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    Trump attempts market stabilization of Obamacare

    As most expected, changes to the Affordable Care Act (ACA), which President Donald Trump threatened to repeal once in office, seem to be on the way.

    Earlier this week, the Trump Administration released a proposed rule for market stabilization of the ACA designed to help convince insurers to remain in the  marketplaces while Congress drafts a replacement plan for the ACA.  


    In case you missed it: Replacing Obamacare not an easy path for new administration


    Provisions in the rule address changes such as special enrollment periods, guaranteed availability, timing of the annual open enrollment period, network adequacy standards and actuarial value requirements.

    The proposed regulations are meant to entice insurance companies to stay in the markets by reducing the number of days people have to sign up and by requiring more documentation of eligibility.   

    Kent Bottles, MD, Thomas Jefferson University College of Population Health, says the news brings into sharp focus the difficult balancing act that the GOP has to tackle since it has repeatedly announced that it wants to repeal the ACA. 

    “The problem with repealing the ACA is that it would take insurance away from about 20 million Americans who recently achieved coverage. They will be mad if that happens,” he says. “The Republicans have also not revealed what they would replace the ACA with, because no matter what they decide on, there will be winners and losers under a new system. Insurance companies need to decide soon if they will sell on the exchanges in 2018 and are nervous because they don’t know what rules will apply.”

    Bottles says there are two schools of thought from doctors on the issue: one is most concerned about physician autonomy and physician income and they have never been big fans of the ACA. Another group likes the ACA in that it has provided many of their patients with insurance for the first time. This means that these doctors get paid something rather than giving charity care.

    Related: Here's why membership medicine is gaining physician attention

    Interestingly enough, a 2017 New England Journal of Medicine survey of primary care physicians found that only 15% wanted to repeal the ACA. It did note that there are things that need to be improved in it, but most physicians believed it has helped their patients.

    Next: "A temporary sense of relief to physicians"

    Keith Loria
    Keith Loria is a contributing writer to Medical Economics.

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    • [email protected]
      Pardon my French, but I wouldn't trust a word about any survey from the NEJM. I cancelled my subscription to them YEARS ago because they came out squarely in favor of socialized medicine, and I thought that grossly inappropriate for a medical journal with the previous stature and trust like the NEJM to take such a polarized political view with so much at stake for us physicians. I now class them along with CNN and other media that would do nothing short of lie or distort the truth to their agenda (sorry, I just do believe that). I haven't seen their so-called survey, but everything I've read about how physicians feel about the ACA is 100% contrary to what they are saying. At least for any of us who are still trying to run a medical practice (like I've been doing for the past 35 years). The government has a new acronym every other week with some new 'plan' to supposedly improve healthcare quality and cost and they've done nothing but put countless, pointless hurdles and perverse incentives into the practice of medicine that it's nearly impossible to run a practice today and stay in business. The whole ideas of 'Managed Care' particularly CMS' version of it is an abject failure and no one is saying so. They are are in fact running small practices out of business (if you don't think this is the case, check out MIPS, MACRA etc.etc. or spend one day in my practice). So I'd be really WARY of anything the NEJM 'reports' that's objective about healthcare particularly what 'ALL' physicians think (remember the election when the media represented Hillary as a landslide victory?). Sorry to be so opinionated but there's a lot of BS that passes as truth/fact.' Just remember the election and how the media used their bias to try to sway people's vote. Can be very damaging. By the way I DO care about people and their access to healthcare, I am just vehemently against a healthcare system that will never deliver it no matter how it's paid for. We NEED a fundamental redesign of our healthcare system and I'm sorry but nothing less will do.

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