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Obamacare, You're Fired - December 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 44 of 132

system. Republican House Speaker Paul Ryan has long wanted to reform Medicare by turning it into a premium support model in which individuals receive vouchers to buy coverage from private payers. "It's a bit of an irony: eliminating exchanges in one market and creating them in another," says legislative and health policy strategist Piper Su, vice president of McDermott+Consulting in Washington, D.C. Mr. Ryan also wants to increase the qualifying age from 65 to 67. Mr. Trump has expressed interest in "modernizing" Medicare, but has pro- vided little detail. Mr. Trump and Mr. Ryan also want to cut Medicaid by establishing block grants to states that would provide local governments with annual funds to allocate as they see fit or a per capita allotment that would provide states a flat amount for each enrollee. With Republicans in control of Congress and Mr. Trump in the White House, Mr. Ryan has the chance to push though the Medicare and Medicaid reforms he's been touting for years. No more excuses Mr. Strazzella says Republicans are already developing an aggressive repeal-and-replace strategy so there will be achievable action points on Mr. Trump's desk as soon as he takes office next month. The GOP is firmly in control of Washington, providing it with the opportunity to fulfill the promise of healthcare reform that has energized its base. That opportunity also comes with immense pressure. "The Republican dog has finally caught the car it's been chasing," says Dr. McDonough. "There's so much at stake. It's entirely possible they'll be able to complete the repeal, but unable to pull off the replace. That would be a train wreck, especially because they have all 3 branches of government and the whole country will be watching." OSM D E C E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 4 5

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