What Affordable Care Act Limbo Looks Like In Wisconsin

A Lot Of Directions And Little Certainty On Future Policy
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Wisconsin Public Television

Repeal and... what exactly then? And is repeal even certain?

In a Dec. 23, 2016 report, Wisconsin Public Television's Here And Now examined the choices facing President-elect Donald Trump and Republican majorities in Congress as they hone in on repealing the Affordable Care Act. This series of health care regulations has been a top target of Republicans since Congress passed the legislation and President Barack Obama signed it into law in 2010.

Controversy over elements of the law — and deliberate political misinformation about it — helped fuel a Republican wave of victories in Congress and many state governments in subsequent elections. But the public has gradually warmed up to the ACA as it's been implemented and helped more than 20 million Americans get insurance, pushing coverage to record levels in Wisconsin.

As Here And Now anchor Frederica Freyberg reported, Republican legislators have floated a lot of ideas about the provisions an ACA replacement might have. A list provided by House Speaker Paul Ryan included several elements: Relaxing restrictions on insurance companies denying coverage based on pre-existing conditions, funding Medicare through block grants to states, expanding the use of health savings accounts and eliminating the much-maligned individual mandate. What hasn't emerged yet is a comprehensive policy package that fits together as intricately as the ACA itself.

It's this intricacy that presents an obstacle to changes in health care regulations, unless Republican leadership pursues a "repeal and delay" strategy that could leave up to 400,000 Wisconsinites without health insurance coverage. One federal health official from Wisconsin believes that even Trump voters will balk at going back to pre-ACA rules. As an interactive New York Times piece demonstrates, various ACA provisions play into each other in a way that makes it hard to eliminate some and keep others.

Since the election, people have been signing up for the ACA's Health Insurance Marketplace coverage at higher levels than ever, and they'll have at least another year to form opinions about it. Whatever the long-term future of the ACA itself, people who like their Obamacare can keep it — at least through 2017.

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