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The Exchange

A Check-Up For The Affordable Care Act


This controversial health care law has undergone some changes since it was signed eight years ago, particularly under the Trump Administration.  We find what that means for the Granite State and what's in store for the Affordable Care Act in the months ahead. 


Alex Feldvebel, Deputy Commissioner with the N.H. Insurance Department.

Julie Rovner, Chief Washington Correspondent with Kaiser Health News and host of the KHN podcast "What the Health?"  


Related Reading

Listen to a recent episode of NHPR's Civics 101 for more context on the ACA.

New Hampshire's U.S. Senators Hassan and Shaheen warn about efforts to weaken the ACA.

  • New Hampshire’s two Democratic senators blamed President Donald Trump and his administration for “sabotaging” the Affordable Care Act – better known as Obamacare.

Gov. Chris Sununu signs Medicaid Expansion, with new work requirement for some Granite Staters.

The Trump Administration resumes risk payments to health insurers. 

  • In adopting a new rule, the administration essentially accepted the arguments of critics, including consumer groups, health insurance companies and Democrats in Congress, who said that suspending the payments would cause turmoil in insurance markets.

The Individual mandate penalty is removed

  • The GOP tax bill doesn’t actually repeal the individual mandate under Obamacare; it simply reduces the penalty for going uncovered to zero. But in practice, eliminating the individual mandate penalty will have the same result as eliminating the individual mandate altogether.

Navigator programs lose funding, get new job description

  • The Trump administration announced  that it was slashing grants to nonprofit organizations that help people obtain health insurance under the Affordable Care Act, the latest step in an escalating attack on the law that threatens to destabilize its insurance markets. The cuts are the second round in two years. The government will provide $10 million this fall, down from $36 million last autumn and $63 million in late 2016 — a total reduction of more than 80 percent.
  • Since they began work in 2013, navigators have helped people enroll in health plans that comply with the Affordable Care Act. Now the Trump administration says they should also inform consumers of other options, like association health plans and short-term, limited-duration insurance.

New Trump Administration rule allows for new insurance arrangements, known as association health plans.

  • The rule will allow small-business owners, their employees, sole proprietors and other self-employed people to join together to buy or provide insurance in the large-group market through association health plans. Because they will be exempt from many requirements of the 2010 health law, Mr. Trump has said, the association health plans can “provide more affordable health insurance options to many Americans, including hourly wage earners, farmers and the employees of small businesses.”

The Trump Administration proposes looser restrictions on short-term health plans that consumer advocates fear will fail to protect consumers from serious medical bills and could destabilize the individual insurance market by pulling healthy people out of insurers’ risk pools

The Trump Administration ends Obamacare subsidies for the poor. 

  • The decision ends speculation about whether the Trump administration would continue making the monthly payments to insurers. That money particularly helps people earning between 100 percent and 250 percent of the poverty level pay for the insurance and health care that they get through the exchanges set up by the Affordable Care Act.

Is coverage for pre-existing conditions in danger?

Timeline: Despite GOP's Failure To Repeal Obamacare, The ACA Has Changed. 

Obamacare Is Proving Resilient Despite Efforts to Undo It. 

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