For Trump and GOP, 'Obamacare' repeal is complex and risky

Cox believes the earliest major changes could take effect without disrupting coverage for more than 20 million Americans would be January 1, 2018.

And maybe an electoral map, too.

While candidate Trump vowed to repeal the law, he also said he'd like to see Medicare negotiate lower drug prices and bring in cheaper drugs from Canada, positions fiercely opposed by most congressional Republicans and the drug industry. These people are spread across the country. If you think the increases in premiums for some policies under Obamacare are large, look out. "They all have to work to make it balance out".

But that can't be said of the prohibition against denial of coverage for those with pre-existing conditions.

Since the act was enacted, more than 20 million people have gained access to insurance. This will end up translating into more people being uninsured. For Pennsylvania and MI, it's near 300,000.

Thanks to the November 8 elections, the Republicans have managed to get themselves into a position where they have a good chance of repealing the Affordable Care Act - but suddenly some of these politicians, including Donald Trump himself, realize there are a lot of good things about it, not the least of which is that some 20 million Americans who didn't have health care coverage before have it now.

They might not mind losing what they have through Obamacare.

What about the other almost 5 million newly insured?

Under the Affordable Care Act, more than one million Pennsylvanians have access to quality health care coverage, with approximately 412,000 people now purchasing coverage through the federal marketplace and 678,000 people enrolled under the Medicaid expansion.

"In light of public statements by the President-Elect and his campaign, there is at least a significant possibility of a meaningful change in policy in the new administration that could either obviate the need for resolution of this appeal or affect the nature and scope of the issues presented for review", their motion, filed Monday, said. Some states will see much bigger jumps, others less.

Pennsylvania, Ohio, Michigan, and Wisconsin all have expanded Medicaid eligibility now.

Republicans aren't promising simply to repeal the the law, of course.

Joining us to help navigate the process of enrolling in the Health Insurance Marketplace and to provide advice on finding an insurance plan that best suits your needs are Legal Aid Society of Greater Cincinnati Paralegal Advocate, Deanna White; Outreach & Enrollment Coordinator and Specialist with the Cincinnati Health Department, Angela Robinson; and Attorney and Health Law Fellow with the Kentucky Equal Justice Center, Cara Stewart.

Certainly, reforming health care will be hard.

To be clear, Obamacare already is reeling from a high profile exodus of major insurers, including Aetna, UnitedHealthcare and Blue Cross-Blue Shield, which suffered millions of dollars in losses during the first few years of the program's operation.

The absence of specifics on health care from the president-elect makes the 37-page plan that Speaker of the House Paul Ryan has released the fullest outline of what Republicans would like to replace Obamacare.

And the vast majority of those people were able to find some kind of coverage instead.

But that plan - which includes a Medicare overhaul that would shift future beneficiaries into a new system that gives them vouchers to shop for private health plans - would likely extend the disruptions years further. In practice, that seems unlikely, given that it would require committing the kind of federal dollars that Obamacare does ― and one of the GOP's main goals is to downsize that commitment.

According to Quinn, last year, The GOP-led House and Senate "passed a budget resolution ... that included instructions to use reconciliation to repeal Obamacare and were ultimately successful in getting it to Obama's desk, where it was vetoed". To replace Obamacare or revamp it in an orderly fashion will take time, she said.

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