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The new plot against health care

05 Jul

by David Leonhardt –

President Trump and Congressional Republicans aren’t giving up on their attempts to take health insurance away from millions of Americans. Here’s a quick guide to their efforts:
• A coalition of conservative groups, including the Heritage Foundation and others, recently released a new repeal plan. It’s similar to last year’s Cassidy-Graham bill. It would reverse Obamacare’s Medicaid expansion and end protections for people with pre-existing conditions.
Various Trump administration officials — including Alex Azar, the secretary of Health and Human Services — claim the bill wouldn’t hurt people with pre-existing conditions, but those claims are simply untrue. At least 20 million people would likely lose coverage if the new Republican plan becomes law, estimate Aviva Aron-Dine and Matt Broaddus of the Center on Budget and Policy Priorities.
The White House praised the plan, as Mary Ellen McIntire of CQ Now noted.
If Republicans keep control of Congress in this year’s midterm election, they are likely to make a new run at passing a plan along these lines next year. Every single Republican health care plan drafted so far would deprive a large number of people of insurance coverage and raise costs for many others. The main point of the plans, in fact, is to reduce federal spending on health care — largely to reduce taxes on the affluent.
Health care is very much on the ballot this year.
• In the meantime, the Trump administration continues to take steps to weaken Obamacare through executive action.
Its boldest attempt is its decision to stop defending the law against a lawsuit filed by some Republican state officials. That attempt seems unlikely to succeed in the long run, given that both conservative and liberal legal experts have criticized it, Aron-Dine told me. But if it did succeed, she added, it would be catastrophic. It would repeal much of the private-market part of the law, leaving only the Medicaid expansion fully in place.
A second sabotage attempt is less ambitious — but more certain to do at least some damage. Last month, the Trump administration announced it would expand so-called short-term insurance plans, which aren’t subject to minimum coverage requirements. Some number of (currently) healthy people will sign up for these bare-bones plans, raising costs for everyone. And, of course, if those healthy people end up getting sick, they may regret having signed on.
The administration will likely announce the details on these short-term plans in the coming weeks.
The bottom line: The recent expansion of Medicaid in Virginia was a major piece of good news on health care. Thirty-three states have now expanded Medicaid as part of Obamacare, and other states, like Nebraska and Utah, may soon follow. But all of this progress is in danger if Republicans keep control of Congress.
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