Repealing Obamacare Subsidies and Medicaid Expansion Could Be First Republican Targets


Based on legislation passed in late 2015 by Republicans in both the House and the Senate, repealing Obamacare subsidies and repealing the law’s Medicaid expansion could easily become law under the Republican government set to take control in 2017.

That legislation was vetoed by President Barack Obama. But it was a marker for what Republicans could do under Senate rules that allow bills to be acted on without 60 votes if they affect the budget. Republicans will control the Senate, along with the House, but they won’t have a 60-vote majority in the Senate.

President-elect Donald Trump has pledged to repeal the Affordable Care Act and replace it, and Washington is abuzz with speculation about how the sweeping 2010 health-care law, under which 20 million people have gained coverage, will be changed.

While Republicans can easily pass legislation similar to H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act, it will be more difficult to repeal health insurance requirements, such as barring insurers from refusing to cover or charging more to people who have medical problems.

In an interview with the Wall Street Journal published Nov. 11, Trump said he would consider leaving that guaranteed issue requirement in place, along with a popular ACA provision under which insurers must allow people to keep their adult children on their health plans until age 26.

The problem will be coming up with a plan that provides for guaranteed issue without destroying the individual health insurance market. Even with the ACA’s individual mandate, not enough healthy people are enrolling in health plans to make the ACA exchanges economically viable, and insurers report that too many people are dropping coverage once they have received medical care.

That has resulted in an exchange market in which most insurers are losing money, premiums for benchmark plans are rising an average of 22 percent in 2017, and most major national insurers have sharply scaled back their participation in the 2017 exchanges.

Read the full story at

Stay on top of new developments in health law and regulation with a free trial to the Health Law Resource Center.

Learn more about Bloomberg Law and sign up for a free trial.