Posted: 03/25/17 02:50, Edited: 03/25/17 02:50
by Dave Mindeman
Well, Obamacare is still standing. It weathered a frontal assault and managed to withstand it.
But there is still a big problem.
The ACA still needs some fixing and we currently have a party in charge that will fix nothing.
HHS is now run by Tom Price. As the Commissioner, he has extraordinary powers to make the law work or make it fail. I think you know what his preference will be.
The Republicans will probably continue to attack the ACA on the margins and they can do more to cut the basic funding for the law's operations. They already have done some of that.
Obamacare can still operate...but it will probably depend on how the insurance companies approach this. It is possible that without any new law on the horizon, they will work with the law as it exists and begin again. Or they could just keep pulling out of the exchanges and try to sabotage it with death by a thousand cuts.
The Republicans and Trump have no incentive to upgrade the law. And that will hurt people. Their insurance will get more complicated and there will probably be less variety of options.
The one thing that should help keep people on the roles is that Medicaid expansion will continue. Red states that did not do the expansion may be more tempted to join it, because otherwise they will be dipping into their own coffers....or possibly get blowback from so many people uninsured.
It may be up to the states to do the fixing. As long as the basic ACA is in place, states could tweak their own health care to make up for the problems and stabilize the marketplace.
Watch California and New York. They will probably be the first to undertake needed fixes and may serve as models for the rest of the country.
We are in a very unusual situation. Be vigilant.