Life after Obamacare: Some anxious to see if Trump ends ACA, what happens next
Following the election of Republican candidate
Before the Affordable Care Act was enacted in 2010 under outgoing President
"In their minds, they're going to be thrown off the ACA. A lot of people think they're being targeted," he said. "They only know the
Eserman said he tries to reassure clients by telling them, "I don't think the ACA can be repealed on its face." But he admits: "I'm not sure whether or not I'm just blowing smoke."
The truth is that no one, including Republican members of
In an interview Friday with the
Meanwhile, experts say they're telling consumers to continue signing up for 2017 plans during the current enrollment period scheduled to end
"We're telling people that we're still enrolling for 2017, that we're still moving forward the way we were," said
Those enrollments represent a contract between insurance companies, the federal government and roughly 20 million consumers nationwide -- including 1.2 million in
A more likely scenario, they say, is for
Florida Blue, a
"The law has been in place for six years and the impact to the 20 million people who now have health insurance under the ACA must be considered," the statement said.
Florida Blue's mission "to help people and communities achieve better health has not changed and we believe that our goal of providing continued access to quality and affordable health care is one shared by many, including those that will lead and serve in the new administration.
"We intend to work diligently with newly elected federal officials, as well as with our own state legislation, to continue to deliver on our mission."
Repeal of the legislation that made the Affordable Care Act law of the land would require a 60-vote, filibuster-proof majority in the
In addition, the ACA is too tightly interwoven with the two other major federal health programs,
Because that process requires just a simple 51-vote majority for passage, it could be used to quickly kill the ACA's federal tax credits, the individual mandate, and
Use of the reconciliation process to kill those Obamacare cornerstones would essentially kill Obamacare, Cox said. But it wouldn't kill the ACA provision that bars insurance companies from denying coverage to people with pre-existing conditions, which would require a filibuster-proof, 60-vote Republican majority or enough
That's a problem, experts say, because taking away the requirement that consumers buy health insurance while the pre-existing conditions provision remains in place would saddle insurers with the responsibility to cover the sickest and costliest patients without a guaranteed pool of healthy premium-payers.
And that, Cox said, would send the individual health insurance market, subsidized or not, into a "death spiral" that would end with insurance companies simply pulling out of the individual market altogether.
Rather than taking a guillotine approach to repealing the ACA, Cox expects
Trump's campaign website includes a health care policy paper with some broad pledges.
In addition to removing the health insurance purchase requirement, Trump promised to make health insurance premiums fully tax-deductible; allow insurers to sell products across state lines; fund
Also, the site says Trump would "review basic options for
Pence's program extended
The Obama administration approved Pence's
"This plan would fit into what Trump is saying about health savings accounts," Cherry said. "And perhaps states could decide whether to keep eligibility to the traditional
Wolfson predicts Obamacare will be replaced with something that more closely resembles "any other expense, like a TV or phone," than an entitlement. The next iteration of health insurance, he thinks, won't charge consumers for services they don't use; will cover people with pre-existing conditions through subsidized high-risk pools or catastrophic coverage; and will pay providers based on patient outcomes rather than traditional "fee for service."
It will also build upon cost-savings measures that have evolved under Obamacare, such as narrow coverage networks and increased use of long-distance telemedicine visits, Wolfson said.
During the transition, patients with HIV/AIDS or other serious illnesses will likely lose some of the benefits they've become accustomed to, he said.
"It's going to be a challenging transition for all of us," he said. "As has always been the case in health care, the blunt end of the sword hits the patient first."
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