amendment offers states the option to apply for waivers to reduce the Affordable Care Act’s consumer protections that are currently in place.

4/27/17Compare Proposals to Replace The Affordable Care Act - from the Kaiser Family Foundation, and updated interactive comparison tool based on the latest amendments to the AHCA.

4/26/17Kaiser Health Tracking Poll - Late April 2017: The Future of the ACA and Health Care & the Budget - Kaiser Family Foundation poll finds that the public is more favorable (48 percent) than unfavorable (41 percent) in their views of the 2010 health care law this month.

4/25/17The MacArthur Amendment Language, Race In The Federal Exchange, And Risk Adjustment Coefficients - Tim Jost writing in Health Affairs Blog shows that health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions.

4/25/17The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments - the Kaiser Family Foundation states that to compensate for the added cost to insurers of the reduced cost-sharing, the federal governments makes payments directly to insurance companies. The Congressional Budget Office (CBO) estimates the cost of these payments at $7 billion in fiscal year 2017, rising to $10 billion in 2018 and $16 billion by 2027.

4/20/17New GOP Health Proposal Could Ditch Protections For People Who Are Sick - NPR: The latest proposal allows states to make changes to the ACA's rules governing health insurance policies and markets, in an effort to allow some states to offer stripped-down policies with lower premiums.

4/20/17Latest ACA Repeal Plan Would Explode Premiums for People with Pre-Existing Conditions - The Center for American Progress estimates that individuals with even relatively mild pre-existing conditions would pay thousands of dollars above standard rates to obtain coverage.

4/19/17Many Veterans Gained Health Care Through The Affordable Care Act - NPR: Almost half a million veterans gained health care coverage during the first two years of the Affordable Care Act, a report finds.

4/12/17What Trump Can Do Without Congress to Dismantle Obamacare - A lot, according to the NYT.

4/6/17House GOP Moves To Add ‘Invisible Risk Sharing Program’ To AHCA; Other ACA Developments - Tim Jost at Health Affairs Blog, looks at risk pools and other AHCA issues.

4/4/17House ACA Repeal Bill Would Be Largest Robin-Hood-in-Reverse Transfer in Modern U.S. History - the Center on Budget Policy and Priorities says that the AHCA would cut more than $1.1 trillion from Medicaid and from subsidies that help moderate-income people afford health coverage and dedicate most of the savings to tax cuts for high-income Americans and corporations.

4/4/17To Help Stabilize the Individual Health Insurance Market, Take ACA Repeal Off the Table - The Center on Budget Policy and Priorities thinks stabilizing the individual health markets should be Congress' #1 priority. 

4/4/17Affordable Care Act Gains Majority Approval for First Time - Gallup. Fifty-five percent of Americans now support the Affordable Care Act (ACA), a major turnaround from five months agowhen 42% approved and 53% disapproved. This is the first time a majority of Americans have approved of the healthcare law.

4/4/17Latest repeal bid may gut one of Obamacare’s most popular provisions - Politico. And then they came after pre-existing conditions...

3/31/17The Next Obamacare Battleground: Subsidies For Out-Of-Pocket Costs  - Kaiser Health News looks at the next battleground for healthcare - cost reduction subsidies. 

3/31/17What’s Next for the ACA and the People It Covers? - The Commonwealth Fund looks forward.

3/27/17A Grand Health Care Bargain: Let States Kill the Exchanges, But Add Public Options - Washington Monthly looks at a grand experiment. Could it work?

3/27/17Five Lessons From The AHCA’s Demise - Health Affairs Blog breaks down what went wrong and what we can learn from it.

3/26/17Here's the bipartisan path forward on health care: Andy Slavitt - USAToday. Slavitt puts says the failure of the AHCA bill provides an opportunity to end the divisiveness that hampered the Obamacare era and move forward in a bipartisan direction that focuses not on destructive rhetoric, but squarely on reducing premiums and expanding access for all Americans.

3/24/17Essential Facts About Health Reform Alternatives: High-Risk Pools - An explainer from the Commonwealth Fund shows that the history of high-risk pools indicates many sicker people would face high premiums and deductibles.

3/24/17Eliminating Essential Health Benefits Will Shift Financial Risk Back to Consumers - The Commonwealth Fund reports that if the ACA is replaced with state-determined essential benefits that don’t contain a minimum federal standard for health benefits, consumers can expect a return to a patchwork system where the adequacy of a person’s coverage varies widely depending on where they live. 

3/23/17CBO: Revisions to GOP health plan add to deficit without improving coverage - Politico reports that the new CBO scores on the amended version of the AHCA would cost $186 billion more over 10 years compared to their initial version, according to a 10-page report from the nonpartisan scorekeeper. The American Health Care Act is now expected to reduce the deficit by $150 billion over 10 years, a decrease from the $337 billion initially projected. And it still forecasts that 24 million fewer people will have insurance in a decade.

3/21/17An Update on the Three Prongs of Health Reform - from the National Academy for State Health Policy: Congress released Manager’s Amendments to the AHCA, inclusive of a series of policy and technical changes to the bill. Here are full statutory text of policy and technical amendments.

3/15/17Kaiser Health Tracking Poll: ACA, Replacement Plans, Women’s Health - the Kaiser Family Foundation March tracking poll, showing that the public’s overall views of the ACA hold steady this month, with 49% holding a favorable view of the 2010 law and 44% holding an unfavorable view.

3/14/17The CBO's other bombshell: the Affordable Care Act isn't imploding - From Vox, the notion of "implosion" has given the campaign for a massive rewrite a sense of urgency that, according to the CBO, is basically unwarranted.

3/14/17CBO Projects Coverage Losses, Cost Savings From AHCA; Administration Signals Flexibility To Governors On Waivers - yet another excellent analysis by Tim Jost in Health Affairs. This time, on the CBO scoring of the American Health Care Act.

3/14/17Defunding Planned Parenthood would lead to thousands more births, CBO says - the Washington Post looks at the bill from a women's healthcare perspective. 

3/13/17How the GOP's Health-Care Bill Would Affect People Insured Through Work - from the Atlantic. Much of the analysis of the bill focuses on people insured through the ACA marketplace, and Medicaid, but the ACA is a broad piece of legislation which also affects everyone with private insurance.

3/13/17The GOP health plan is an act of class warfare by the rich against the poor - Vox looks at the impact on the poor and elderly.

3/13/17CBO: 24 million fewer insured under House bill repealing Obamacare - Politico looks at the much-anticipated Congressional Budget Office analysis that would leave 24 millions people uninsured.

3/11/17The major critics of the GOP’s health reform plan, in one chart - from Vox. You’ll notice the list is pretty broad, and that it includes some of the most powerful lobby groups on the Hill, as well as influential conservative thinkers and right-wing media.

3/10/17 - Why the House Repeal Bill Is Unlikely to Stabilize Insurance Markets - another excellent piece of analysis by Tim Jost writing at the Commonwealth Fund

3/8/17Who Wins and Who Loses Under Republicans’ Health Care Plan - great set of maps from the Kaiser Family Foundation, which estimated the subsidies for every county in the United States across three variables. The result reveals stark contrasts in federal support, particularly for the poor. 

3/7/17 Hospitals come out against GOP healthcare bill - The first of many healthcare organizations and groups as it turns out. The Hill reports.

3/7/17Examining The House Republican ACA Repeal And Replace Legislation - solid analysis of the American Health Care Act by Tim Jost at Health Affairs.

3/6/17 - The Parts of Obamacare Republicans Will Keep, Change or Discard - The NYT looks closely at the first glimpse of the House GOP bill which was unveiled Monday. Still no details on the cost, how it will be funded, or how many people it will cover.

3/4/17High anxiety: Healthcare execs want coverage continuity - Modern Healthcare poll of 110 CEOs, who are impatient to see the details of GOP plans so they can offer informed input.

2/28/17Trump proposed 5 specific policies to replace Obamacare. Here’s how they work. -  President Donald Trump used his first congressional address to deliver a five-point outline of some policies he supports in an Obamacare repeal-and-replace plan. Vox reviews.

2/28/17States Be Warned: High-Risk Pools Offer Little Help At A High Cost - Health Affairs Blog: "While changes to expand affordability, accessibility, and quality of health care should be debated, evidence suggests Congress should keep the ACA’s set of protections for people with pre-existing conditions intact."

2/24/17Leaked GOP Obamacare replacement shrinks subsidies, Medicaid expansion - Politico breaks the first look at the GOP replacement plan.

2/24/17 Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid - The poll finds attitudes towards the Affordable Care Act (ACA) have shifted with a larger share reporting a favorable opinion towards the law (48%) than reporting an unfavorable opinion (42%). This is the highest level of favorability of the ACA measured in more than 60 Kaiser Health Tracking Polls since 2010.

2/17/17 - Three Ways Republicans Want to Replace Obamacare - Tax credits, Health Savings Accounts and overhauling Medicaid. CNN Money reports.

2/16/17 - House GOP Documents Outline Plan to Replace Obamacare - PBS  provides links to the first two documents which outline an initial approach by House Republicans. They are the first printed summaries of a GOP health plan include a PowerPoint presentation with messaging recommendations and a 19-page paper that outlines the direction Republicans hope to take with new health care legislation.

2/15/17 - ACA Repeal Would Have Outsized Impact on Women of Color - from Rewire News, a report on the state-by-state analysis by the National Women’s Law Center (NWLC) found the ACA’s repeal would most imperil the coverage of women enrolled in Medicaid, including working women insured through Medicaid and women of color. You can access the full report in our Resource Section.

2/09/17 - Hospitals in low-income areas could lose billions in Obamacare repeal - Hospitals serving low-income communities would lose $40.5 billion in potential losses from 2018 through 2026 if Congress repeals the ACA without a comparable replacement - The Hill.

2/09/17 - The Reality of Repeal - A report absolutely chock full of links, data, polls, facts and figures on why the ACA needs to stay instead of repealed from

2/08/17GOP boxed in replacing unpopular Obamacare coverage mandate - Good analysis of the pros and cons of the ACA's most popular provisions, and the dangers in repealing them from Politico.

2/01/17 - ACA Has Improved Consumers' Ability to Purchase Health Plans - A report from the Commonwealth Fund shows dramatic increases in peoples' ability to purchase health care plans on their own. Increase primarily for the poor, disabled, and those with pre-existing conditions.

1/31/17 - 8 Ways to Judge Potential ACA Replacement Plans - From Families USA, a handy Fact Sheet which spells out the components that the various replacement plans being bandied about must or should include. 

1/19/17 - Why Reproductive Care is a Favorite Target- from The Century Foundation, a good look at where we've been, where we are, and what we can expect in legislation and policies for reproductive rights.

1/03/17 - From Obamacare to Trumpcare - from Health Affairs, regularly updated list of news articles and resources on the ACA and its future.

12/13/16 - Marylanders have more coverage, lower premiums under the ACA - HHS released an extensive, data rich, report, summarizing the impact of the ACA state by state. This article teases out the MD specific data - Baltimore Business Journal

12/09/16 - Fact Sheet: Affordable Care Act Repeal - Center for American Progress - Data and talking points on what repeal without replace really means.

12/07/16 - Dems and Liberals Join Forces to Fight ACA Repeal - Over the last week or so, a number of groups and organizations have joined forces to collect stories from consumers and families about how the ACA has affected their lives, and their fears about a repeal. - Politico - remember, you can share your stories here, we'll make sure they're heard.

12/07/16 - The Issues at Stake for Contraception Coverage - A really good, really comprehensive review of the last 25 years of health policy related to contraception policies, and what's at risk with an ACA repeal. - Kaider Family Foundation

12/05/16 - Freedom Caucus Opposes GOP's ACA Replacement - A three-year phaseout 'will meet with major resistance,' said the group's incoming leader, Rep. Mark Meadows - POLITICO

12/01/16 - Though the ACA Faces Tough Critics, Millions are Having an Easier Time Paying Medical Bills - Citing a report from the National Center for Health Statistics at the CDC, it was found that dramatically fewer people are struggling to pay medical bills, compared to what they faced before the ACA. The number declined by nearly 13 million people, or 22%. The trend was consistent across demographics and insurance types. - Center On Health Insurance Reforms

12/01/16Is the GOP Having Second Thoughts about full ACA Repeal? Republicans have shifted a full SEVENTEEN points from wanting the law repealed entirely, to simply scaling back or amending what the law does since the election. Lots of other good data regarding consumer attitudes towards the ACA too. - Kaiser Health Tracking Poll, November '16

11/29/16Future of Affordable Care Act in Maryland is Uncertain.  "When we woke up on Wednesday morning (after the election), our agendas changed completely. Instead of continuing to move forward, we are now looking at an agenda that requires us to look carefully at those state laws and those state regulations and make sure that we can provide policies and advocacy to make sure that Maryland keeps moving forward." Leni Preston, CHF President - Capital News Service

11/29/16Women Likely to Pay More than Men for Health Care under Trump. Contraception (if it's covered at all), pre-natal care, childbirth, and general health insurance. All covered under the ACA with a mandate for equal prices for equal care, and all up for grabs. - Kaiser Health News

11/28/16 -Picking Tom Price to head the HHS, signals near certainty of an ACA repeal. Rep. Price is the author of the Empowering Patients First Act, one of the most detailed proposals put forth so far, and one from our perspective that is not good for consumers. - Vox

11/21/16 - Let's Say Obamacare is Repealed - What Then? - More armchair quarterbacking and predictions from the folks in the know at the New York Times

11/17/16 - 7 Obamacare Replacement Scenarios - this was one of the earliest, and most comprehensive reviews of the various repeal and replace scenarios. Highly recommend as a first read if you want to get the 30,000 foot view of all the possibilities. - Vox

11/11/16 - President Elect Trump's Health Care Platform - Highlights include repealing the ACA and replacing it with a solution that includes Health Savings Accounts (HSAs). He says the goal will be to create a patient-centered healthcare system that promotes choice, quality and affordability. No details provided. - Trump Website

11/10/16 - The Affordable Care Act in 2017: Challenges for President Elect Trump and Congress: It is critical that the nation remain committed to affordable, high-quality care for everyone.- Commonwealth Fund

11/09/16Day One and Beyond: What Trump's Election Means for the ACA - Timothy Jost at Health Affairs Blog - gave one of the first, and most comprehensive overviews of what this could mean for the ACA the day after the election. - Health Affairs Blog

11/09/16Trump could change health insurance programs that affect hundreds of thousands of Marylanders: A local perspective featuring Consumer Health First President, Leni Preston. - Baltimore Sun