Republicans fail to repeal Obamacare

WASHINGTON - President Donald Trump suffered a stunning political setback on Friday in a Congress controlled by his own party when Republican leaders pulled legislation to overhaul the U.S. healthcare system, a major 2016 election campaign promise of the president and his allies.

Republican leaders of the House of Representatives pulled the legislation due to a shortage of votes despite desperate lobbying by the White House and its allies in Congress, ensuring that Trump's first major legislative initiative since taking office on Jan. 20 ended in failure.

House Republicans had planned a vote on the measure after Trump late on Thursday cut off negotiations with Republicans who had balked at the plan and issued an ultimatum to vote on Friday, win or lose.

Republican moderates as well as the most conservative lawmakers had objected to the legislation. The White House and House leaders were unable to come up with a plan that satisfied both moderates and conservatives, despite Trump's vaunted image as a deal maker.

"We learned a lot about loyalty. We learned a lot about the vote-getting process," Trump told reporters at the White House, although he sought to shift the blame to the Democrats, who were unified in their opposition, even though his party controls the White House, the House and the Senate.

Amid a chaotic scramble for votes, House of Representatives Speaker Paul Ryan, who championed the bill, met with Trump at the White House before the bill was pulled from the House floor after hours of debate. Ryan said he recommended that the legislation be withdrawn from the House floor because he did not have the votes to pass it, and that Trump agreed.

"There were things in this bill that I didn't particularly like," Trump added, without specifying what those were, but expressed confidence in Ryan's leadership.

"Perhaps the best thing that could happen is exactly what happened today, because we'll end up with a truly great healthcare bill in the future after this mess known as Obamacare explodes," Trump said.

Friday's events cast doubt on whether Ryan can get major legislation approved by fractious Republican lawmakers.

"I will not sugarcoat this. This is a disappointing day for us," Ryan said at a news conference, adding that his fellow Republicans are experiencing what he called "growing pains" transitioning from an opposition party to a governing party.

"Doing big things is hard," Ryan added, noting that he got close but failed to muster the 216 votes needed to pass it.

Ryan said he did not know what the next steps would be on healthcare, but called Obamacare so flawed that it would be hard to prop up.

Without the bill's passage in Congress, Democratic former President Barack Obama's signature domestic policy achievement, the 2010 Affordable Care Act - known as Obamacare - remains in place despite seven years of Republican promises to dismantle it.

Repealing and replacing Obamacare was a top campaign promise by Trump in last year's presidential election, as well as by most Republican candidates, "from dog-catcher on up," as White House spokesman Sean Spicer put it during a briefing on Friday.

AGENDA AT RISK

The House failure to pass the measure called into question Trump's ability to get other key parts of his agenda, including tax cuts and a boost in infrastructure spending, through Congress.

News that the bill had been pulled before a final vote was greeted initially with a small sigh of relief by U.S. equity investors, who earlier in the week had been fretful that an outright defeat would damage Trump's other priorities, such as tax cuts and infrastructure spending.

Benchmark U.S. stock market indexes ended the session mixed after rallying back from session lows following the news. The S&P 500 Index ended fractionally lower, the blue chip Dow Jones Industrial Average slipped about 0.3 percent and the Nasdaq Composite Index rose about 0.2 percent.

The dollar also strengthened modestly on the news and U.S. Treasury bond yields edged up from session lows.

"There's nobody that objectively can look at this effort and say the president didn't do every single thing he possibly could with this team to get every vote possible," Spicer told reporters before the legislation was pulled.

Trump already has been stymied by federal courts that blocked his executive actions barring entry into the United States of people from several Muslim-majority nations. Some Republicans worry a defeat on the healthcare legislation could cripple his presidency just two months after the wealthy New York real estate mogul took office.

In a blow to the bill's prospects, House Appropriations Committee Chairman Rodney Frelinghuysen announced his opposition, expressing concern about reductions in coverage under the Medicaid insurance program for the poor and the retraction of "essential" health benefits that insurers must cover.

"We need to get this right for all Americans," Frelinghuysen said.

Republican Representative Dana Rohrabacher said before the bill was pulled that voting it down would be "neutering Trump" while empowering his opponents.

"You don't cut the balls off a bull and then expect that he can go out and get the job done," Rohrabacher told Reuters. "This will emasculate Trump and we can't do that. ... If we bring this down now, Trump will have lost all of his leverage to pass whatever bill it is, whether it's the tax bill or whatever reforms that he wants."

Trump and House Republican leaders could not afford to lose many votes in their own party because Democrats were unified in opposition, saying the bill would take away medical insurance from millions of Americans and leave the more-than-$3 trillion U.S. healthcare system in disarray.

Republican supporters said the plan would achieve their goal of rolling back the government's "nanny state" role in healthcare.

Obamacare boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies. About 20 million Americans gained insurance coverage through the law.

The nonpartisan Congressional Budget Office said under the Republican legislation 14 million people would lose medical coverage by next year and more than 24 million would be uninsured in 2026.

Days of negotiations involving Republican lawmakers and the White House led to some changes in the bill but failed to produce a consensus deal.

The House plan would rescind a range of taxes created by Obamacare, end a penalty on people who refuse to obtain health insurance, end Obamacare's income-based subsidies to help people buy insurance while creating less-generous age-based tax credits

It also would end Obamacare's expansion of the Medicaid state-federal insurance program for the poor, cut future federal Medicaid funding and let states impose work requirements on some Medicaid recipients.

House leaders agreed to a series of last-minute changes to try to win over disgruntled conservatives, including ending the Obamacare requirement that insurers cover certain "essential benefits" such as maternity care, mental health services and prescription drug coverage.

source: news.abs-cbn.com

US health care vote postponed in blow to Trump

WASHINGTON - US President Donald Trump's bid to repeal his predecessor's signature health care law suffered a bitter blow Thursday, as opposition from within his Republican Party forced the delay of a crucial vote in Congress.

"No vote tonight," a House leadership source told AFP, signaling a stunning political setback for Trump -- who prides himself on his deal-making skills -- to win sufficient support for a Republican bill repealing and replacing Obamacare.

The president and his lieutenants repeatedly voiced optimism about the bill's prospects and said they had made progress in convincing doubters to join his camp in dismantling the Affordable Care Act.

But the votes for Trump's plan -- dubbed the American Health Care Act -- weren't there.

"I am still a no at this time. I am desperately trying to get to yes," said Mark Meadows, chairman of the conservative House Freedom Caucus, whose members have demanded major changes to the plan before giving their blessing.

While Meadows sought to portray optimism about the process, he revealed the width of the gap between Trump and plan opponents.

"At this point, we are trying to get another 30 to 40 votes that are currently in the 'no' category to 'yes,'" Meadows said after meeting with his caucus.

"Once we do that, I think we can move forward to passing it on the House floor."

House Republicans were preparing to head into a closed-door conference at 7 p.m. (2300 GMT) to thrash out their differences and perhaps come to agreement on a way to bring enough Republicans on board.

A White House official said the expectation was for a vote Friday, and downplayed suggestions that Trump had failed to close the deal, claiming the delay did not spell doom for the measure.

"The vote will be in the morning to avoid voting at 3 am," the official said.

"We feel this should be done in the light of day, not in the wee hours of the night and we are confident the bill will pass in the morning," the official said.

That schedule was reiterated by House Majority Leader Kevin McCarthy after the vote's postponement.

But with negotiations unable to provide the necessary breakthrough, nighttime debate is likely to be intense as the two sides seek an elusive compromise.

Failure to work out their differences would mark a humiliating defeat for Trump's biggest legislative battle to date.

DIVISION

Republicans have spent years railing against the Affordable Care Act, branding it an example of Democrats pushing for socialized medicine.

But seven years to the day since Barack Obama signed his landmark reforms into law, House Republican leaders were unable to present a united front within their own ranks for the alternative.

With Democrats opposed to Trump's effort to rip out his predecessor's crowning domestic achievement, and his own party's right flank in revolt, the White House and Republican leaders have been burning the midnight oil to find ways to make the bill palatable to enough conservatives without angering moderates.

Confidence by the White House appeared to highlight the disconnect between Trump's team and rank-and-file conservatives.

Asked Thursday whether House Speaker Paul Ryan might delay the vote, White House spokesman Sean Spicer said "nothing leads me to believe that that's the case."

A few hours later, the vote was postponed.

Many conservatives say their party's plan is still too costly for the government.

They have said they want to repeal health benefits that all insurance policies must pay for under Obamacare -- including maternity care, emergency room visits, and preventive care like screenings and vaccines -- arguing they have driven up costs.

LIMITING DEFECTIONS

The House Freedom Caucus, about 30 lawmakers who are heirs apparent to the ultra-conservative Tea Party movement, have dubbed the new bill "Obamacare Lite," as it will only reduce, not eliminate, health coverage subsidies by replacing them with refundable tax credits.

At the other end of the spectrum, some Republican moderates also worry their constituents would no longer be able to afford health insurance under the new plan.

A nonpartisan congressional budget estimate says it would lead 14 million Americans to lose their coverage from next year.

The Democratic minority is prepared to vote against it as a bloc, so Republican leaders need to limit defections to fewer than 22 out of their party's 237 representatives among the House's 430 current members.

Further pressuring recalcitrant Republicans, Trump tweeted out messages to his tens of millions of followers urging them to contact their local lawmakers in support of the plan.

Congressman Thomas Massie said the arm-twisting would not work on him.

"I'm still opposed to the bill," the Kentucky Republican told MSNBC. "I think it's worse than Obamacare."

Obama himself weighed in Thursday on the law's anniversary, saying the reform that has helped 20 million people get coverage should be improved, not pulled out by its roots.

"We should start from the baseline that any changes will make our health care system better, not worse for hardworking Americans. That should always be our priority," Obama said in a statement.

source: news.abs-cbn.com

US Congress approves first step for repealing Obamacare

WASHINGTON - The US House of Representatives on Friday joined the Senate in passing a critical measure that marks the first major step toward repealing outgoing President Barack Obama's landmark but controversial health care reforms.

The House's near party-line vote of 227 to 198 approved a budget blueprint which provides Republicans, who control both chambers of Congress, with a framework for dismantling the Affordable Care Act.

But one week before Republican President-elect Donald Trump takes office, a sense of urgency has swept over Washington about what his party will put forward as a replacement for the law, with Democrats warning of disastrous consequences should Republicans act too hastily.

"This resolution essentially fires the starting pistol... for repealing Obamacare," said Representative Bill Johnson, an Ohio Republican.

"This is a critical first step to deliver relief to Americans struggling under this law," House Speaker Paul Ryan told fellow members, describing as a "rescue mission" the latest effort to unwind Obamacare.

"This experiment has failed," and "we have to step in before things get worse."

The Senate passed the resolution Thursday. It received no Democratic support in either chamber, highlighting the intensely partisan fight that lies ahead.

The resolution provides Republicans with a powerful tool, called reconciliation, which allows repeal legislation to proceed through the 100-member Senate with a simple majority, protected from a Democratic filibuster that requires a 60-vote threshold to overcome.

Trump made repeal of the law a central plank of his insurgent campaign, and he sounded triumphant ahead of the vote.

"The 'Unaffordable' Care Act will soon be history!" he tweeted early Friday.

Days earlier he said the Republicans ought to repeal and replace Obamacare quickly and "simultaneously."

During a Thursday town hall style event Ryan said he was on board, and that he envisioned action on a plan "within the first hundred days."

'CUT' AND RUN?

Unwinding Obamacare will be a monumental task. Republican leadership is moving carefully, stressing it does not want to "pull the rug out from anyone" who might lose coverage if there is no replacement plan on offer.

But there is debate among Republicans about how -- and how fast -- to proceed.

Charlie Dent, one of nine House Republicans who voted against the resolution, expressed "reservations" about quickly repealing parts of Obamacare without a credible replacement at the ready.

"I think the repeal plan needs to be fully developed and better articulated prior to moving forward," he told CNN.

The White House touts Obamacare as a success, saying more than 20 million Americans have gained health insurance through the law.

The Affordable Care Act forbids insurance companies from denying health care due to pre-existing conditions, abolishes lifetime caps on care, and allows children to stay on their parents' plans until age 26, three provisions that have proved popular nationwide.

Ryan insists the Republican plan that moves forward will include its own versions of such provisions.

Democrats warn that scrapping the law could result in tens of millions of Americans losing coverage.

"They want to cut benefits and run. They want to cut access and run," House minority leader Nancy Pelosi said of Republicans, and accused Ryan of peddling "mythology" about the law.

House Democrat Hakeem Jeffries offered harsher criticism about Republican efforts to swiftly dismantle the reforms, despite not formulating a viable replacement plan in the last six years.

"All you have is smoke and mirrors, and the American people are getting ready to get screwed," Jeffries said on the House floor.

source: news.abs-cbn.com

How Obamacare helps boost BPO employment in PH

MANILA – More and more Filipino nurses are finding jobs in Business Process Outsourcing (BPOs) firms following the US Supreme Court verdict upholding Obamacare, or the Affordable Care Act.

According to Pasig City Representative Roman Romulo, chairman of the House Committee on Higher and Technical Education, the Philippine units of Dublin-based Accenture plc and New York-based EXL Service Holdings Inc. have increased their hiring of Filipino nurses, mainly for deployment to their global delivery centers in Cebu City.

"Both firms are signing up Filipino nurses with US licenses as well as those who have passed the NCLEX but still without US licenses," said Romulo.

Romulo said both firms provide a wide range of outsourced business support services to American health insurers. Accenture has 16 delivery centers in the Philippines, while EXL has three.

"There's no question Obamacare is driving US health insurers to transfer additional contact center, insurance claims processing, clinical support analysis, medical coding, and other non-core, business support jobs to the Philippines, either through independent BPO providers, or through in-house back offices,'' Romulo said.

Meanwhile, Romulo said UnitedHealth Group Inc. is also enlisting Filipino nurses and other fresh college graduates for training and employment opportunities as transition managers, assistant managers, team leaders, specialists handling health care accounts, customer service representatives and medical coders, whether certified or not.

source: www.abs-cbnnews.com

Fewer uninsured Americans thanks to Obamacare

REDWOOD CITY, Calif. – As critics of President Barack Obama’s Affordable Health Care Act continue to attack it, a new report shows the law is actually working.

Gallup says the rate of Americans without health insurance has dropped, thanks in part to Obamacare.

As of the end of 2014, 12.9 percent of adults lacked health coverage. That’s down by over 4 percent since the program rolled out in 2013.

As of last fall, about 6.7 million Americans have enrolled in the health program.

The expansion of Medicaid in more than half of the country also helped to bring down the number of uninsured Americans.

Read more from Balitang America

source: www.abs-cbnnews.com

Fil-Ams getting health insurance as Obamacare deadline nears

NEW YORK – March 31 is a deadline that will cost you $95 if you don’t have health insurance and it's a fine that will cost you even more next year.

The Patient Protection and Affordable Care Act or more commonly known as Obamacare is a federal law enacted to increase the quality and affordability of health insurance.

It's meant to lower the rate of the uninsured by expanding public and private insurance coverage and reducing the costs of healthcare for individuals and the government.

New York's Office of Citiwide health outreach specialist Iman James said, "Don't wait until March 30th because they might ask for income verification or they may ask you to verify your identity and that might take longer and you might miss that open enrollment date."

US Department of Health officials said you don't have to enroll in plans in the marketplace if you already have health insurance coverage through your employer.

But if an individual is unemployed, or if their health insurance premium costs are equal to or greater than 10 percent of their personal or household income, they may be eligible for free public insurance or lower cost health insurance.

New York resident John Mallonga said he is young, in good health and he feels that he doesn’t really need to spend for health insurance at this time.

While the penalty is not his main concern, he said it doesn’t hurt to start looking into the cheapest available private insurance he could get at the Obamacare Market Place.

Mallonga said, "I just think that Affordable Care Act is a good proposition for the whole country so it will be better for us in the long run. The truth is, all of us should be covered.”

Meantime, Jen Furer and her husband are self-employed, running a consulting company that makes more than $126,000 a year.

Pre-Obamacare, she said, for a family of six, they pay nearly $17,000 a year for premium health insurance plan.

"No Deductibles, very minimal co-payment and I could go to any specialist that I want. When Obamacare kicked in starting this year, I was informed that my plan was increasing to $33,000," Furer said.

Furer said under Obamacare, their consulting firm no longer qualifies as small business without having a single paid employee.

She pointed out that if their income stayed below $120,000 annually, she would have qualified for a tax subsidy of $8,376.

Obamacare experts advise Furer to look into other ways to insure her family with the help of navigators who could guide her through her family’s healthcare needs.

Navigator Caitlin O’Brian said, "If you have four kids, I'd have you come see a navigator, instead of just doing it on the website because there are lots of other things that you can do to kind of tweak it."

The deadline to find a healthcare plan using the Market Place is on March 31. Obamacare experts told people not to wait until the last minute to get insured to avoid various penalties.

source: www.abs-cbnnews.com

Many Fil-Ams still unsure about 'Obamacare'

NEVADA - As the deadline to sign up for Affordable Care Act draws near, many kababayans living in the valley are still longing for answers if this health care is sustainable and will provide long term coverage for years to come.

Obamacare has been the talk of the town for months in Nevada. With President Obama's 'mea-culpa” for the glitch and confusion brought to Americans on healthcare coverage, Nevadans still continue to wonder what Obamacare is really all about and if it will be beneficial for them.

Enrique Jamelo was in the military for five years. Because he voluntarily discharged from the service, he wasn't able to carry over the coverage veterans and military personnel have.

He is back to ground zero in providing healthcare insurance for his family. Although his wife Joan works in a casino, she is still not eligible for insurance coverage as she only works part time.

"Mahirap kasi it's like no security at all lalo na may kids. You have kids na magka-kasakit. Yun yung concern namin. That's why we are asking about those coverage and how much plans," said Joan.

Her husband added, "Kasi hindi mo naman alam kung kelan ka magkakasakit paano kung wala kang insurance magkano ang babayaran mo sa hospital?”

Like many other households, the Jamelos is just one of the many families in Nevada who are longing for affordable healthcare insurance.

White House Commissioner Rozita Villanueva Lee said that the Affordable Care Act had a very slow start due to some technical glitches.

"Nevada ACA is almost the same as national because we had glitches in our computer as well. But we are so glad that Governor [Brian] Sandoval decided to make it as state thing and its really gonna be more helpful to our people," Lee said.

"What our role is to make sure that the Filipinos, our kababayans, know about what's happening because many of them don't know that they can get subsidize as well even though they are not working. They're so afraid to come and sign up. We can also help them out to get good health care,” she said.

Lee added that although security issues are now a concern to many, she assured Nevadans that all information is kept confidential. She is optimistic that technicalities are being fixed and will be running smoothly in the silver state of Nevada.

"Many of them still have a big question mark primarily, and that our role is to help them to understand. How expensive is it? It's the cost. They don't know what the cost is. It's not expensive. It's affordable. That's why we tell them come here. We will put all the information about you and your family in here," Lee said.

Dr. Noel Fajardo of Las Vegas Gastroenterology said that in the medical community, misconceptions by both medical practitioners and patients alike, led to confusion regarding Obamacare coverage.

"People are misinformed and there's a lot of confusion as to when they are going to be eligible for receiving services under the ACA, and whenever they asks us questions we could not give direct answers because it's quite difficult for us to find a resource and this is the same situation when they go to the website and internet. They find a lot of misinformation as well. So I think this is where the government can come in and educate us what this act is all about,” said Dr. Fajardo.

Dr. Fajardo added that a more aggressive educational campaign for the ACA should be given to both medical practitioners and patients to gain a better understanding and awareness.

"We may get some newsletter from insurance companires but not exactly specific guidelines and this is quite frustrating for the patient, and also our practice as well, because there are some inconsistencies on what they tell us and this is something we don't know if it's the act itself or the insurance,” he said.

In a recent meeting, US Majority Floor Leader Senator Harry Reid said that the ACA will be beneficial for uninsured Americans.

source: www.abs-cbnnews.com

It's Health Plan Open Enrollment Time: Navigating Your Benefit Options

With open enrollment at U.S. companies right around the corner, many workers will find themselves sifting through mounds of paperwork trying making sense of the benefit options awaiting them.

This year's enrollment season gets even more complicated with an expanded health insurance marketplace as part of the president's Affordable Care Act. While more options mean price points will be more competitive, it can also make finding the right plan daunting.

Many consumers just don't understand the health plan choices they need to make and that means they could be wasting money or unnecessarily paying out-of-pocket expenses.

To cut through the confusion, many turn to a trusted financial expert. Conversely, savvy financial advisors typically reach out to clients as open enrollment approaches.

"I send a note to working clients saying that if they are facing open enrollment, they should contact me," said Roger Wohlner, a certified financial planner with Asset Strategy Consultants.

As health-care costs outpace annual inflation at a clip of 4 percent, with some estimates pegging even higher costs in coming years, companies increasingly have adjusted insurance offerings to mitigate their own cost for offering coverage.

What this means is that more employers are steering employees into consumer-directed health plans, which generally require workers to take more control over how health-care dollars are spent.

"You really need to look at all options and changes before you make a decision," said Ted Jenkin, a certified financial planner who is co-CEO and founder of oXYGen Financial. "Your overall decision should be predicated on past medical expenses and what you anticipate (spending) going forward."
The number of large employers offering only a consumer-directed health plan continues to rise, with 22 percent of firms planning to implement such plans for 2014, up from 19 percent this year, according to a survey released in August by the Washington, D.C.-based National Business Group on Health. Already, 72 percent offer such plans, the survey found.

Basically, it's getting more complicated. No longer will choices be limited to low-deductible plans where coverage choice is based solely on in-network or out-of-network coverage or a focus on preventive or catastrophic care coverage.

Consumer-directed health plans all have one thing in common: They are tax-advantaged accounts. Included in those plans are health savings accounts, flexible spending accounts and health reimbursement arrangements.

FSAs are funded through pretax payroll deductions and can be used for eligible medical expenses. The IRS contribution limit now is $2,500, with the amount scheduled to be adjusted yearly for inflation.

The downside is FSAs are use-it-or-lose-it accounts, meaning unused funds at either year-end or an employer-imposed deadline are forfeited.




Wohlner advises clients who use FSAs to evaluate their medical expenses and adjust contributions accordingly.

"If you see your expenses were lower this year (than your 2013 commitment), don't contribute as much for next year," Wohlner said.

Additionally, FSAs no longer can be used to fund over-the-counter expenses because of provisions in the Affordable Care Act. In past years, FSA owners with unused funds could stock up on needed OTC medications.

FSAs are not used in conjunction with high-deductible plans -- that's what HSAs are for.

HSAs must be coupled with a high-deductible plan. IRS guidelines for 2014 dictate the deductible must be at least $1,250 for self-only coverage or $2,500 for family coverage. But, the 2014 pretax contribution limit to an HSA is higher than for an FSA -- $3,300 per individual and $6,550 per family -- and unused funds remain in the account.

Another appeal is an HSA's portability -- it can move with the employee from job to job.

Tom Henske, a certified planner with Lenox Advisors, advises clients to use HSAs if they are offered.

"Clients generally will worry about 12 to 24 months from now, not 12 to 24 years," Henske said. "But we don't see any end in sight for rising costs. We don't know where this is going. So workers should build a war chest."

Certified financial planner Jennifer Cray agrees.

"It's really a way to save for retirement," said Cray, who works for Investor's Capital Management.

Another benefit to HSAs over FSAs is that they require less guesswork, Henske explains.

"Deciding how much to put into an FSA is just a guesstimate of how much you need," Henske said.

Health reimbursement arrangements increasingly are being explored by companies. In fact, Jenkin has seen a growth in their use specifically among small-business owners.

The biggest difference between an HRA and that of an FSA or HSA is that it is owned by the employer. The company funds it, but the employee uses the money for qualified medical expenses.

Although workers cannot contribute to an HRA, they are not taxed on the employer's contributions. The company, meanwhile, gets a tax break -- which is why some companies view such accounts as a way to mitigate their rising health-care costs, according to some financial experts.

Federal law also allows significant flexibility in how employers implement HRAs.

Behavioral health coverage, including mental health and substance abuse, fall under the jurisdiction of federal law requiring certain levels of coverage. Exact coverage, including deductibles and allowable visits, varies from state to state.

Additionally, many companies also offer dental and vision coverage.

"It's usually very cheap relative to health insurance, so it's almost always worth getting," Cray said. "But make sure your doctors are in network."

She adds that for workers with children, vision and dental coverage can be more crucial because of unanticipated costs such as orthodontic care and eye glasses or contact lenses. And, typically, preventive care such as routine dental cleanings and vision checks are low cost.

The bottom line, Jenkin said, is employees need to evaluate the full picture of insurance options before blindly committing with little thought.

"Look at your options," he said. "And really give thought to how you build an overall construct that meets your needs."

source: dailyfinance.com