Trump considers provocative new hostage strategy on health care

The overall effect of the new rules is that health insurance will be harder to buy in 2018, especially for people whose circumstances change during the year, enabling them to buy policies outside the annual sign-up period.

There are now 20 million Americans, many of them low income, who have health care for the first time because of Obamacare.

This year saw premium increases averaging 25 percent for a standard plan in states served by

Most Louisiana residents approve of Medicaid expansion, according to an LSU survey.

Analyst Larry Levitt, of the nonpartisan Kaiser Family Foundation, told the AP that the new rules will be "meaningless" in encouraging insurance companies to stay in the market if the government ends cost-sharing subsidies.

-A shortened sign-up window of 45 days, starting with coverage for 2018. In previous years, they had twice that much time, and could still buy coverage until January 31.

In other words, they want to make insurance more affordable for the young and healthy by making it unaffordable for the old and sick, and worse for everyone. That's no quick task when a patient has several doctors, insurers are leaving exchanges, and those that remain have narrow doctor networks.

The taxes used to pay for the expanded health coverage under the ACA were carefully crafted to affect only the wealthy. A few states may allow it, and that could work in your favor if the plan is subject to state law. "It's not a five-minute conversation".

Requiring individuals to submit supporting documentation for special enrollment periods and ensuring that only those who are eligible are able to enroll. That could create coverage delays. Which is to say that they attack the unpopular parts of the law, like penalizing people for not getting insurance, at the same time that they support the popular parts, like banning insurance companies from discriminating against people with preexisting conditions.

It could also raise out-of-pocket medical expenses, the experts said, because it gives insurers more flexibility in determining the value of their coverage.

Whether these changes help convince insurers to stick around for 2018 remains to be seen. Democrats have not offered a replacement plan. Insurers say these have been too easily granted, allowing some people to sign up only when they need costly treatment. But a key concern has yet to be addressed. "Most urgently, health plans and the consumers they serve need to know that funding for cost-sharing reduction subsidies will continue uninterrupted".

The future of the cost-sharing subsidies, estimated at $7 billion this year, is under a legal cloud. Conflicting statements from the administration about its intentions with the ACA means insurers will hedge their bets and hike premiums to cover the costs of this uncertainty.

Let's talk about the free market in health care.

"For me, if I were a politician, to get behind something that only 17 percent of the population supported was terrible hard", Clarke said.

Most communities will have competing insurers on the public marketplace next year, but a growing number will be down to one, and some areas may face having none.

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