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3 reasons Congress could approve an ACA change bill (with video)

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Even many of the Republican speakers who appeared last week at the Health Agents for America meeting said they are now resigned to the possibility that the Affordable Care Act may be too politically tough to kill.

But one of the speakers, Sen. Bill Cassidy (R-La.), told a room of about 140 health agents and brokers in New Orleans that he thinks there’s still hope for getting major changes to the ACA commercial health insurance provisions, including the ACA public health insurance exchange, provisions, through Congress. 

Cassidy recently released a major ACA overhaul bill proposal, the Healthcare Accessibility, Empowerment and Liberty Act of 2016, together with Rep. Pete Sessions (R-Texas).

Related: Sessions-Cassidy PPACA overhaul bill, dissected

The proposed bill would repeal ACA coverage mandates, let a state decide for itself whether to keep its ACA health insurance exchange, expand the health savings account program, and support efforts by physicians to start all-cash concierge medical practices.

Many say that making major ACA change legislation law could be difficult, even if Donald Trump becomes president and the Republicans retain majorities in the House and Senate, because Republicans would need a supermajority to get an ACA-changer bill through the Senate, even using the simplified process available to budget reconciliation bills. To get a more comprehensive ACA-changer bill through Congress, supporters would probably need at least 60 firm votes in the Senate to get the bill to the Senate floor, skeptics say.

For a look at why Cassidy thinks the Sessions-Cassidy proposal, or some future version based partly on the proposal, could move forward, based on his remarks at the HAFA meeting, and a video of his remarks, read on:

In some "Blue" states, individual policy out-of-pocket costs are soaring along with premiums. (Image: Thinkstock)

In some “Blue” states, individual policy out-of-pocket costs are soaring along with premiums. (Image: Thinkstock)

1. Some Democratic lawmakers now represent states with very high individual health insurance prices.

“People cannot afford $1,600 a month [in premiums] and a $10,000 family deductible,” Cassidy said.

Related: Covered California sees 2017 rates rising 13.2% 

Some states are on track to have just one individual coverage issuer left in 2017. (Photo: Thinkstock)

Some states are on track to have just one individual coverage issuer left in 2017. (Photo: Thinkstock)

2. Some Democratic lawmakers represent states with just one remaining individual health coverage issuer.

Arguments for an alternative to the current system may be especially appealing to a Democratic lawmaker in a state with an individual market “that’s now down to one carrier, that’s now threatening to pull out,” Cassidy said.

Related: Republicans have a shot at replacing Obamacare

Maze

For a Democrat in a state with severe 2017 coverage supply problem, ACA “change” might sound like a way out of the policy maze. (Image: Thinkstock)

3. Voting to give states options to change how they implement the ACA might be more politically acceptable than voting to repeal the ACA.

“A Democrat may feel as if she or he cannot vote for repeal,” Cassidy said. “There’s too much invested by their party.”

But “we’re not repealing and replacing,” Cassidy said. 

Asking Democrats to vote for changes in the ACA, and for giving states the option of changing their ACA programs, might be easier to sell to Democratic lawmakers who are looking for solutions to their constituents’ problems, Cassidy said.

Related:

Health agents head to New Orleans

Republicans’ new ACA replacer, dissected

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