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Marco Rubio votes to repeal Affordable Care Act

U.S. Senator Marco Rubio has cast his vote to repeal the Affordable Care Act, commonly known as Obamacare.

Early Thursday morning, the Senate GOP took a first step towards a repeal of the law – which they’ve long said was a goal of theirs and which President-elect Donald Trump made a campaign promise to do. In a marathon voting session, they approved a budget resolution that would speed through the repeal of the law.

Rubio was right on board with that.

“ObamaCare has led to rising premiums, a collapse of the individual insurance market and fewer choices for patients,” Rubio said. “The law is an absolute failure, and its proponents insist it must be salvaged with a taxpayer-funded bailout of health insurance companies. We’ve now taken an important first step to repeal this law and replace ‎it with a patient-centered approach that expands access to providers and lowers costs of care.

“It is my hope and expectation that the transition to a replacement program can be done relatively seamlessly and minimize disruptions to patients.”

Opponents of the measure say a repeal of the Affordable Care Act would be disastrous and leave many people without health care, as well as leaving people with pre-existing conditions unable to find coverage.

The GOP and Trump say they’ll work towards implementing a replacement for the law that will be better, though no details on what that plan will be have surfaced.

Survey finds bipartisan divide on ACA but bipartisan support for key provisions

The Affordable Care Act has a clear partisan divide but individual, key provisions have broadly bipartisan support, the Pew Research Center is reporting Monday.

Pew found that the partisan divide that began immediately in 2009 when Congress was debating President Barack Obama’s health care bill that got dubbed “Obamacare” remains a gulf – with more than 70 percent of Democrats wanting to keep the law and more than 85 percent of Republicans wanting to scrap it, as the now solidly-Republican led Congress and president-elect Donald Trump intend to do as soon as possible.

But individual provisions? Pew cited a Kaiser Family Foundation survey that shows that’s where the challenge is for Republicans pledging a repeal-and-replace plan.

Kaiser asked people about ten specific ACA provisions: nine of them got overall 60 percent support, and eight of them even got 60 percent support from Republicans.

The only provision Kaiser inquired about that clearly lacks support is the one requiring people to pay tax fines if they don’t sign up for a health insurance plan. Only 21 percent of Republicans support the idea, and only 35 percent of all Americans surveyed support it. Democrats still favor it, with 57 percent support.

Otherwise, Americans like the provisions in Obamacare:

– Overall, 85 percent of Americans surveyed said they like that young adults can stay on their parents’ policies through the age of 26, and that rule also got an 82 percent approval rating among Republicans.

– 83 percent of Americans said they like that there’s no out-of-pocket expenses for preventative-care medicine, and that includes 77 percent of Republicans surveyed.

– Closing the Medicare prescription drug “donut hole;” creating insurance exchanges for small businesses; providing subsidies for low- and moderate-income people to buy coverage; and giving states the option to expand Medicaid to cover uninsured; all got approval from at least 80 percent of Americans and at least two-thirds of Republicans.

– Preventing insurance companies from refusing coverage because of pre-existing conditions; and increasing the Medicare payroll tax on upper-income Americans; both got 69 percent overall approval and 63 percent approval among Republicans.

The only other provision Republicans rebelled against besides the fines for uninsured is the requirement that businesses with at least 50 employees provide health insurance. Just 45 percent of Republicans liked that, though overall 60 percent of Americans like it.

Democrats pretty much liked everything, giving 75 percent approval ratings for all the provisions Kaiser, asked about except the fines for uninsured people.

“Regardless of what they would like to see happen with the law, a growing share of Americans – across partisan lines – now see a dim future for the law’s major provisions. Roughly half of U.S. adults (53 percent) expect that its major provisions will probably be eliminated, while 39 percent say they are probably here to stay,” reported Pew authors Kristen Bialik and Abigail Geiger.

 

Rick Scott to US House Majority Leader: ‘repeal and replace Obamacare’

On Monday, Florida Governor Rick Scott sent a letter to the United States Congress majority leader calling for the body to “repeal and replace” Obamacare.

Scott’s position on what he calls the “excessive overreach” of Obamacare is not necessarily a surprise, given his historic opposition to the president’s approach to the Affordable Care Act.

However, it is newly salient in light of Republican control of the executive and legislative branches.

“For far too long, it has been fashionable in Washington to say Obamacare can only be tweaked. We have seen debate after debate in Washington about this bad law but nothing has been changed. It has to be completely overhauled and now is the time to do it. We cannot let the usual political games or partisan gridlock of Washington get in the way of immediately repealing and replacing Obamacare with a plan that actually works,” Scott noted.

“The impact of Obamacare has been devastating in Florida and our nation. Obamacare was sold on a lie from the very start. Costs are skyrocketing, people have not been able to keep their doctors and many people have fewer doctors to choose from. The increases in health care costs are at a 32-year high and are expected to continue increasing in the coming months. Recent news of Obamacare rates rising 25 percent is absurd and families simply cannot afford it. We can do better and the families and businesses footing the bill deserve better,” Scott added.

In the five-page letter, Scott advocated for “state flexibility,” rather than a “one size fits all” approach to the replacement.

“Specifically,” Scott wrote, “our state needs the greatest possible amount of flexibility from Washington … without creating a massive government program that makes promises to patients that we could never afford to keep.”

Scott’s letter laid out the governor’s suggestions for replacement.

One suggestion: to repeal the individual and employer mandates, allowing people to choose to deposit funds into a health savings account instead of giving the money to an insurance company.

Scott also urged the allowance of insurance companies to sell across state lines, which currently isn’t an option.

Scott also backs greater flexibility in packages sold, and allowing families to opt for a single plan for the entire family, rather than one plan for children and another for adults.

Regarding the state’s needs, Scott told the House Majority Leader that he’d like Florida to have “flexibility to run our own Medicaid program that uses the state’s successful managed care model.”

Scott would also like to see the elimination of “burdensome” Obama regulations, such as the Managed Care Rule, the Access Rule, and the Outpatient Drug Rule, examples of “intensive but often purposeless federal micromanagement” that privileges federal bureaucracy at the expense of the state process.

If Republicans have a better idea to replace Obamacare, let’s hear it

I have a friend who has owned a small restaurant in Tampa for decades. He voted for Donald Trump for two important reasons: Trump isn’t Hillary Clinton, and he hates Obamacare.

Let me rephrase that: He doesn’t like Hillary, but he loathes Obamacare with unyielding venom. Keeping up with its requirements, he said, has been an expensive nightmare. He wants it gone.

Today.

This is a kind and decent man who is all-in on goodness. He is charitable, law-abiding and is happy to lend a hand. So, over several plates of bacon and eggs at his joint, I have deduced that his position can best be summed up like this: He wants his employees and anyone in need to have access to health care, but he despises the bureaucracy and costs imposed by Obamacare.

It looks like he is going to get his way as the Republican-controlled Congress is tripping over itself to defund, defeat and dethrone the signature accomplishment of President Barack Obama’s administration. But then what?

Well, to borrow the infamous quote from House Speaker Nancy Pelosi from 2010 when the Affordable Care Act was coming to life, “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”

That quote was taken out of context and fed to Pelosi for breakfast, lunch and dinner, along with Obama’s vow that people could keep the doctors they liked. That became the rallying cry for opponents, but Trump now basically is saying the same thing – promising Americans that law will be replaced with something great.

While we wait for greatness, consider these Florida statistics from a recent federal Health and Human Services report.

— An estimated 132,000 young Floridians have been able to keep insurance by the provision allowing them to stay on their parents’ policies until age 26.

— It claims premiums grew 1.3 percent annually from 2010-2015, far less than the 8.2 percent of the previous decade.

Hold on just a minute there.

The HHS apparently forgot to include the estimated 25 percent premium hike for Floridians this year. There are many factors for that, especially the fact that far fewer people enrolled in Obamacare than the government projected and fewer insurers are offering coverage now that federal backstops against financial losses have been phased out.

All this sets up as a trap for Republicans in their zeal to end the program, though.

With lower enrollments than expected and the end to the safety net for insurance companies, any plan Republicans pass to replace the ACA probably will come up short of what Obamacare offered.

I can see the attack ads now when congressional seats are up for grabs in two years.

Incoming HHS head Tom Price of Georgia, a ferocious critic of Obamacare, has proposed a plan that would include a series of tax credits, health savings accounts, state grants and so on. Analysists have said Price’s proposal, if adopted, could mean reduced coverage and much higher premiums, especially for older Americans.

Republicans have the votes, for now, to move ahead with something. What that is, though, is anyone’s guess – especially Republicans. After barking their hatred for Obamacare for six years, they have, in the words of Senate Minority Leader Chuck Schumer, become “the dog that caught the car.”

Now what?

I know my friend would say to get rid of Obamacare and we’ll out the consequences later.

My take is a little different. I know this makes some people cringe, but I think health care is a right in a civilized society. It’s not something only those who can afford it should have. If Republicans have a better idea, let’s hear it.

After all, as Schumer said, they caught the car. They need to do more than just pee on the tires.

 

Health insurance board bracing for Donald Trump, Congress, to act on Obamacare

Members of a state insurance advisory panel called Friday for legislation fixing a regulatory “family glitch” that can make health insurance unaffordable to dependents of employees of small businesses.

The Florida Health Insurance Advisory Board declined additional proposed recommendations, however — in part because of uncertainty about what Donald Trump and the Republican Congress would do about the Affordable Care Act.

Board member Bill Herrle, Florida director of the National Federation of Independent Business, asked Insurance Commissioner David Altmaier, who chairs the panel, to begin bracing for whatever changes might be in store.

Herrle noted suggestions that Congress might set the ACA, sometimes referred to as “Obamacare,” to expire following the 2018 elections, and come up with a replacement plan in the interim.

“While that sounds like a long time, that could leave Florida with potentially only one legislative session in which to account for these changes,” Herrle said.

“Many of which may be ministerial, but some of which will not be as simple as going back to pre-ACA Florida statutes and plugging them back in. The market has changed very much.”

Altmaier agreed, saying his Office of Insurance Regulation has already started studying the situation.

“I think it would be prudent on the board’s part to initiate some of these dialogs,” Altmaier said.

The panel advises state leaders about health insurance matters and includes representatives of the industry, business interests, and state agencies. It needs a consensus to send recommendations to the Legislature.

Members agreed only once Friday: On the family glitch.

Louisa McQueeney, who manages an ACA navigator project for Florida CHAIN in Boynton Beach, argued that small group plans sometimes don’t cover employees’ family members. Depending on how much the family earns, the dependents might not qualify for ACA premium subsidies.

Other proposals failed, including to make health savings accounts available through high-deductible plans requiring policyholders to pay high out-of-pocket expenses; and to repeal a state law offering coverage through small-group plans to employees’ dependents until age 30. The ACA covers them until age 26.

Another idea that didn’t get off the drawing board involved improving coverage for sufferers of “maple syrup urine” disease, a genetic malady. State law mandates coverage through age 24 — a level established years ago when patients frequently died young.

Now they can live much longer, but have trouble paying for the expensive drugs that help keep them alive.

Often, board members cited uncertainty about what Republicans in Washington would do to the health insurance market.

“There are undoubtedly going to be some changes, maybe some substantial changes to the marketplace and how it functions, said John Matthews, southeastern general counsel for UnitedHealthcare.

“I question the wisdom of us making firm statutory mandate recommendations in light of what could be rather substantial changes to the ACA in general,” Matthews said.

Nearly 880,000 Floridians sign up for Obamacare

Nearly 880,000 Floridians have signed up for health coverage on President Obama‘s federal marketplace so far this year.

The deadline to enroll was Thursday for those seeking coverage starting on January 1. More than 4 million Americans chose plans on healthcare.gov this year. The figures were released by federal health officials and include both new and returning consumers who are updating or switching plans. Federal health officials say most consumers can find plans for less than $75 a month.

The robust enrollment comes amid uncertainty about the health care program as President-elect Donald Trump repeatedly promised to repeal it during his campaign. Few details about a replacement plan have been released and changes could take months or years to unfold.

No changes are expected next year for the more than 10 million people covered.

Republished with permission of the Associated Press.

Randy Fine’s consumer choice: Let us pay for his doctors

Anyone who has ever dressed a toddler knows that “consumer choice” has its limits. “Empowering” the little ones to “shop the marketplace” of their own closet predictably ends up in tantrums, tears, cranky goodbyes at daycare and late arrivals at work.

Florida’s “repeal and replace” crowd spends little time dressing toddlers, and no time plowing through the pounds of fine print, disclaimers and traps for the unwary faced by consumers exercising their choice in the Insurance Marketplace that was born before Obama, let alone Obamacare.

The Insurance Industrial Complex will carry on for the foreseeable future, inflicting surprise billings, followed by medical bankruptcy, upon overwhelmed “consumers” who can barely lift the contracts they’ve been asked to “compare,” and cannot possibly be expected to comprehend what’s in them.

This is not a problem for Gov. Rick Scott and his zombie army of millionaire allies in the legislature. Their employment entitlements include eligibility to purchase a state health plan that covers almost everything and costs next to nothing.

Reporting last week from the Associated Industries of Florida conference, POLITICO’s Christine Sexton described how easy it is for lawmakers like newly-elected Rep. Randy Fine to be an empowered health care consumer.

As a candidate, the Harvard-educated “millionaire who founded a casino management company” railed against the health care market, damning it as a “disaster.”

Once elected, he signed his family up faster than you can buy a bottle of aspirin, and for almost as little money.

Who in their right mind wouldn’t?

Sexton needed no help from Harvard to crunch the numbers: Fine’s monthly premium is $180 for himself, his wife and two children. That’s $2,160 per year for him, a fraction of the real annual tab, which exceeds $15,000 and is picked up by the rest of us.

Fine told Sexton that he signed up with the state to “broaden his perspective on things … I wanted to understand what government health insurance is like.”

Here’s a prediction: He’s gonna like it just Fine.

Poll: Only about 1 in 4 wants Donald Trump to repeal health law

Only about one in four Americans wants President-elect Donald Trump to entirely repeal his predecessor’s health care law that extended coverage to millions, a new poll has found.

The postelection survey released Thursday by the nonpartisan Kaiser Family Foundation also found hints of a pragmatic shift among some Republican foes of “Obamacare.”

While 52 percent of Republicans say they want the law completely repealed, that share is down from 69 percent just last month, before the election. And more Republicans now say they want the law “scaled back” under the new president and GOP Congress, with that share more than doubling from 11 percent before the election to 24 percent after.

Kaiser CEO Drew Altman said the foundation’s polling experts aren’t quite sure what to make of that finding, and will continue to track the apparent shift in future polls. The organization is a clearinghouse for information and analysis about the health care system.

It could be that some Republicans “got a protest vote off their chests, and they’re done with that,” Altman said. “They now have a more moderate position.”

After branding the Affordable Care Act a “disaster” during an election campaign that saw big premium hikes unveiled in its closing days, Trump has been saying he’d like to keep parts of the law.

On Capitol Hill, Republican leaders are trying to choreograph a legislative dance that would let them quickly repeal “Obamacare,” then allow an interlude to segue to a replacement. The complex undertaking is fraught with political risk, because success is not guaranteed. It could disrupt coverage for millions by destabilizing the law’s already fragile health insurance markets, such as HealthCare.gov.

The poll found some skepticism about that approach. Forty-two percent of those who want the 2010 health care law repealed said lawmakers should wait until they figure out the details of a replacement plan before doing so.

Americans were divided on next steps for President Barack Obama‘s signature law. Overall, 30 percent said the new president and Congress should expand what the law does, and another 19 percent said it should be implemented as is. On the other side, 26 percent said the law should be entirely repealed and 17 percent called for it to be scaled back.

Among Trump voters, 8 in 10 viewed the health care law unfavorably, and half wanted it entirely repealed.

As Republicans start to make changes in health care, potentially revamping Medicare and Medicaid as well, the politics of the issue could turn against them, Altman said. “They are going to go from casting stones to owning the problem,” he said.

The poll found majorities across party lines support many of the health care law’s provisions, but not its requirement that individuals have coverage or risk fines, and its mandate that medium-to-large employers pay fines if they don’t offer health insurance.

Among the provisions with support across party lines:

— Allowing young adults to stay on a parent’s insurance until age 26.

— No co-payments for many preventive services.

— Closing the Medicare prescription drug coverage gap known as the “doughnut hole.”

— Financial help for low- and moderate-income people to pay their insurance premiums.

— A state option to expand Medicaid to cover more low-income adults.

— Barring insurance companies from denying coverage because of a person’s medical history.

— Increased Medicare payroll taxes for upper-income earners.

The telephone poll was conducted from Nov. 15-21 among a nationally representative random digit dial sample of 1,202 adults, including people reached by landlines and cellphones. The margin of sampling error is plus or minus 3 percentage points for the full sample. For subgroups, the margin of sampling error may be higher.

Republished with permission of The Associated Press.

Donald Trump taps Tom Price to lead HHS, plans 2nd meeting with Mitt Romney

President-elect Donald Trump moved to fill out his Cabinet Tuesday, tapping Georgia Rep. Tom Price to lead the Department of Health and Human Services. Aides signaled that at least one other Cabinet nomination was imminent.

The president-elect appeared to still be torn over his choice for secretary of state. He summoned former Massachusetts Gov. Mitt Romney to New York for dinner Tuesday night to discuss the post for a second time. He was also meeting with Tennessee Sen. Bob Corker, the chairman of the Senate Foreign Relations Committee who was getting new attention from Trump’s team. On Monday, Trump spent an hour with retired Gen. David Petraeus, another new contender.

Trump’s decision to consider Romney for the powerful Cabinet post has sparked an unusual public backlash from some of his closest aides and allies. Campaign manager Kellyanne Conway has warned that it would be a “betrayal” to Trump supporters if he selected Romney, who was a fierce critic of the president-elect.

Three people close to the transition team said Trump was aware that Conway planned to voice her concerns about Romney in public and they pushed back at suggestions that the president-elect was angry at her for doing so.

Even as he weighed crucial Cabinet decisions, Trump appeared distracted by outside forces — or eager to create distractions himself. He took to Twitter early Tuesday to declare that “nobody should be allowed to burn the American flag.” He warned that those who do should face “perhaps loss of citizenship or year in jail!”

Trump offered no context for his message. The Supreme Court has ruled that flag burning is protected by the First Amendment.

The president-elect spent the weekend tweeting his opposition to a recount effort in up to three states that is led by Green Party candidate Jill Stein and joined by Hillary Clinton‘s team. He also falsely claimed that millions of people had voted illegally in the presidential election and provided no evidence to back up the baseless charge.

Trump won praise from Republicans Tuesday for his pick of Price to serve as health and human services secretary. A six-term congressman and orthopedic surgeon, Price has been a leading critic of President Barack Obama‘s health care law. If confirmed by the Senate, he’ll be a leading figure in Republican efforts to repeal the measure.

Incoming Senate Democratic Leader Chuck Schumer said Price “has proven to be far out of the mainstream of what Americans want” for programs that help seniors, women, families and those with disabilities. His nomination, Schumer said, is “akin to asking the fox to guard the henhouse.”

Trump’s team also announced Tuesday that Seema Verma had been chosen to be administrator of the Centers for Medicare and Medicaid Services.

Jason Miller, a transition team spokesman, said at least one other Cabinet post would be announced in the afternoon. He did not elaborate.

Transition aides said Trump was likely at least a few days away from a decision on secretary of state. Romney has supposed from Vice President-elect Mike Pence, who is heading the transition efforts.

Romney was fiercely critical of Trump throughout the campaign, including his preparedness for the foreign policy and national security decisions that confront a president. Still, he is said to be interested in serving in the administration and held a lengthy initial meeting with Romney before Thanksgiving.

Other top Trump allies, notably Conway, have launched a highly unusual public campaign against a Romney nomination. Conway’s comments stirred speculation that she is seeking either to force Trump’s hand or give him cover for ultimately passing over Romney.

Former New York City Mayor Rudy Giuliani, a loyal Trump ally, was initially seen as the leading contender to helm the State Department. But questions about his overseas business dealings, as well as his public campaigning for the job, have given Trump pause.

Trump is now said to be considering Giuliani to head the Homeland Security Department, according to those close to the transition process.

Republished with permission of the Associated Press.

Rick Scott on Donald Trump: ‘I’ll do everything I can to help him be successful’

In St. Augustine for his monthly jobs numbers presser, Florida Gov. Rick Scott took questions about his meeting with President-elect Donald Trump and discussed the 2018 political landscape.

Scott said he had a “great meeting yesterday with President-elect Trump” lasting roughly 45 minutes.

When asked if he might be part of one of Trump’s “landing teams,” designed to help with the transition on a departmental level, Scott was not especially specific.

“I’ll do everything I can to help him be successful. I’m going to help him repeal Obamacare. We’ve got to replace it with something that will be better for Americans. We’ve got to reduce our costs. We’ve got to have better access to health care,” Scott said.

“I’ll work with him with Republican governors. We’ve got 32 Republican governors with great ideas. I’ll be a liaison with Republican governors,” Scott added.

“On top of that,” Scott continued, “we have to redesign government. Government’s got to work better at the federal level. We’ve done it in our state by cutting regulations and reducing taxes. We have to think about what’s better for our citizens.”

“I told Donald Trump I’ll do anything I can to help him. Whatever he wants me to do, I’ll do,” Scott continued.

Althought that apparently doesn’t include accepting an official role with the administration.

“He’s got a lot of energy,” Scott added. “When I sat down with him yesterday, he was excited about the job. He wants to get things done … bring change to Washington D.C. He’s going to make it happen.”

When asked to elaborate on a statement Scott made earlier this week, regarding running for Senate as an “option” in 2018, Scott stuck to his talking points, saying he was focused on the job that he’s doing at the moment.

Scott likewise was noncommittal when asked to review potential successors of his in the governor’s office, a list that includes names such as Agriculture Secretary Adam Putnam and — according to some Jacksonville locals who are not part of the mayor’s political operation — Lenny Curry.

“I’m sure there will be a lot of people who are running for governor. It’s a great job. If you care about people,” Scott said, “it’s the best job you can imagine.”

“I’m sure there’s going to be a lot of good people running. Lenny Curry’s doing a great job as mayor of Jacksonville. You’re starting to see significant job growth here,” Scott added.

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