Connect with us

Published

on

President-elect Donald Trumps return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles.

This story also ran on NPR. It can be republished for free.

Trump, long an ACA opponent, expressed interest during the campaign in retooling the health law. In addition, some high-ranking Republican lawmakers who will now have control over both the House and the Senate have said revamping the landmark 2010 legislation known as Obamacare would be a priority. They say the law is too expensive and represents government overreach.

The governing trifecta sets the stage for potentially seismic changes that could curtail the laws Medicaid expansion, raise the uninsured rate, weaken patient protections, and increase premium costs for millions of people.

The Republican plans they dont say they are going to repeal the ACA, but their collection of policies could amount to the same thing or worse, said Sarah Lueck, vice president for health policy at the Center on Budget and Policy Priorities, a research and policy institute. It could happen through legislation and regulation. Were on alert for anything and everything. It could take many forms.

Congressional Republicans have held dozens of votes over the years to try to repeal the law. They were unable to get it done in 2017 after Trump became president, even though they held both chambers and the White House, in large part because some GOP lawmakers wouldnt support legislation they said would cause such a marked increase in the uninsured rate.

Similar opposition to revamping the law could emerge again, especially because polls show the ACAs protections are popular.

While neither Trump nor his GOP allies have elaborated on what they would change, House Speaker Mike Johnson said last month that the ACA needs massive reform and would be on the partys agenda should Trump win. Email Sign-Up

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

Congress could theoretically change the ACA without a single Democratic vote, using a process known as “reconciliation.” The narrow margins by which Republicans control the House and Senate mean just a handful of “no” votes could sink that effort, though.

Many of the more ambitious goals would require Congress. Some conservatives have called for changing the funding formula for Medicaid, a federal-state government health insurance program for low-income and disabled people. The idea would be to use budget reconciliation to gain lawmakers approval to reduce the share paid by the federal government for the expansion population. The group that would be most affected is made up largely of higher-income adults and adults who dont have children rather than traditional Medicaid beneficiaries such as pregnant women, children, and people with disabilities.

A conservative idea that would let individuals use ACA subsidies for plans on the exchange that dont comply with the health law would likely require Congress. That could cause healthier people to use the subsidies to buy cheaper and skimpier plans, raising premiums for older and sicker consumers who need more comprehensive coverage.

Its similar to an ACA repeal plan, said Cynthia Cox, a vice president and the director of the Affordable Care Act program at KFF, a health information nonprofit that includes KFF Health News. Its repeal with a different name.

Congress would likely be needed to enact a proposal to shift a portion of consumers ACA subsidies to health savings accounts to pay for eligible medical expenses.

Trump could also opt to bypass Congress. He did so during his previous tenure, when the Department of Health and Human Services invited states to apply for waivers to change the way their Medicaid programs were paid for capping federal funds in exchange for more state flexibility in running the program. Waivers have been popular among both blue and red states for making other changes to Medicaid.

Trump will do whatever he thinks he can get away with, said Chris Edelson, an assistant professor of government at American University. If he wants to do something, hell just do it.

Republicans have another option to weaken the ACA: They can simply do nothing. Temporary, enhanced subsidies that reduce premium costs and contributed to the nations lowest uninsured rate on record are set to expire at the end of next year without congressional action. Premiums would then double or more, on average, for subsidized consumers in 12 states who enrolled using the federal ACA exchange, according to data from KFF.

That would mean fewer people could afford coverage on the ACA exchanges. And while the number of people covered by employer plans would likely increase, an additional 1.7 million uninsured individuals are projected each year from 2024 to 2033, according to federal estimates.

Many of the states that would be most affected, including Texas and Florida, are represented by Republicans in Congress, which could give some lawmakers pause about letting the subsidies lapse.

The Trump administration could opt to stop defending the law against suits seeking to topple parts of it. One of the most notable cases challenges the ACA requirement that insurers cover some preventive services, such as cancer screenings and alcohol use counseling, at no cost. About 150 million people now benefit from the coverage requirement.

If the Department of Justice were to withdraw its petition after Trump takes office, the plaintiffs would not have to observe the coverage requirement which could inspire similar challenges, with broader implications. A recent Supreme Court ruling left the door open to legal challenges by other employers and insurers seeking the same relief, said Zachary Baron, a director of Georgetown Universitys Center for Health Policy and the Law.

In the meantime, Trump could initiate changes from his first day in the Oval Office through executive orders, which are directives that have the force of law.

The early executive orders will give us a sense of policies that the administration plans to pursue, said Allison Orris, a senior fellow at the Center on Budget and Policy Priorities. Early signaling through executive orders will send a message about what guidance, regulations, and policy could follow.

In fact, Trump relied heavily on these orders during his previous term: An October 2017 order directed federal agencies to begin modifying the ACA and ultimately increased consumer access to health plans that didnt comply with the law. He could issue similar orders early on in his new term, using them to start the process of compelling changes to the law, such as stepped-up oversight of potential fraud.

The administration could early on take other steps that work against the ACA, such as curtailing federal funding for outreach and help signing up for ACA plans. Both actions depressed enrollment during the previous Trump administration.

Trump could also use regulations to implement other conservative proposals, such as increasing access to health insurance plans that dont comply with ACA consumer protections.

The Biden administration walked back Trumps efforts to expand what are often known as short-term health plans, disparaging the plans as junk insurance because they may not cover certain benefits and can deny coverage to those with a preexisting health condition.

The Trump administration is expected to use regulation to reverse Bidens reversal, allowing consumers to keep and renew the plans for much longer.

But drafting regulations has become far more complicated following a Supreme Court ruling saying federal courts no longer have to defer to federal agencies facing a legal challenge to their authority. In its wake, any rules from a Trump-era HHS could draw more efforts to block them in the courts.

Some people with ACA plans say theyre concerned. Dylan Reed, a 43-year-old small-buiness owner from Loveland, Colorado, remembers the days before the ACA and doesnt want to go back to a time when insurance was hard to get and afford.

In addition to attention-deficit/hyperactivity disorder and anxiety, he has scleroderma, an autoimmune disease associated with joint pain and numbness in the extremities. Even with his ACA plan, he estimates, he pays about $1,000 a month for medications alone.

He worries that without the protections of the ACA it will be hard to find coverage with his preexisting conditions.

It’s definitely a terrifying thought, Reed said. I would probably survive. I would just be in a lot of pain. Stephanie Armour: sarmour@kff.org, @StephArmour1

Sam Whitehead: swhitehead@kff.org

Julie Rovner: jrovner@kff.org, @jrovner Related Topics Elections Health Care Costs Health Industry Insurance Obamacare Plans Trump Administration U.S. Congress Contact Us Submit a Story Tip

Continue Reading

Politics

Wes Streeting denies Labour has made ‘mistakes’ with ‘unpopular’ policies despite poor local election results

Published

on

By

Wes Streeting denies Labour has made 'mistakes' with 'unpopular' policies despite poor local election results

Health Secretary Wes Streeting has defended “unpopular” policies such as the cut to the winter fuel allowance despite Labour’s poor performance at the local elections.

Mr Streeting denied the government had made any mistakes when asked whether the policy was partly to blame for the party losing 189 council seats less than a year since the General Election.

Since coming into government last July, Labour has enacted a number of policies that were not in its manifesto.

These include means-testing winter fuel payments for pensioners, increasing employers’ national insurance contributions and slashing £5bn from the welfare bill.

Asked what mistakes his government had made so far that had led to its drubbing at the ballot box, Mr Streeting told Sunday Morning with Trevor Phillips: “Well, we will make plenty of mistakes.”

Politics latest: Lucy Powell ‘right’ to apologise for grooming gangs comments

Pressed again on whether he believed “mistakes” had been made, the health secretary replied: “No. When we made those choices, we knew they would be unpopular. And we knew that they would be opposed.

“The reason we made those choices is because we genuinely believe they’re the right choices to get the country out of the massive hole it was left in. And right across the board. Whether it’s the NHS, whether it’s schools, whether it’s prisons, whether it’s our defence and security, whether it’s crime and policing, there were enormous challenges facing this country when we came in.

“And we’ve had to make big and sometimes unpopular decisions so that we can face those challenges and deal with them. People might thank us if we just kind of go for the easy but we want to make the right choices.”

Some Labour MPs have urged the government to change direction, with one telling Sky News the cut to winter fuel was a “catastrophic error” that must be “remedied” if the party is to see any improvement in public opinion.

Others have warned that in courting Reform voters, the party risks fracturing its coalition of voters on the left who may be tempted by the Liberal Democrats and Green Party.

However, in the aftermath of the local elections, Sir Keir Starmer suggested the poor results meant he needed to go “further and faster” in delivering his existing agenda.

Please use Chrome browser for a more accessible video player

Inside Reform’s election success

The real victor to emerge from Thursday’s local elections was Reform UK, which won control of 10 councils and picked up 677 council seats largely at the expense of the Conservatives in the south.

However, Reform also won the Runcorn by-election from Labour by just six votes, as well as control of Doncaster Council from Labour – the only local authority it had control of in this set of elections – in a significant win for Nigel Farage and his party.

The Reform UK leader declared that two-party politics was now “finished” and that his party was now the official “opposition” to Labour.

Asked whether the results meant that Labour would now treat Reform as “your most serious opposition”, Mr Streeting said: ” I certainly do treat them as a serious opposition force.”

“As I say, I don’t know whether it will be Reform or the Conservatives that emerge as the main threat,” he added.

“I don’t have a horse in that race, but like alien versus predator, I don’t really want either one to win.”

Read more:
Reform’s mission to ‘remoralise’ young people
Reform has put the two traditional parties on notice

Please use Chrome browser for a more accessible video player

Reform UK are ‘fighting force’

Tory Party chairman Nigel Huddleston said Reform UK was not just a protest party and that Mr Farage was “a force in British politics”.

He told Trevor Phillips: “But the one thing about Nigel Farage is, and we’re seeing this again and again and again, he is a populist.

“He is increasingly saying everything that anybody wants to hear. He’s trying to be all things to all men.”

“We are establishing ourselves as a credible alternative government based on sound conservative principles and values and our values and our principles, and therefore our policies, will define the future of our party,” he added.

Continue Reading

Environment

It’s back: Hyundai IONIQ 5 qualifies for $7,500 tax credit – again!

Published

on

By

It's back: Hyundai IONIQ 5 qualifies for ,500 tax credit – again!

The Hyundai IONIQ 5 got a raft of upgrades and sporty, rally-focused XRT trim level for 2025 – but the biggest upgrade for the Made in America Hyundai might be this: the 5 has regained eligibility for the full $7,500 federal EV tax credit!

Despite being assembled at Hyundai’s Georgia meta plant for the last four month, the 2025 Hyundai IONIQ 5 was nowhere to be found on the EPA’s list of rebate-eligible vehicles. But that was then – with a fresh updated to the list coming online May 1st, Hyundai’s new-age electric hot hatch is back in the rebate game.

It’s worth noting that lease customers had been able to access the incentive under some circumstances, but this latest update to the EPA list makes it possible for cash and payment buyers to take advantage of the full Federal incentive, too – as long as they earn less than $300,000 as a married couple filing jointly, less than $225,000 as a head of household, or less than $150,000 as an individual.

With the $7,500 federal tax credit in the equation, you can get a new 2025 IONIQ 5 for somewhere in between $36,575 and $49,475, well under the $80,000 Federal MSRP cap.

Advertisement – scroll for more content

Victory lap

As if to celebrate, Hyundai announced that it was taking on the celebrate One Lap of America road rayy and race event in a factory collaboration with the track-focused enthusiasts at Grassroots Motorsports this week with One Lap veterans Andy Hollis and Tom Suddard campaigning a stock, 601 hp 2025 Hyundai IONIQ 5 N in the Alternative Fuels class.

“After winning our class in a gutted, caged race car last year, we wanted to compete in the best-of-all worlds this year: A vehicle that’s incredibly fast, incredibly comfortable on a road trip, and incredibly capable on a racetrack,” explains Suddard. “Electrification means it’s finally possible to have huge power without huge compromises in a street car, and the IONIQ 5 N promises to pair that huge power with the durability and capability to survive a week of racing.”

One Lap is widely regarded as one of the toughest street-legal motorsports events in the world, pitting amateur and professional drivers alike compete in stock and heavily modified vehicles of every description, battling it out in a series of scored challenges, including timed events at road courses, drag strips, skid pads, and autocross courses.

In between tracks, competitors safely travel thousands of miles around the country, proving the mettle and durability of the vehicles and the teams that drive them. This year, 86 teams from all over the country will compete in 17 scored events over the course of eight days at tracks like Virginia International Raceway and NCM Motorsports Park.

The Tire Rack One Lap of America is currently underway – you can track the Hyundai’s progress here, then let us know what you think of this new tax development in the comments.

SOURCES | IMAGES: Hyundai, One Lap of America; FuelEconomy.gov.


Your personalized solar quotes are easy to compare online and you’ll get access to unbiased Energy Advisors to help you every step of the way. Best of all? Contractors won’t call you unless you give them your number. Get started here.

FTC: We use income earning auto affiliate links. More.

Continue Reading

Politics

It is ‘feasible’ Nigel Farage could be the next prime minister, says Kemi Badenoch

Published

on

By

It is 'feasible' Nigel Farage could be the next prime minister, says Kemi Badenoch

Kemi Badenoch has admitted it is “feasible” that Nigel Farage could become the next prime minister.

The Tory leader told the BBC’s Sunday With Laura Kuenssberg programme Mr Farage’s party was “expressing the feeling of frustration that a lot of people around the country are feeling” – but added it was her job to “come up with answers and solutions”.

Asked if it was feasible that Mr Farage could be the next prime minister, she cited how Australian Prime Minister Anthony Albanese had won re-election this weekend.

“As I said, anything is feasible,” she said. “Anthony Albanese: people were writing him off. He has just won a landslide, but my job is to make sure that he [Farage] does not become prime minister because he does not have the answers to the problems the country is facing.”

Politics latest: Lucy Powell ‘right’ to apologise for grooming gangs comments

Please use Chrome browser for a more accessible video player

Could Nigel Farage be prime minister?

Asked what Mr Farage was doing right, Ms Badenoch said: “He is expressing the feeling of frustration that a lot of people around the country are feeling.

“But he also doesn’t have a record in government like the two main parties do. Now he’s going to be running some councils. We’ll see how that goes.”

Mr Farage was the undoubted winner of Thursday’s local elections, in which 23 councils were up for grabs.

His party picked up 677 council seats and took control of 10 councils.

By contrast, the Conservatives lost 677 council seats as well as control of 18 councils in what was their worst local elections performance on record.

Mr Farage said the outcome spelt the end of two-party politics and that his party was now the official “opposition” to Labour – with the Tories having been rendered a “waste of space”.

Read more:
Reform has put the two traditional parties on notice

‘I get it’: Starmer responds after losing Runcorn by-election

Ms Badenoch said she believed the vote for Mr Farage on Thursday was partly down to “protest” but added: “That doesn’t mean we sit back. We are going to come out fighting.

“We are going to come out with the policies that people want to see, but what we are not going to do is rush out and tell the public things that are not true just so we can win votes.

“This is not about winning elections; this is about fixing our country. Yes, of course, you need to win elections to do that, but you also need a credible plan.”

Please use Chrome browser for a more accessible video player

‘Farage is a force in British politics’

Conservative co-chairman Nigel Huddleston sought to play down the threat from Reform UK, telling Sky News: “When they’re in a position of delivering things, that’s when the shine comes off.”

He told Sunday Morning with Trevor Phillips: “The one thing about Nigel Farage is, and we’re seeing this again and again and again, he is a populist.

“He is increasingly saying everything that anybody wants to hear. He’s trying to be all things to all men.”

“We are establishing ourselves as a credible alternative government based on sound conservative principles and values and our values and our principles, and therefore our policies, will define the future of our party,” he added.

Asked whether the results meant that Labour would now treat Reform as “your most serious opposition”, Health Secretary Wes Streeting told Trevor Phillips: ” I certainly do treat them as a serious opposition force.”

“As I say, I don’t know whether it will be Reform or the Conservatives that emerge as the main threat,” he added.

“I don’t have a horse in that race, but like alien versus predator, I don’t really want either one to win.”

Continue Reading

Trending