What's next for Obamacare?

- President-elect Donald Trump has been promising for months that Obamacare will soon be history.

But Dr. David Howard, Ph.D., Associate Professor of Health Policy at Emory's Rollins School of Public Health, says don't expect major changes to the Affordable Care Act anytime soon.

"I don't think the Republicans  want to do anything that is going to further destabilize the insurance markets,” says Dr. Howard.  “And they also don't want to have stories running every night on the news about cancer patients getting thrown off their insurance."

For that reason, Howard believes the Trump administration will keep two popular pieces of Obamacare: the provision that bans insurance companies from denying coverage because of a pre-existing condition, and the clause that allows young people to stay on their parents' health plan until they turn 26.

"That's not very costly, it's not very controversial,” says Howard. “I don't think the  Republicans are going to repeal that."

One thing that will almost certainly go, and maybe quickly, is requirement you purchase insurance coverage or face a tax penalty.

"The individual mandate is very unpopular,” says Howard.  “I think they will be under a lot of pressure to strip that away."

That would mean that 27 million Americans who have chosen not to purchase health coverage would not be penalized when they file their taxes.

Holden thinks the Republican-controlled Congress could get rid of or tweak parts of the ACA that have been problematic for some.

The government-run insurance marketplace Healthcare.gov could be replaced by a privately-run system.

Instead of only being able to purchase coverage through their state insurance marketplace, Americans might be able to shop around in neighboring states.

And, Howard predicts, Americans who have been receiving subsidies to offset the cost of their insurance coverage will still receive support.

It may come in the form of tax credit for having coverage rather than a subsidy.

Holden says it's unlikely the Affordable Care Act will be repealed outright.

That could undermine the U.S. insurance market, leaving 20 million Americans and their insurers with few options.

"And if insurers threaten to walk away from the individual market, that will really tie the Republicans hands,” says Howard.  “So, I expect they are going to go fairly slowly, and a lot of the elements of the Affordable Care Act are going to be kept in some form."

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