What happens to Obamacare now that the incoming president has campaigned hard for its demise? President elect Donald Trump ran on a "replace and repeal" platform for the Affordable Care Act, which mandated all Americans buy health insurance and provided government subsidies to help 20 million Americans afford it. The ACA ended up giving coverage to roughly 900,000 New Jersey residents: 250,000 who get their health insurance through the subsidized federal marketplace, and another 650,000 who became eligible for Medicaid when it was expanded to cover more than severely poor families. Trump has said repealing Obamacare is in his 100-Day to-do list when he takes office in January. Here are five immediate questions: 1. Will people covered by Obamacare lose their insurance as soon as Trump takes office? Experts strongly doubt Obamacare will be gone by the spring. Turning off the Washington subsidy spigot would be fairly easy, they say, but drafting the replacement part of Trump's platform would take longer. "It takes just as long for Congress to repeal a law as it does to pass one," said Joel Cantor, Director of the Center for State Health Policy at Rutgers University. "I think it's safe to say that people who buy coverage for 2017 will have it throughout the year." 2. Can people still buy "Obamacare" policies? Yes. "Right now, it's still the law," said Katherine Hempstead, an expert in health insurance at the Princeton-based Robert Wood Johnson Foundation. "We haven't crowned a king here. We have to go through a process to change the law." Open enrollment for coverage staring in January is now underway. "People definitely should still enroll if they want health insurance. They should definitely apply for tax credits. All systems are go," said . "There is no reason for people who want insurance not to take advantage of the opportunities they have." 3. Will people who don't have health coverage still pay a fine when they file their taxes? Obamacare is currently the law, anyone who willingly went without health coverage this year will still most likely have to pay that fine when they file their 2016 taxes in a few months. What is less clear is whether people who don't want health insurance should risk flouting the current law in hopes they won't face a fine down the road. Under Obamacare, Americans who don't get health insurance must pay a surcharge when they file their taxes the following year. 4. Will some of the popular parts of Obamacare remain? Here's the dilemma facing policymakers: Voters didn't like being ordered to buy insurance. Yet, a majority strongly favors the requirement that insurers cover everybody, regardless of their health. Many also liked the provision that allowed them to insure their adult children until age 26. And large sectors of the economy that changed their business strategies for Obamacare don't want to see the slate wiped clean of all reform, Cantor said. That includes doctors, hospitals, and insurance companies. "None of those groups are going to say, 'OK, let's go back to the good old days - because the good old days aren't so good." 5. What happens to people in N.J. on Medicaid? Hard to say, at this point. As of August, about 650,00 additional people in New Jersey had obtained their health coverage through Medicaid. The Affordable Care Act picks up the entire cost of additional people covered under Medicaid until the end of this year. Republican governors, Gov. Chris Christie included, have praised the expanded program for the poor because it has saved the states money and reduced the amount spent on expensive emergency room care, said Heather Howard, a lecturer at Princeton University's Woodrow Wilson School of Public and International Affairs. "The Medicaid expansion has been working in red and blue states. Vice President-elect Mike Pence expanded Medicaid; so did Ohio and Michigan," Howard said. "There's always the option the states could cover the people, but that is highly unlikely because of budget restraints," she said. Trump could divvy up funding for the Medicaid program into state block grants, a finite amount of money to be used as they see fit. "Obviously he made a clear call to repeal the Affordable Care Act but it's unclear what that means, and by no means is there consensus what he would replace it with," Howard said. "Even small changes in health care are very complicated and hard to implement," she added. Source
