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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 The individual and employer mandates and all the Obamacare taxes could be repealed this way.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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