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Years of Attack Leave Obamacare a More Government-Focused Health Law

In days, the Trump administration is expected to carry out an executive order with proposed rules that would allow people to buy less expensive — and less comprehensive — coverage, through either business and professional associations or short-term private policies.The Affordable Care Act’s success in reducing the number of uninsured owes more to Medicaid than to private health insurance. About 75 million people are now enrolled in Medicaid, a number that has increased by about one-third since the adoption of the Affordable Care Act. A smaller number, about 10 million, buy coverage from private insurers through the health law’s marketplace.Among people ages 18 to 64, the proportion with private health insurance coverage is about the same today as in 2005, according to the National Center for Health Statistics. But the proportion with public insurance coverage has increased to more than 19 percent, from 11.5 percent in 2005, and the share of people in that age range who are uninsured has fallen to 12.5 percent, from about 19 percent.In total, more than one-third of the population is covered with federal assistance, through Medicare, Medicaid, the Department of Veterans Affairs, the military and Affordable Care Act subsidies. (And that does not include the larger group of people who benefit from tax subsidies for health insurance provided by employers.)Mr. Trump and Republicans in Congress failed this year in their efforts to cut Medicaid and could try again in 2018. Speaker Paul D. Ryan said this month that Republicans would try next year to slow the growth of federal health spending because “it’s the health care entitlements that are the big drivers of our debt.”But Senator Mitch McConnell, the majority leader, has been leery of another run at health care in an election year, and it is possible that Medicaid could, in the near future, actually grow further under the Affordable Care Act. Maine voters approved a referendum last month to expand Medicaid in that state, though Maine’s Republican governor, Paul R […]

Health Bill Appears Dead as Pivotal G.O.P. Senator Declares Opposition

“Health care is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy,” Ms. Collins said in a statement, lamenting the rushed process and the content of legislation that has shifted as Republican leaders scrambled for votes. “Sweeping reforms to our health care system and to Medicaid can’t be done well in a compressed time frame, especially when the actual bill is a moving target.”OPEN DocumentDocument: Read the C.B.O. Report on the Graham-Cassidy Health Care BillThe Senate majority leader, Mitch McConnell of Kentucky, now faces the unpalatable choice of admitting defeat or moving ahead with a vote that appears certain to fail.Republican leaders in the Senate can afford to lose only two of their members, and they now have three firm opponents within their ranks: Rand Paul of Kentucky, John McCain of Arizona and Ms. […]

Health Bill Appears Dead as Pivotal G.O.P. Senator Declares Opposition

“Health care is a deeply personal, complex issue that affects every single one of us and one-sixth of the American economy,” Ms. Collins said in a statement, lamenting the rushed process and the content of legislation that has shifted as Republican leaders scrambled for votes. “Sweeping reforms to our health care system and to Medicaid can’t be done well in a compressed time frame, especially when the actual bill is a moving target.”OPEN DocumentDocument: Read the C.B.O […]

News Analysis: Consensus Is Health Law Can Be Fixed. Now the Hard Part.

Among the hardest hit are those who do not qualify for subsidies to help with premiums or out-of-pocket costs, which rise along with rate increases. Michael Lawson, an independent consultant for local governments in Washington, D.C., said the monthly premiums for his basic plan from CareFirst jumped to $527 this year from $290 last year. He is 60 and earns too much to get a subsidy, but because of various health problems he has already reached his $5,000 deductible for the year. He likes his plan but thinks that to keep rates more stable, Congress and the Trump administration need to do a better job of enforcing the law, particularly its requirement that most people have health insurance.PhotoDemonstrators in front of the Supreme Court in Washington in 2015 cheered after its decision to allow nationwide health care subsidies, which affirmed a key element of the health care law.Credit Zach Gibson/The New York Times“They need to enforce the A.C.A. […]

How the Senate Health Care Bill Failed: G.O.P. Divisions and a Fed-Up President

The effort by Senate Republican leaders to remake the nation’s health care system — which went well beyond the perimeters of Mr. Obama’s health care law — was in retrospect doomed from the moment it began, even with the wind of an unlikely win in the House at their backs.The Senate measure would impose annual caps on Medicaid spending, ending what has been an open-ended entitlement for the poor and disabled. The process bypassed committees, any public airing of the bill or formal bill drafting. Instead, Senator Mitch McConnell of Kentucky, the majority leader, farmed out the remaking of 17 percent of the economy to a small group of senators, all Republican white men. The bad first look did not fade.But under fire for the all-male panel, Mr. […]

A Top Republican Vows a Vote on Health Care, but Uncertainty Reigns

Mr. McCain’s surgeons are not giving interviews. His communications director, Julie Tarallo, said more information would be released when it became available.Continue reading the main storyAides to the Senate majority leader, Mitch McConnell of Kentucky, said it was unclear how long the delay would last.The timing of the Senate vote is crucial. The more it is delayed, the more likely the bill is to fail, supporters and opponents say. […]

Governors Give Chilly Reception to Health Bill Push

The timing is critical because the Senate is expected to take up its health care overhaul this week, and Republicans — who control the body with a slim 52-vote majority — have already lost the support of two of their senators. Losing one more Republican senator would effectively sink the legislation, and a handful of Republican senators from states that have expanded Medicaid under the Affordable Care Act have signaled they will closely follow the lead of their state’s governor.Continue reading the main storyAt a private luncheon for governors on Saturday, three Democratic governors called for the group to release some sort of joint, bipartisan statement on the health bill. Gov. Dannel P. Malloy of Connecticut proposed a letter formally opposing the Senate legislation, while Gov. Terry McAuliffe of Virginia, the chairman of the National Governors Association, and Gov. Steve Bullock of Montana suggested a more restrained approach that would communicate their unease with the measure. But a handful of Republican governors opposed making a collective statement, noting there was no broad agreement about the nature of their opposition.“It’s important if anything goes out under the name of the N.G.A. that it has the endorsement of members certainly, and I think there was not consensus on that,” Gov. […]