Republicans begin to grumble: Why haven't we repealed Obamacare yet?
...The sentiment is beginning to simmer within the influential conservative wing of the Republican Party and hints at what could be the opening of an intra-party rift as the GOP's mission to overhaul the country's health care system appears to be losing steam.
...That shift in tone has irked other Republicans who are eager to take a swift vote to roll back as much of Obamacare as possible. Their fear: their conservative constituents back home won't settle for anything else.
"For goodness sake, we should be able to put something on President Trump's desk that's at least as good as what we put on President Obama's desk. Not something watered down," Rep. Jim Jordan, R-Ohio, told CNN in an interview. "Let's repeal it. Let's do what the voters sent us here to do."
MAJOR UPDATE 3/22/17: As I've noted repeatedly, my estimates of how many people are at risk of losing their coverage has always been based on the assumption of full repeal with immediate effect and, most importantly, no replacement healthcare policy whatsoever. I had to do it this way at first because there was no Republican replacement plan available until a couple of weeks ago. Then, when the AHCA plan was released, I didn't have the time or expertise to properly overhaul my projections accordingly.
Fortunately, the Center for American Progress does have the time, manpower and expertise to do exactly this. They crunched the numbers and, based in part on the recent Congressional Budget Office scoring of the AHCA, put together their own fully-detailed analysis of what impact partially repealing the ACA by passing the AHCA would have on coverage losses.
In light of this, at this point you can pretty much ignore everything below, as it no longer applies; the question is no longer "what happens if the ACA is repealed without anything replacing it?" but rather "what happens if the ACA is partially gutted and replaced with the AHCA?"
Unfortunately, due to the sheer amount of time it would take to do so, and the fact that the House is voting on the AHCA tomorrow (Thursday, 3/23), I don't have time to completely update/overhaul the Google Docs version of this data.
2017 using my known flawed data was running .96% behind 2016 on the January 14th inclusive update. 2017 ended up running 5.25% behind 2016 on Healthcare.gov states. The increment (using favorable to the null hypothesis data) slowdown in pace that can be attributed to Trump Administration actions is 5.25-.96 or 4.29% of enrollment was lost due to the executive order and other Trump administration actions such as shutting down some outreach and advertising in the last eleven days of enrollment.
Before the election, I was assuming the 2017 Open Enrollment Period would rack up between 13.5 - 14.0 million QHP selections...between 6% - 10% more than last year. The HHS Dept. agreed with me, projecting around 13.8 million (an 8.6% increase).
Last year the federal exchange included around 76% of the total enrollments (around 9.6 million). This year, HC.gov added Kentucky, which should have bumped the ratio up to around 77% this year. Assuming 13.8 million total, that would mean roughly 10.6 million enrolling via the federal exchange.
After Trump won and the GOP immediately started the actual legislative process to repeal the Affordable Care Act with preliminary votes in both the House and Senate, I downgraded my projections to around 13.3 million nationally (10.2 million via HC.gov).
Over 700,000 Additional Pennsylvanians Enrolled in Governor Wolf’s Medicaid Expansion Plan
February 02, 2017
Harrisburg, PA – In February of 2015, Governor Wolf expanded Medicaid to ensure that Pennsylvanians can receive affordable, straightforward, accessible healthcare without unnecessary delays and confusion. Today, Governor Wolf announced that over 700,000 Pennsylvanians have enrolled in HealthChoices, Pennsylvania’s mandatory managed care Medicaid program, since expansion occurred two years ago. U.S. Census data shows that the commonwealth’s uninsured rate has dropped from 10.2 percent in 2010 to 6.4 percent in 2015.
NEARLY 158,000 MARYLANDERS ENROLLED IN HEALTH COVERAGE FOR 2017 THROUGH THE STATE MARKETPLACE
INCLUDING MEDICAID, 501,000 HAVE ENROLLED SINCE NOV. 1
BALTIMORE (Feb. 1, 2017) – A total of 157,637 Marylanders enrolled in private health coverage plans for 2017 by yesterday’s deadline for open enrollment, capped by the largest single-day call volume ever for Maryland Health Connection, the state’s health insurance marketplace.
Including Medicaid enrollments, more than a half-million Marylanders have newly enrolled or renewed in health coverage for 2017 through the state marketplace since Nov. 1 when open enrollment began. Maryland Health Connection now covers 1.1 million in all — one of every six people in Maryland.
Hmmm...I'm honestly not sure what this last number (1.1 million covered by the exchange) refers to...they just said it was 158K QHPs + 343K in Medicaid = 501K total.
More than 225,000 people used Washington Healthplanfinder to select Qualified Health Plans – a 13% increase over last year’s total.
The ASPE report for OE3 showed WA's official 2016 tally at 200,691, so 225K would actually only be 12.1% higher, but the press release says it's 13%, so either they're basing it on a slightly lower unofficial 2016 tally, or "over 225K" actually means closer to 226,000.
GOP Rebrands Obamacare Strategy From 'Repeal' to 'Repair'
Some Republicans in Congress are starting to talk more about trying to “repair” Obamacare, rather than simply calling for "repeal and replace.”
There's good reason for that.
The repair language was discussed by Republicans during their closed-door policy retreat in Philadelphia last week as a better way to brand their strategy. Some of that discussion flowed from views that Republicans may not be headed toward a total replacement, said one conservative House lawmaker who didn't want to be identified.
Using the word repair “captures exactly what the large majority of the American people want,” said Frank Luntz, a prominent Republican consultant and pollster who addressed GOP lawmakers at their retreat.
I'm actually a bit surprised that NY State of Health is the first state exchange out of the gate with final enrollment numbers, but good for them:
Press Release: NY State of Health Announces Enrollment Surges: More Than 3.6 Million New Yorkers Secure Health Coverage
Feb 1, 2017
Nearly 50,000 sign up during final two days of Open Enrollment
An additional 800,000 New Yorkers enroll through the Marketplace since January 2016
ALBANY, N.Y. (February 1, 2017) -- NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.6 million New Yorkers enrolled in comprehensive health coverage through NY State of Health, a 28 percent increase from 2016.
“New York continues its commitment to bring affordable, comprehensive health coverage to New Yorkers” said NY State of Health Executive Director, Donna Frescatore. “New Yorkers now have access to affordable health insurance coverage, giving hundreds of thousands of previously uninsured individuals economic and healthcare security.”
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
