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Obama warns GOP on healthcare: ‘Now comes the hard part’

President Obama said he thinks Republicans’ efforts to repeal and replace ObamaCare will get harder now that they have the responsibility of governing.

 At a press conference Monday, Obama noted that while repealing his signature law has long been a “holy grail” for Republicans, the GOP will have to contend with the real-world consequences such action would have for the 20 million people who gained health coverage under the law.

In addition to winning the White House, the GOP also maintained its House and Senate majorities.

“It’s one thing to characterize this thing as not working when it’s just an abstraction, now suddenly you’re in charge and you’re gonna repeal it,” Obama said. “OK, well what happens to those 20 million people who have health insurance? Are you going to just kick them off and suddenly they don’t have health insurance?”

He pointed to other benefits of the law, such as slowing the growth of healthcare costs.

Obama acknowledged that the law could be repealed and replaced with something else. But what that replacement would be, he said, is key.

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What will Trump do about Obamacare?

The prognosis for the Affordable Care Act is looking dire.

President-elect Donald Trump promised to “immediately repeal and replace Obamacare” while he was campaigning, a promise that will at the very least put President Obama’s signature health care legislation in the ER. The law remains divisive in the country, with opinions equally split between 45 percent with favorable views of it and 45 percent who see it negatively, according to the Henry J. Kaiser Family Foundation.

Health-services stocks took a dive on Wednesday morning, reflecting expectations from investors that a Trump presidency will deliver major changes to the law. Because the ACA has boosted demand for treatment, thanks to the additional 20 million Americans who gained health insurance as a result, its repeal could lead to sharply lower demand for health care and pharmaceutical services.

Yet it’s not clear that Trump will be able to completely erase the law because the Republican-dominated Senate will lack the 60 votes needed for a full repeal.

Obamacare “has clearly been a touch point for Republican campaigns across the country,” said Michael Moran, principal for global risk analysis at Control Risks, on a conference call to discuss the election results. “Repealing it is a very difficult proposition. Trump has been careful about talking about replacing it with something. It’s like, what is that something?”

He added: “The Democrats will dig their heels in.”

Still, it’s clear that Trump is going to challenge the law. Here are five questions about the future of Obamacare under the new president.

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What Will TrumpCare Look Like?

President-elect Donald Trump made repealing Obamacare the cornerstone of his campaign. Now that he has won, his future administration is faced with the daunting task of unraveling nearly seven years of Obamacare.  It will not be easy. The most pressing goal should be to replace all the costly provisions in Obamacare with the consumer-friendly health plans most Americans prefer. In the process, reformers must change the way medical care is financed so that consumers have control over their health care dollars as well as the means to pay for medical care over their lifetimes.

Congress can repeal some Obamacare provisions — but not all — using budget reconciliation, which requires only a simple majority. The individual and employer mandates and all the Obamacare taxes could be repealed this way. This wouldn’t help with the regulations that prevent insurers and employers from designing affordable health plans, however. Repealing the insurance mandates, including the “essential benefits” package, would require a filibuster-proof majority. As a starting point, the president should command his incoming HHS Secretary to drop the appeal of House vs. Burwell. The Obama administration already lost the court case, which found Obamacare’s cost-sharing reduction payments to be illegal since they had not been unappropriated by Congress. Without being reimbursed for the cost-sharing reduction payments, insurers would likely drop out of the market, since they are required to provide the subsidies whether or not they get reimbursed for them. The administration should also prevent any Court Settlement Funds from being used for insurance bailouts. powerful weapon Trump will possess is the power to order his HHS Secretary to stop enforcing Obamacare’s provisions. Taken together, these may apply enough pressure to encourage moderate Democrats to side with Republicans to amend Obamacare’s insurance regulations to better suit consumers’ needs.

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CEO Power Panel: No Repeal Without Replace

Shortly after Donald Trump’s unexpected victory in the presidential election, leaders of the six-hospital Mission Health system decided to put large capital investments on hold. They wanted to preserve financial flexibility in case the new Republican administration pushed through “very harmful changes and reductions in payment,” said Dr. Ronald Paulus, CEO of the Asheville, N.C.-based system.

Meanwhile, Mission Health chose to continue investing in population health initiatives, its new health insurance company and its Medicare Advantage program.

Paulus said those decisions flowed out of the huge uncertainty caused by Trump’s and congressional Republicans’ promise to rapidly repeal and replace the Affordable Care Act. “It’s eight years going in one direction, then turning on a dime and going in a completely different direction,” he said. “Uncertainty wreaks havoc in any industry. As a nation, we should decide on a direction and provide some long-standing stability.”

Healthcare CEOs, Paulus among them, are willing to consider Trump’s healthcare reform ideas. But they have strong concerns about whether his plan would match the ACA’s performance in expanding coverage and slashing the uninsured rate to less than 9%, according to Modern Healthcare’s post-election Power Panel survey, which got responses from 93 of 123 CEOs contacted. Leaders of large hospitals and health systems are disproportionately represented on the panel, but the participants also include CEOs of insurers, suppliers and technology companies, as well as associations representing sectors across the industry.

Beyond the ACA, the CEOs surveyed stressed the need for action to curb the growth of prescription drug prices, with 60% saying that should be a top priority for the new administration and Congress.

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Employee Benefits Update – Year-End Compliance Checklist

2016 Year-End Compliance Checklist

With the results of the Presidential election just behind us, it is likely that the landscape of employee benefit plans—and the regulations that govern them—will change. For the time being, however, there are still some important compliance deadlines quickly approaching, so we wanted to remind plan sponsors of these key compliance actions as 2016 comes to a close.

Click here to access the checklist with deadlines and required actions.