Repeal & Replace Watch

KHN On Call: When Is ACA Repeal For Real?

KHN On Call is a new regular feature, a product of our ongoing partnership with NPR. Each week, , KHNs chief Washington correspondent, will answer a few audience questions about the new administrations effort to revamp U.S. health care to repeal and replace the Affordable Care Act. Which changes are real and imminent? What can the president do without congressional agreement? How will policy changes affect patient lives? Tell us what youd like to know. The segment will air on Morning Edition and well repost the audio and a storyhere. You can submit questions via Twitter #插唬插釵堯硃喧泭棗娶 #KHNOnCall.

Health care under the Affordable Care Act is poised to change again. The Republican-led Congress has vowed to repeal and replace the health law known as Obamacare.

That has left many people anxious and confused about what will happen and when. So NPRs Morning Edition asked listeners to post questions on Twitter and Facebook, and we will be answering some of them here and on the radio in the weeks ahead.

Many of the questions or comments that have come in so far have to do with timing. For example, Steva Stowell-Hardcastle of Lewisburg, Pa., said, Im confused about what parts of the ACA have been repealed and when those changes take place.

First, while some parts of the huge health law since it passed in 2010, nothing substantive has been repealed in 2017.

In January, Republicans in Congress passed a that called for major changes to the law to be made in a subsequent bill, called . That will allow the bill to pass the Senate with only a majority of votes, rather than the 60 votes needed to overcome a filibuster by Democrats. Congressional leaders have yet to unveil what they plan to put in that second bill.

Whatever they include, however, they cannot repeal the entire law in reconciliation. Thats because the budget process limits changes to those that directly affect the federal budget. Put simply, they can modify money but not rules. While there is some debate over how that will look, most people believe the rule that requires insurers to cover people with preexisting conditions could not be repealed through a budget bill.

The Trump administration has taken a few actions, but none making concrete changes yet. In January, Trump signed an calling for federal agencies to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the act that would impose a fiscal burden on states, individuals, healthcare providers, and others in the health industry.

But so far the only federal action in response to that order has come from the IRS, which decided not to more strictly enforce the that requires most Americans to have health insurance. The IRS, however, noted that the requirement is still law.

A related question comes from Kathryn Henry of Iowa City, Iowa. She asks, If it is repealed, what happens to people like me who currently have insurance through it and when?

Both President Trump and GOP congressional leaders have insisted that they want a smooth transition from the current system to a new one, particularly for the who purchased coverage on the federal or state health insurance exchanges.

We don’t want to pull the rug out from under people while we’re replacing this law,” said House Speaker Paul Ryan (R-Wis.) . Trump has insisted that it be done essentially simultaneously, so as not to leave people without insurance.

Unless something unexpected happens, people who purchased insurance for 2017 should be covered through the remainder of the year.

The bigger question is what happens in 2018. The uncertainty alone is prompting some insurers to get out of the individual insurance market, which is the most affected by the health law.

Insurance company has already said it wont participate in the health insurance exchanges next year, and the told reporters that his company might drop out, too. If Congress deadlocks over how to overhaul the health law, that exodus could accelerate.

Insurers were supposed to tell the federal government whether they planned to participate in the insurance exchanges by May 3, but the Trump administration has now given them until .

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InsuranceAffordable Care ActTrump AdministrationU.S. CongressRepeal And Replace Watch

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