>> Even as Republicans debate the future of Obamacare,
healthcare.gov says there have been extraordinary demand to
enroll in Affordable Care Act plans.
In Wisconsin, enrollment is up 14% over this time last year.
Those plans cover 2017.
But as Frederica Freyberg reports, people are worried
about what could happen to their coverage.
>> Real change that begins with immediately repealing and
replacing Obamacare, a total disaster.
[cheers and applause]
>> Ever since the law went into effect, "repeal and replace" has
been the clarion call of Republicans, and now with a
like-minded Donald trump as president-elect, the Affordable
Care Act of today would appear to be toast.
>> That has people who signed up for marketplace health plans
that first year it became available watching what's next
with worry.
People like Georgia Curry, who aged out of her parents' plan.
>> You want to cultivate in your practice.
>> And whose work as a yoga instructor did not provide
coverage.
She's been on a mid-tier plan ever since.
Paying well under $100 a month because of subsidies calculated
by income.
>> It's really important to me and I'm relatively healthy, but
because I do have chronic conditions, I would be nervous
to be without coverage, without insurance.
It's important for me to be able to see my doctor.
I have a really active lifestyle.
I teach yoga, obviously, so my livelihood depends on me being
physically healthy.
>> God bless you, everybody.
Thank you. Thank you.
[cheers and applause]
>> It is quite evident that the leadership, both the
president-elect Trump and the Republican leadership in
Congress are intent on fulfilling the promise that was
made during the campaign to repeal the Affordable Care Act.
But the route to getting there is rather complicated.
And it seems that the most recent discussion is being
termed repeal and delay rather than repeal and replace.
>> Health policy director at the UW Population Health Institute,
Donna Friedsam, says what could be repealed right away are
provisions related to the federal budget.
So those subsidies would be likely to go.
Subsidies which she reports, about 85% of the 230,000 people
in Wisconsin covered by the ACA receive.
Another provision on the immediate chopping block because
it's linked to tax revenue that supports the law, the individual
mandate which requires everyone to have health insurance.
We spoke with Health and Human Services Regional Director in
the Obama administration, Kathleen Falk about selective
repeal of the ACA.
>> Can the president and Congress cherry-pick and keep
part of it, like keeping children on health care until
they're 26 or covering pre-existing conditions but
ditching things like the individual mandate?
Does it work if you just repeal parts of it?
>> Well, there will be consequences to repealing any
just parts of it.
So, for example, if the mandate was repealed, it means all the
rest of us who already have insurance will end up paying
more because we pay for the health care costs of those
without insurance when they show at their emergency room, for
example.
So there are a lot of people who are affected if you cherry-pick
pieces.
>> Including potentially the insurance industry, because if
the requirement for everyone to have insurance goes away, but
the part of the law that requires coverage for people
with pre-existing conditions stays, insurers could wind up
with an insurance pool that includes more of the sick and
fewer of the healthy.
>> I don't think anybody in Washington in any manner,
Republican leadership, is interested in doing something
that's going to collapse the individual insurance market.
And so they're looking for a way to signal to the people that
elected them that they are serious about repeal of the
Affordable Care Act, but that they need to create enough space
and enough time to come up with a solution that is acceptable to
the insurance industry and to people such that we won't have
massive losses of insurance coverage that stands today.
>> Among replacement solutions being talked about in Washington
on the part of Republican leaders, getting rid of the
individual mandate to have insurance, providing tax credits
based on age to help buy insurance, expanding the use of
health savings accounts, limiting coverage for people
with pre-existing conditions to those who have had continuous
insurance coverage and phasing out expanded Medicaid.
That's the federal insurance for those at or near the poverty
level.
On Medicaid, another change would have the federal
government give states a block grant or a fixed per capita
allotment to manage as they see fit.
Right now federal Medicaid money flows to states based on need
and demand.
In Wisconsin, 1.2 million people are in the Medicaid program.
>> I think governors imagine that if they have a federal
block grant, they would be able to reduce the spending in the
Medicaid program through these kinds of innovations that they
have not been able to do with the existing federal
requirements.
That being said, there is a lot of concern about whether the
existing block grant allocations would keep up with the need and
demand for the program.
>> There is a lot of imagining going on right now about how to
replace Obamacare.
And because it's so complicated to unravel, the replacement may
be delayed beyond the full or partial repeal of it.
All of the unanswered questions with the clarion call to get rid
of the law as backdrop leaves some currently insured under the
ACA taking it day by day.
>> I don't want the rug ripped out from under me, but I guess
I'm just trying to take it a step at a time and see what's
next.
>> When Georgia Curry renewed her plan to keep it the same as
last year, she reports the premiums went up about 60%.
The final deadline for those looking to enroll or change
plans for 2017 is the end of January.