California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

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Perspectives On Health Law: President Obama Is ‘First To Say We Can Make Improvements’

Read recent commentaries about the future of the Affordable Care Act.

The New England Journal of Medicine: Repealing The ACA Without A Replacement — The Risks To American Health Care
I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans know the security of health care in a system that is more effective and efficient. At the same time, there is more work to do to ensure that all Americans have access to high-quality, affordable health care. What the past 8 years have taught us is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people. That is why Republicans’ plan to repeal the ACA with no plan to replace and improve it is so reckless. ... This approach of “repeal first and replace later” is, simply put, irresponsible — and could slowly bleed the health care system that all of us depend on. (And, though not my focus here, executive actions could have similar consequential negative effects on our health system.) If a repeal with a delay is enacted, the health care system will be standing on the edge of a cliff. (President Barack Obama, 1/6)

Los Angeles Times: Obamacare Repeal: A Bad Goal That’s Proving Hard To Achieve
Repealing the law is bad enough, but doing so without an alternative that could preserve coverage for the estimated 20 million Americans who gained it through Obamacare would be reckless and irresponsible. And that’s just one problem. Here’s another: Some Republicans are now questioning whether it’s wise to revoke all the tax increases in the Affordable Care Act, which offset some of the cost of the healthcare subsidies for lower-income and elderly Americans. In fact, there are at least two compelling reasons to leave those tax hikes in place. (1/5)

Orange County Register: The Life Or Death Fight To Preserve Medicaid Expansion
California is one of 32 states that now extend Medicaid benefits to all adults who meet income eligibility under the Affordable Care Act. Since 2014, California has expanded enrollment from 8 million individuals to 13.5 million individuals, more than a third of the state’s population. California has the highest Medicaid enrollment in the country. (Ellen Rothman, 1/1)

The New England Journal of Medicine: The End Of Obamacare
Donald Trump’s triumph in the 2016 presidential election marks the beginning of an uncertain and tumultuous chapter in U.S. health policy. In the election’s aftermath, the immediate question is this: Can Republicans make good on their pledge to repeal Obamacare? The Affordable Care Act (ACA) has persisted largely thanks to President Barack Obama’s protection. With Trump in the White House and Republicans maintaining House and Senate majorities, that protection is gone. (Jonathan Oberlander, 1/5)

Los Angeles Times: Some Obamacare Advice For Republicans: First Do No Harm
[House Speaker Paul] Ryan promised “bold action” to make things better, but he and other Republican lawmakers can’t be more specific about their plans because they don’t know themselves. All they’re saying now is that they’ll take apart Obamacare in bits and pieces, and they’ll come up with a replacement in perhaps a few years. The insurance industry and most major medical groups say this is crazy. They’ve warned that all this uncertainty will destabilize insurance markets and will push many insurers to stop selling coverage to individuals, putting lives at risk. (David Lazarus, 1/5)

The New York Times: A Bipartisan Reason To Save Obamacare
The A.C.A. is more than insurance. As the Times reported yesterday, the law is leading a transformation of America’s health care system. It’s a change that nearly everyone, Republicans and Democrats, agrees is desperately needed — and for it to happen, the relevant parts of the A.C.A. must be preserved. The transformation moves health care away from a fee-for-service model, which pays doctors and hospitals according to the number of procedures they do, toward value-based care, which pays based on what helps patients get better. (Tina Rosenberg, 1/4)

Bloomberg: Republicans Really Can Pretend To Repeal Obamacare
The Republicans may have a way out of their "repeal and replace" Obamacare position, which is proving a lot more difficult than they realized. The catch is that their alternative may be even more phony. It could phonier than the "repeal and rename" strategy I anticipated. For years, I've said that Republicans could simply rename the Affordable Care Act and its various components -- so we might have, for example, "Ronald Reagan Freedom Insurance Choices" instead of the current Obamacare marketplaces. The reasoning is that while Republicans have hated "Obamacare" as a symbol of the president they can't stand, few of them are particularly upset about the law itself. (Jonathan Bernstein, 1/5)

Bloomberg: Republicans Should Save These 3 Unpopular Parts Of Obamacare
As Republicans consider repealing Obamacare, what bits should they be looking to keep? A lot of people will have different answers to this, of course, but to my mind the most important and unobjectionable bits of Obamacare are payment reform, comparative-effectiveness research and the tax on gold-plated health-care plans. These are not, you will notice, the most popular bits of Obamacare, the one that President-elect Donald Trump seems to favor. Nor are they the most famous. But all three attempt to tackle the biggest problem with our health-care system: its exorbitant cost. (Megan McArdle, 1/5)

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