Barack Obama won the 2012 election, becoming the last Democrat president to serve two consecutive terms. However, his second term was marked by the rise of Donald Trump, who went on to become the Republican president, ousting the Democrats from power after eight years of Obama.

Many Americans loved the first African American president, with some even urging him to run again for a third term in 2016. But US presidents cannot have more than two terms, and Obama went on to campaign for the subsequent Democratic candidates, including Joe Biden, who was his vice president.

Watch: US Presidential Elections: Harris Rallies With Obama, Celebrities In Georgia

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In 2012, Obama was seeking a second term in the wake of the global financial crisis that started in late 2007 with the collapse of some major American banks, insurance firms and other financial institutions.

As the Great Reccession continued for the common people, the rich continued to become richer, which led to the Occupy Wall Street movement just a few months before the election.

Obama's Republcan rival was Mitt Romney, the former Massachusetts governor.

The key issues in the 2012 election cycle&nbsp;were the recovery of the American economy, the landmark yet contentious healthcare reforms of Obama, and his foreign policy.&nbsp;

<a href="https://www.wionews.com/world/former-president-barack-obama-and-singer-bruce-springsteen-pitch-for-kamala-harris-771734">Also read: Former president Barack Obama and singer Bruce Springsteen pitch for Kamala Harris</a> 
 
Obama had passed the massive medical care reform called the Affordable Care Act, often referred to as Obamacare. He also spent much of his first term stabilising the economy after the financial crisis of 2007-08 left behind by his Republican predecessor George W Bush.

Unemployment, which was above 8 per cent as of 2012 remained a key issue during the 2012 election, as the working class was still feeling the pinch from the financial crisis.

This made many question the economic policies of Obama in his first term.

Romney seized on this opportunity to attack Obama.

Hightlighting his private sector experience - he was the co-founder of investment firm Bain Capital - Ronmey argued that he can fix the economy.

With the campaign slogan 'Believe in America,'&nbsp;Romney focused on claiming that debt increased and job growth was slow during Obama's first term.

Obama's campaign, with the slogan 'Forward', mobilised supporters on the progress made during his presidency on women's rights, immigration reform and healthcare. He even took a pro-LGBTQ stance closer to election date.&nbsp;

But on the healthcare front, Obama was often cornered by Romney, who advocated repeal of the Affordable Care Act.&nbsp;

They sparred on these issues at debates, with Obama appearing to be on the backfoot in the first one. But he recovered and improved his performance in later debates.

Well into the last days of campaign, Obama appeared to be on a weak position but his emotional and rousing speeches and Demcratic party's massive ground-level surge campaign managed to convince most voters to give him four more years.&nbsp;

The 2012 election also cemented the role of technology, which was already used in the previous one. Data analytics was used as effectively by Obama campaign as grassroot voter mobilisation.

Romeny somehow did not have the same arsenal when it came to using technology, particularly social media outreach to young voters.

There was also an increase in early voting, which is believed to have helped Obama.

<a href="https://www.wionews.com/world/and-hes-talking-about-illegals-biden-slams-musk-over-illegal-worker-claims-tesla-ceo-hits-back-771298">Also read: 'And he's talking about illegals': Biden slams Musk over 'illegal worker' claims; Tesla CEO hits back</a>

The election, held on 6 November 2012, saw better participation from minorities and youngsters, which also was to Obama's advantage.

Eventually, Obama won re-election by getting 332 electoral college votes as against 206 for Romney, and 51 per cent of the popular vote as against 47 per cent for the Republican.

But the election was, in many ways, a predictor of the fact that American electorate was getting slowly divided. If you look at the results map in this story, it is clear that red states and blue states were practically split through the middle of the nation. Obama won the more populous and coastal states where miniorities and immigrants live in large numbers. Romney won much of the north, middle America and conservative south, often described as the Bible Belt.

Obama did extremly well with youth, Latinos and Blacks, whereas white voters appear to have preferred Romney. In the second term of Obama, that division only worsened, including protests after police killings of Black people.

The emergence of migrant communities as voting blocs became an issue for many in the white majority, who gravitated towards a more rightwing approach opposing immigration, a sentiment captured and amplified by Donald Trump.

(With inputs from agencies)

Barack Obama won the 2012 election, becoming the last Democrat president to serve two consecutive terms. However, his second term was marked by the rise of Donald Trump, who went on to become the Republican president, ousting the Democrats from power after eight years of Obama.

Barack Obama won the 2012 election, becoming the last Democrat president to serve two consecutive terms. However, his second term was marked by the rise of Donald Trump, who went on to become the Republican president, ousting the Democrats from power after eight years of Obama. Many Americans loved the first African American president, with some even urging him to run again for a third term in 2016. But US presidents cannot have more than two terms, and Obama went on to campaign for the subsequent Democratic candidates, including Joe Biden, who was his vice president. Watch: US Presidential Elections: Harris Rallies With Obama, Celebrities In Georgia × In 2012, Obama was seeking a second term in the wake of the global financial crisis that started in late 2007 with the collapse of some major American banks, insurance firms and other financial institutions. As the Great Reccession continued for the common people, the rich continued to become richer, which led to the Occupy Wall Street movement just a few months before the election. Obama's Republcan rival was Mitt Romney, the former Massachusetts governor. The key issues in the 2012 election cycle were the recovery of the American economy, the landmark yet contentious healthcare reforms of Obama, and his foreign policy. Also read: Former president Barack Obama and singer Bruce Springsteen pitch for Kamala Harris Obama had passed the massive medical care reform called the Affordable Care Act, often referred to as Obamacare. He also spent much of his first term stabilising the economy after the financial crisis of 2007-08 left behind by his Republican predecessor George W Bush. Unemployment, which was above 8 per cent as of 2012 remained a key issue during the 2012 election, as the working class was still feeling the pinch from the financial crisis. This made many question the economic policies of Obama in his first term. Romney seized on this opportunity to attack Obama. Hightlighting his private sector experience - he was the co-founder of investment firm Bain Capital - Ronmey argued that he can fix the economy. With the campaign slogan 'Believe in America,' Romney focused on claiming that debt increased and job growth was slow during Obama's first term. Obama's campaign, with the slogan 'Forward', mobilised supporters on the progress made during his presidency on women's rights, immigration reform and healthcare. He even took a pro-LGBTQ stance closer to election date. But on the healthcare front, Obama was often cornered by Romney, who advocated repeal of the Affordable Care Act. They sparred on these issues at debates, with Obama appearing to be on the backfoot in the first one. But he recovered and improved his performance in later debates. Well into the last days of campaign, Obama appeared to be on a weak position but his emotional and rousing speeches and Demcratic party's massive ground-level surge campaign managed to convince most voters to give him four more years. The 2012 election also cemented the role of technology, which was already used in the previous one. Data analytics was used as effectively by Obama campaign as grassroot voter mobilisation. Romeny somehow did not have the same arsenal when it came to using technology, particularly social media outreach to young voters. There was also an increase in early voting, which is believed to have helped Obama. Also read: 'And he's talking about illegals': Biden slams Musk over 'illegal worker' claims; Tesla CEO hits back The election, held on 6 November 2012, saw better participation from minorities and youngsters, which also was to Obama's advantage. Eventually, Obama won re-election by getting 332 electoral college votes as against 206 for Romney, and 51 per cent of the popular vote as against 47 per cent for the Republican. But the election was, in many ways, a predictor of the fact that American electorate was getting slowly divided. If you look at the results map in this story, it is clear that red states and blue states were practically split through the middle of the nation. Obama won the more populous and coastal states where miniorities and immigrants live in large numbers. Romney won much of the north, middle America and conservative south, often described as the Bible Belt. Obama did extremly well with youth, Latinos and Blacks, whereas white voters appear to have preferred Romney. In the second term of Obama, that division only worsened, including protests after police killings of Black people. The emergence of migrant communities as voting blocs became an issue for many in the white majority, who gravitated towards a more rightwing approach opposing immigration, a sentiment captured and amplified by Donald Trump. (With inputs from agencies)

US elections: Did Obama re-election lead to rise of Trump? Remembering Obama vs Romney in 2012

The Obamacare has survived yet another challenge after the US supreme court upheld the Affordable Care act. The decision left the entire law intact, saving healthcare coverage for millions of Americans. By a vote of 7-2, the justices ended up turning down the challenge.

US: Obamacare survives third Supreme Court challenge

Democratic Vice Presidential candidate Kamala Harris on Wednesday grilled Donald Trump's nominee for the Supreme Court, on Obamacare. &nbsp;Amy Coney Barrett, who will be a judge in US Supreme Court if US Senate confirms her, is currently facing Senate Judiciary Committee for hearing in order to get clearance. Democratic Party fears that if confirmed, Barrett will be instrumental in striking down Obamacare (Affordable Care Act) that has given health cover to millions of Americans.

Harris asked Barrett whether she knew President Trump was seeking to nominate a judge who would strike down Affordable Care Act.

Without naming the President, Amy Coney Barrett said that she did not recall seeing or hearing those statements.&nbsp;

During the Senate Judiciary Committee confirmation hearing, Harris also focussed on abortion rights and the record of the woman who held the seat Barrett would fill.

"As the Senate considers filling the seat of Justice Ruth Bader Ginsburg, who was straightforward enough in her confirmation hearing to say that the right to choose is, quote, essential to woman's equality, unquote," Harris said. "I would suggest that we not pretend that we don't know how this nominee views a woman's right to choose and make her own health care decisions."

Also Read | <a href="https://www.wionews.com/world/trumps-supreme-court-pick-says-she-is-not-hostile-to-obamacare-dodges-on-abortion-335070">Trump's Supreme Court pick says she is not 'hostile' to Obamacare, dodges on abortion</a>

Amy Coney Barrett is known for her conservative views on a range of issues. Her confirmation to US Supreme Court will see conservative judges have a 6-3 majority over those having liberal views.

Republican Party has long resented Affordable Care Act brought in effect by former US President Barack Obama. A hearing on the Act is due on November 10.

Amt Coney Barrett opted not to say whether she would step aside from taking part in the hearing as Democrats have requested.

(With Reuters inputs)

Democratic Vice Presidential candidate Kamala Harris on Wednesday grilled Donald Trump's nominee for the Supreme Court, on Obamacare. Amy Coney Barrett, who will be a judge in US Supreme Court if US Senate confirms her, is currently facing Senate Judiciary Committee for hearing in order to get clearance.

Democratic Vice Presidential candidate Kamala Harris on Wednesday grilled Donald Trump's nominee for the Supreme Court, on Obamacare. Amy Coney Barrett, who will be a judge in US Supreme Court if US Senate confirms her, is currently facing Senate Judiciary Committee for hearing in order to get clearance. Democratic Party fears that if confirmed, Barrett will be instrumental in striking down Obamacare (Affordable Care Act) that has given health cover to millions of Americans. Harris asked Barrett whether she knew President Trump was seeking to nominate a judge who would strike down Affordable Care Act. Without naming the President, Amy Coney Barrett said that she did not recall seeing or hearing those statements. During the Senate Judiciary Committee confirmation hearing, Harris also focussed on abortion rights and the record of the woman who held the seat Barrett would fill. "As the Senate considers filling the seat of Justice Ruth Bader Ginsburg, who was straightforward enough in her confirmation hearing to say that the right to choose is, quote, essential to woman's equality, unquote," Harris said. "I would suggest that we not pretend that we don't know how this nominee views a woman's right to choose and make her own health care decisions." Also Read | Trump's Supreme Court pick says she is not 'hostile' to Obamacare, dodges on abortion Amy Coney Barrett is known for her conservative views on a range of issues. Her confirmation to US Supreme Court will see conservative judges have a 6-3 majority over those having liberal views. Republican Party has long resented Affordable Care Act brought in effect by former US President Barack Obama. A hearing on the Act is due on November 10. Amt Coney Barrett opted not to say whether she would step aside from taking part in the hearing as Democrats have requested. (With Reuters inputs)

Kamala Harris grills Barrett on Obamacare, she sidesteps question

The Trump administration urged the Supreme Court to invalidate the Affordable Care Act in a legal brief filed Thursday, putting health care at center stage in an election year already focused on the coronavirus pandemic’s impact.

The Justice Department said the 2010 health law, a signature achievement of the Obama administration, is invalid because Congress in 2017 ended the financial penalty for not having health insurance, though it didn’t take effect until 2019.

Also read:&nbsp;<a href="https://www.wionews.com/world/bolton-says-donald-trump-had-turned-a-blind-eye-to-coronavirus-pandemic-308499" hreflang="en">Bolton says Donald Trump had turned 'a blind eye' to coronavirus pandemic</a>

The administration's latest high court filing came the same day the government reported that close to half a million people who lost their health insurance amid the economic shutdown have gotten coverage through HealthCare.gov.

In a late-night filing,&nbsp;Solicitor General Noel Francisco&nbsp;said that once the law's individual coverage mandate and two key provisions are invalidated, "the remainder of the ACA should not be allowed to remain in effect."

Also read:&nbsp;<a href="https://www.wionews.com/world/us-supreme-court-blocks-trump-from-ending-daca-immigrant-program-306946">US Supreme Court blocks Trump from ending DACA immigrant program</a>

The justices&nbsp;will hear arguments in the case sometime next term, although it is unclear if they will occur before the November election.

In&nbsp;the case before the Supreme Court, Texas and other conservative-led states argue that the ACA was essentially rendered unconstitutional after Congress passed tax legislation in 2017 that eliminated the law's unpopular fines for not having health insurance, but left in place its requirement that virtually all Americans have coverage. 
&nbsp; 
After failing to repeal "Obamacare" in 2017 when Republicans fully controlled Congress, President Donald Trump has put the weight of his administration behind the legal challenge.

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It will be the third time the court has heard a significant challenge to the law. The case pits a coalition of Democratic attorneys general led by California and the House of Representatives, which are defending the law, against the Trump administration and a group of red state attorneys general led by Texas.

At issue is whether the law's individual mandate was rendered unconstitutional because Congress reduced the penalty for remaining uninsured to zero and, if so, whether that would bring down the entire law. A federal appeals court in December ruled that the mandate was unconstitutional but punted the decision on which, if any, of the law's provisions could be retained back to the district court -- which had previously found the entire law to be invalidated.

Some 20 million Americans could lose their health coverage and protections for people with preexisting health conditions also would be put at risk if the court agrees with the administration in a case that won't be heard before the fall. 
&nbsp;

The Trump administration urged the Supreme Court to invalidate the Affordable Care Act in a legal brief filed Thursday, putting health care at center stage in an election year already focused on the coronavirus pandemic’s impact.

The Trump administration urged the Supreme Court to invalidate the Affordable Care Act in a legal brief filed Thursday, putting health care at center stage in an election year already focused on the coronavirus pandemic’s impact. The Justice Department said the 2010 health law, a signature achievement of the Obama administration, is invalid because Congress in 2017 ended the financial penalty for not having health insurance, though it didn’t take effect until 2019. Also read: Bolton says Donald Trump had turned 'a blind eye' to coronavirus pandemic The administration's latest high court filing came the same day the government reported that close to half a million people who lost their health insurance amid the economic shutdown have gotten coverage through HealthCare.gov. In a late-night filing, Solicitor General Noel Francisco said that once the law's individual coverage mandate and two key provisions are invalidated, "the remainder of the ACA should not be allowed to remain in effect." Also read: US Supreme Court blocks Trump from ending DACA immigrant program The justices will hear arguments in the case sometime next term, although it is unclear if they will occur before the November election. In the case before the Supreme Court, Texas and other conservative-led states argue that the ACA was essentially rendered unconstitutional after Congress passed tax legislation in 2017 that eliminated the law's unpopular fines for not having health insurance, but left in place its requirement that virtually all Americans have coverage. After failing to repeal "Obamacare" in 2017 when Republicans fully controlled Congress, President Donald Trump has put the weight of his administration behind the legal challenge. It will be the third time the court has heard a significant challenge to the law. The case pits a coalition of Democratic attorneys general led by California and the House of Representatives, which are defending the law, against the Trump administration and a group of red state attorneys general led by Texas. At issue is whether the law's individual mandate was rendered unconstitutional because Congress reduced the penalty for remaining uninsured to zero and, if so, whether that would bring down the entire law. A federal appeals court in December ruled that the mandate was unconstitutional but punted the decision on which, if any, of the law's provisions could be retained back to the district court -- which had previously found the entire law to be invalidated. Some 20 million Americans could lose their health coverage and protections for people with preexisting health conditions also would be put at risk if the court agrees with the administration in a case that won't be heard before the fall.

Trump administration asks Supreme Court to invalidate Affordable Care Act

The US has been witnessing protests against discrimination for the past few weeks now, after the killing of unarmed man in police custody. Thousands of protestors have been carrying out demonstrations and protests against the Trump administration and the racial discrimination.

However, the&nbsp;Trump administration has added fuel to the fire by finalizing a rule that overturns Obama's nondiscrimination rule in the healthcare sector.

The rule has been finalized in June, which is celebrate as Pride Month worldwide.

<a href="https://www.wionews.com/videos/gay-pride-embraces-its-roots-by-teaming-up-with-us-black-activists-305449">Also watch|&nbsp;Gay Pride embraces its roots by teaming up with U.S. black activists</a>

The Trump administration passed a rule that now defines 'sex' as either man or woman only.&nbsp;The Department of Health and Human Services has announced that the revised sex discrimination protections will now be “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.”

This new rule goes against the protection rights&nbsp;for transgender people against sex discrimination in health care, which was introduced and promoted by former US President Barack Obama.

This rule plays down the guidelines for&nbsp;nondiscrimination protections&nbsp;in Section 1557 of the Affordable Care Act. That federal law makes it illegal to discriminate on the basis of&nbsp;"race, color, national origin, sex, age or disability in certain health programs and activities."

<a href="https://www.wionews.com/world/far-but-virtually-connected-pride-month-shifts-online-amid-covid-19-303275">Also read|&nbsp;Far but virtually connected: Pride month shifts online amid COVID 19</a>

However, considering the lack of explanation, in 2016, under the Obama administration, the rule was changed to state that&nbsp;protections regarding "sex" include those based on gender identity, which it defined as "male, female, neither, or a combination of male and female."

However, a year ago, in June 2019, the HHS office for civil rights proposed a reversal of the rule, and that was finalized this week.

Roger Severino --&nbsp;who directs the Office for Civil Rights in the Department of Health and Human Services and has previously written about doctors having the right to refuse treatment that contradicts their religious or moral beliefs --&nbsp;believes this will&nbsp;save hospitals and insurers&nbsp;$2.9 billion over five years since they will not have to print notices of nondiscrimination in several languages.

The move has been highly criticised by the LGBTQ community and their supporters, especially at the time of a pandemic.

The US has been witnessing protests against discrimination for the past few weeks now, after the killing of unarmed man in police custody. Thousands of protestors have been carrying out demonstrations and protests against the Trump administration and the racial discrimination.

The US has been witnessing protests against discrimination for the past few weeks now, after the killing of unarmed man in police custody. Thousands of protestors have been carrying out demonstrations and protests against the Trump administration and the racial discrimination. However, the Trump administration has added fuel to the fire by finalizing a rule that overturns Obama's nondiscrimination rule in the healthcare sector. The rule has been finalized in June, which is celebrate as Pride Month worldwide. Also watch| Gay Pride embraces its roots by teaming up with U.S. black activists The Trump administration passed a rule that now defines 'sex' as either man or woman only. The Department of Health and Human Services has announced that the revised sex discrimination protections will now be “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.” This new rule goes against the protection rights for transgender people against sex discrimination in health care, which was introduced and promoted by former US President Barack Obama. This rule plays down the guidelines for nondiscrimination protections in Section 1557 of the Affordable Care Act. That federal law makes it illegal to discriminate on the basis of "race, color, national origin, sex, age or disability in certain health programs and activities." Also read| Far but virtually connected: Pride month shifts online amid COVID 19 However, considering the lack of explanation, in 2016, under the Obama administration, the rule was changed to state that protections regarding "sex" include those based on gender identity, which it defined as "male, female, neither, or a combination of male and female." However, a year ago, in June 2019, the HHS office for civil rights proposed a reversal of the rule, and that was finalized this week. Roger Severino -- who directs the Office for Civil Rights in the Department of Health and Human Services and has previously written about doctors having the right to refuse treatment that contradicts their religious or moral beliefs -- believes this will save hospitals and insurers $2.9 billion over five years since they will not have to print notices of nondiscrimination in several languages. The move has been highly criticised by the LGBTQ community and their supporters, especially at the time of a pandemic.

Trump administration reverses nondiscrimination rule; defines 'sex' as man and woman only

US President Donald Trump's administration is considering unveiling, as early as September, his healthcare plan as part of his presidential re election campaign strategy, the Wall Street Journal reported on Saturday.

US President Donald Trump's administration is considering unveiling, as early as September, his healthcare plan as part of his presidential re election campaign strategy, the Wall Street Journal reported on Saturday. The plan would lay out an alternative to former President Barack Obama's Affordable Care Act, which has been challenged by Republicans in court, and could include coverage for people with pre existing conditions and a variety of insurance options, the Wall Street Journal said, citing unnamed sources. Trump has not signed off on the tentative plan, the newspaper said, describing ongoing debate about the plan and the timing for the roll out. Polling shows that healthcare is a top concern for voters leading up to the election. The White House did not immediately respond to a request for comment on the timing. Democrats vying to be their party's candidate for the November 2020 presidential election have focused on healthcare, debating how far to go to transform the U.S. healthcare system. Some candidates have suggested abolishing private insurance in favour of a single government run plan, sometimes referred to as “Medicare for All,” while others favour more modest reforms. On Tuesday, Trump is slated to give a speech at The Villages in Florida a large retirement community where he will address his administration's efforts to secure and improve Medicare. While he is there, Trump is expected to sign an executive order related to Medicare, a White House official said separately, declining to comment on specific details. Reuters has previously reported that Trump was considering an executive order to cut prices on branded prescription drugs sold to Medicare and other government programs.

Trump administration considers September unveiling of healthcare plan: Report

The future of Obamacare could be at stake on Tuesday when a coalition of Democratic-led states and <a href="https://www.wionews.com/world/us-house-panel-launches-probe-into-possible-obstruction-by-trump-200941">House of Representatives</a> urge a federal appeals court to overturn a Texas judge's ruling that the US healthcare reform law is unconstitutional.

Republicans have repeatedly tried to repeal Obamacare, or the Affordable Care Act (ACA), since its 2010 passage, and while the Justice Department would normally defend a federal law, the Trump administration has declined to defend its constitutionality against a challenge by 18 Republican-led states.

A coalition of Democratic state attorneys general led by <a href="https://www.wionews.com/world/california-desert-braces-for-aftershocks-from-major-71-quake-233580">California</a> Attorney General Xavier Becerra stepped into the void to defend the law. The House intervened after Democrats won control in November's elections after many focused their campaigns on defunding Obamacare.

A three-judge panel of the 5th US Circuit Court of Appeals in New Orleans, including two judges appointed by Republican presidents and one by a Democrat, will take up a ruling by a federal judge in Texas last year that the entire ACA was unconstitutional.

An appellate ruling declaring Obamacare unconstitutional could prompt an appeal to the US Supreme Court, opening the door for the top court to take up the issue during the 2020 US presidential election.

Obamacare, the signature domestic achievement of Trump's Democratic predecessor, Barack Obama, has been a political flashpoint since its passage.

Republican opponents call the law an unwarranted intervention by government in health insurance markets, while supporters say that striking it down would put at risk the healthcare of 20 million people who have gained insurance since its enactment.

In 2012, a divided <a href="http://wionews.com/world/us-supreme-court-to-take-up-dreamers-case-231345">US Supreme Court</a> upheld most of its provisions, including the individual mandate, which requires people to obtain insurance or pay a penalty.

The mandate compelled healthy people to buy insurance to offset sicker patients' costs after Obamacare barred insurers from denying coverage to people with pre-existing conditions.

The Supreme Court's conservative majority argued that Congress could not constitutionally order people to buy insurance. But Chief Justice John Roberts joined the court's four liberal members to hold the mandate was a valid exercise of Congress' tax power.

Republicans in Congress subsequently failed to overturn Obamacare, but in December 2017, <a href="http://wionews.com/world/donald-trump-has-discussed-iran-nuclear-standoff-with-macron-white-house-234187">Trump</a> signed into law a tax bill passed by a Republican-led Congress that reduced the tax penalty to zero dollars.

A coalition of Republican-led states headed by Texas sued, alleging the tax penalty's elimination rendered Obamacare unconstitutional.

US District Judge Reed O'Connor in Fort Worth, Texas, agreed in December 2018, saying the individual mandate was unconstitutional because it no longer triggered a tax.

O'Connor, nominated by former Republican President George W. Bush, said that because Obamacare called the mandate "essential," the entire law must be struck down.

The Justice Department initially argued the mandate was unconstitutional but most of Obamacare could be severed from it. But it argues on appeal the law's balance must be struck down.

The future of Obamacare could be at stake on Tuesday when a coalition of Democratic-led states and House of Representatives urge a federal appeals court to overturn a Texas judge's ruling that the US healthcare reform law is unconstitutional.

The future of Obamacare could be at stake on Tuesday when a coalition of Democratic-led states and House of Representatives urge a federal appeals court to overturn a Texas judge's ruling that the US healthcare reform law is unconstitutional. Republicans have repeatedly tried to repeal Obamacare, or the Affordable Care Act (ACA), since its 2010 passage, and while the Justice Department would normally defend a federal law, the Trump administration has declined to defend its constitutionality against a challenge by 18 Republican-led states. A coalition of Democratic state attorneys general led by California Attorney General Xavier Becerra stepped into the void to defend the law. The House intervened after Democrats won control in November's elections after many focused their campaigns on defunding Obamacare. A three-judge panel of the 5th US Circuit Court of Appeals in New Orleans, including two judges appointed by Republican presidents and one by a Democrat, will take up a ruling by a federal judge in Texas last year that the entire ACA was unconstitutional. An appellate ruling declaring Obamacare unconstitutional could prompt an appeal to the US Supreme Court, opening the door for the top court to take up the issue during the 2020 US presidential election. Obamacare, the signature domestic achievement of Trump's Democratic predecessor, Barack Obama, has been a political flashpoint since its passage. Republican opponents call the law an unwarranted intervention by government in health insurance markets, while supporters say that striking it down would put at risk the healthcare of 20 million people who have gained insurance since its enactment. In 2012, a divided US Supreme Court upheld most of its provisions, including the individual mandate, which requires people to obtain insurance or pay a penalty. The mandate compelled healthy people to buy insurance to offset sicker patients' costs after Obamacare barred insurers from denying coverage to people with pre-existing conditions. The Supreme Court's conservative majority argued that Congress could not constitutionally order people to buy insurance. But Chief Justice John Roberts joined the court's four liberal members to hold the mandate was a valid exercise of Congress' tax power. Republicans in Congress subsequently failed to overturn Obamacare, but in December 2017, Trump signed into law a tax bill passed by a Republican-led Congress that reduced the tax penalty to zero dollars. A coalition of Republican-led states headed by Texas sued, alleging the tax penalty's elimination rendered Obamacare unconstitutional. US District Judge Reed O'Connor in Fort Worth, Texas, agreed in December 2018, saying the individual mandate was unconstitutional because it no longer triggered a tax. O'Connor, nominated by former Republican President George W. Bush, said that because Obamacare called the mandate "essential," the entire law must be struck down. The Justice Department initially argued the mandate was unconstitutional but most of Obamacare could be severed from it. But it argues on appeal the law's balance must be struck down.

United States appeals court to take up constitutionality of Obamacare

Outraged Democrats vowed to appeal a federal judge's ruling that could undo the US health care law known as Obamacare, saying on Saturday that they will use their new power in Congress to hold Republicans responsible and "expose their lies."

US District Judge Reed O'Connor ruled late Friday that the <a href="http://www.wionews.com/world/federal-judge-rules-obamas-affordable-care-act-unconstitutional-184151">health insurance reform, officially known as the Affordable Care Act (ACA), is unconstitutional</a>.

The White House said it expects the ruling to be appealed to the Supreme Court. For now, it said in a statement, "the law remains in place."

But Democrats, who have seen the law survive scores of legal and legislative attacks, vowed to fight back, saying the health coverage of millions of Americans is at stake.

Senate Democratic leader Chuck Schumer tweeted that Republicans had pretended to care about those protected by Obamacare "while quietly trying to remove that support in the courts. Next year, we will force votes to expose their lies."

Democrats see the law as a signature achievement of former president Barack Obama, while Republicans dismiss it as governmental overreach. Donald Trump made abolishing and replacing the program a central pledge of his presidential campaign.

In a separate Obamacare case in 2012, five of the nine Supreme Court justices upheld the law. All five remain on the court.

Still, it remains unclear how they might rule in the new case. If the decision is upheld, it could significantly disrupt the US health care system.&nbsp;

In his ruling Friday, the Texas-based judge said that the full Obamacare program was unconstitutional because Congress, in its 2017 tax overhaul, eliminated a penalty for anyone lacking health insurance who failed to sign up for the program.

The 2012 case was over whether such a penalty was legal -- but now that it is gone, O'Connor said, the whole ACA should be stricken down because that provision is "the keystone" of the program.

Trump expressed delight at the court's ruling on a complaint brought by several Republican attorneys general and two Republican governors.

"It's a great ruling for our country. We'll be able to get great health care," Trump told reporters. "It was a big, big victory by a highly respected judge."

"As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!" he tweeted the previous day.

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<blockquote class="twitter-tweet" data-lang="en">
Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!
— Donald J. Trump (@realDonaldTrump) <a href="https://twitter.com/realDonaldTrump/status/1073763695807877120?ref_src=twsrc%5Etfw">December 15, 2018</a></blockquote>
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Trump urged Republican Senate Majority Leader Mitch McConnell and the House of Representatives speaker-designate, Democrat Nancy Pelosi, to "pass a STRONG law that provides GREAT healthcare."

'Monstrous endgame'

The court ruling came on the eve of the deadline for people to sign up for ACA coverage for 2019.&nbsp;

Angry Democrats blamed Republicans for what they see as a debacle that could leave millions of Americans without health care. &nbsp;

Republicans "know that they can't repeal the ACA in Congress. So they've continued their crusade through the courts," tweeted Democratic Senator Elizabeth Warren, a consumer-protection activist. "The ACA is still the law of the land."

Polls consistently show strong public support for the ACA guarantee of coverage regardless of pre-existing health conditions -- an issue Democrats used with great success in last month's midterm elections as they won control of the House of Representatives.

"#Republicans' legal crusade against the #AffordableCareAct is a political stunt, but a dangerous one that puts health coverage and vital health protections for millions of Americans at risk," Democratic Senator Sheldon Whitehouse tweeted Saturday.

Democratic Representative Joe Kennedy said "they found one judge to agree, and now Medicaid expansion could be gone, pre-existing condition protections could be wiped out, prices skyrocket and millions lose insurance. And they call that success."

O'Connor's ruling "exposes the monstrous endgame of Republicans' all-out assault on people with pre-existing conditions and Americans' access to affordable health care," Pelosi said in a statement.

While the court's "absurd ruling will be immediately appealed, Republicans are fully responsible for this cruel decision," she said.

She vowed that when Democrats take control of the House next month, lawmakers "will move swiftly to formally intervene in the appeals process" to uphold Obamacare.

Opposing the Republican lawsuit were 17 Democratic attorneys general led by Xavier Becerra of California.

They argue that the tax law changes do not mean that the whole Affordable Care Act becomes unconstitutional.

The Texas ruling "is an assault on 133 million Americans with pre-existing conditions" and on all who rely on Obamacare coverage, Becerra said in a statement. "Our fight to save Obamacare is far from over."

Outraged Democrats vowed to appeal a federal judge's ruling that could undo the US health care law known as Obamacare, saying on Saturday that they will use their new power in Congress to hold Republicans responsible and "expose their lies.

Outraged Democrats vowed to appeal a federal judge's ruling that could undo the US health care law known as Obamacare, saying on Saturday that they will use their new power in Congress to hold Republicans responsible and "expose their lies." US District Judge Reed O'Connor ruled late Friday that the health insurance reform, officially known as the Affordable Care Act (ACA), is unconstitutional. The White House said it expects the ruling to be appealed to the Supreme Court. For now, it said in a statement, "the law remains in place." But Democrats, who have seen the law survive scores of legal and legislative attacks, vowed to fight back, saying the health coverage of millions of Americans is at stake. Senate Democratic leader Chuck Schumer tweeted that Republicans had pretended to care about those protected by Obamacare "while quietly trying to remove that support in the courts. Next year, we will force votes to expose their lies." Democrats see the law as a signature achievement of former president Barack Obama, while Republicans dismiss it as governmental overreach. Donald Trump made abolishing and replacing the program a central pledge of his presidential campaign. In a separate Obamacare case in 2012, five of the nine Supreme Court justices upheld the law. All five remain on the court. Still, it remains unclear how they might rule in the new case. If the decision is upheld, it could significantly disrupt the US health care system. In his ruling Friday, the Texas-based judge said that the full Obamacare program was unconstitutional because Congress, in its 2017 tax overhaul, eliminated a penalty for anyone lacking health insurance who failed to sign up for the program. The 2012 case was over whether such a penalty was legal -- but now that it is gone, O'Connor said, the whole ACA should be stricken down because that provision is "the keystone" of the program. Trump expressed delight at the court's ruling on a complaint brought by several Republican attorneys general and two Republican governors. "It's a great ruling for our country. We'll be able to get great health care," Trump told reporters. "It was a big, big victory by a highly respected judge." "As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!" he tweeted the previous day. Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America! — Donald J. Trump (@realDonaldTrump) December 15, 2018 × Trump urged Republican Senate Majority Leader Mitch McConnell and the House of Representatives speaker-designate, Democrat Nancy Pelosi, to "pass a STRONG law that provides GREAT healthcare." 'Monstrous endgame' The court ruling came on the eve of the deadline for people to sign up for ACA coverage for 2019. Angry Democrats blamed Republicans for what they see as a debacle that could leave millions of Americans without health care. Republicans "know that they can't repeal the ACA in Congress. So they've continued their crusade through the courts," tweeted Democratic Senator Elizabeth Warren, a consumer-protection activist. "The ACA is still the law of the land." Polls consistently show strong public support for the ACA guarantee of coverage regardless of pre-existing health conditions -- an issue Democrats used with great success in last month's midterm elections as they won control of the House of Representatives. "#Republicans' legal crusade against the #AffordableCareAct is a political stunt, but a dangerous one that puts health coverage and vital health protections for millions of Americans at risk," Democratic Senator Sheldon Whitehouse tweeted Saturday. Democratic Representative Joe Kennedy said "they found one judge to agree, and now Medicaid expansion could be gone, pre-existing condition protections could be wiped out, prices skyrocket and millions lose insurance. And they call that success." O'Connor's ruling "exposes the monstrous endgame of Republicans' all-out assault on people with pre-existing conditions and Americans' access to affordable health care," Pelosi said in a statement. While the court's "absurd ruling will be immediately appealed, Republicans are fully responsible for this cruel decision," she said. She vowed that when Democrats take control of the House next month, lawmakers "will move swiftly to formally intervene in the appeals process" to uphold Obamacare. Opposing the Republican lawsuit were 17 Democratic attorneys general led by Xavier Becerra of California. They argue that the tax law changes do not mean that the whole Affordable Care Act becomes unconstitutional. The Texas ruling "is an assault on 133 million Americans with pre-existing conditions" and on all who rely on Obamacare coverage, Becerra said in a statement. "Our fight to save Obamacare is far from over."

Outraged Democrats vow to challenge court ruling undercutting Obamacare

President Donald Trump on Saturday hailed a court decision against <a href="http://www.wionews.com/world/outraged-democrats-vow-to-challenge-court-ruling-undercutting-obamacare-184387">Obamacare </a>as "a great ruling for our country," while a US&nbsp;government official said the decision by a Texas judge would have no immediate impact on health coverage.

US&nbsp;District Judge Reed O'Connor in Fort Worth, Texas, on Friday, said that Obamacare, known formally as the 2010 Affordable Care Act (ACA), was unconstitutional based on its mandate requiring that people buy health insurance.

In a decision that could reach the US&nbsp;Supreme Court, O'Connor sided with a coalition of 20 states that argued requiring people to pay for insurance coverage is illegal because a change in tax law last year eliminated a penalty for not having health insurance.

"It's a great ruling for our country. We will be able to get great healthcare. We will sit down with the Democrats if the Supreme Court upholds," Trump told reporters during a visit to Arlington National Cemetery in Virginia on a rainy Saturday.

Trump offered no details on the potential for healthcare talks with the Democrats, who are poised to take majority control of the US&nbsp;House of Representatives in early January. The Senate will remain in Republican hands.

O'Connor's decision was issued the day before the end of a 45-day sign-up period for 2019 health coverage under the law.

The head of the federal Centers for Medicare and Medicaid Services (CMS), which oversees the Affordable Care Act, said there were no changes and exchanges were open for business.

"We expect this ruling will be appealed to the Supreme Court," CMS Administrator Seema Verma wrote on Twitter on Saturday. "Pending the appeal process, the law remains in place.”

"There is no impact to current coverage or coverage in a 2019 plan,” she said late on Friday.

High Political Stakes

Since the law's formative stages amid concern about millions of Americans lacking health insurance, Republicans have opposed Obamacare, calling it a costly and unneeded government intrusion into Americans' lives. Trump campaigned against it in 2016.

They have repeatedly tried but failed, to repeal the law, which was the signature domestic policy achievement of former Democratic President Barack Obama. Even with control of both chambers of Congress and the White House in 2017, Republicans could not push through a repeal.

The O'Connor ruling underscored the high political stakes involved in the divide over healthcare, especially for Trump and his fellow Republicans ahead of the 2020 presidential election.

If the Supreme Court were to uphold O'Connor's ruling, it would go a long way toward dismantling Obamacare. That would be a political victory for Republicans, but it would also likely strip millions of Americans of their health coverage, a policy problem for which Republicans have offered no clear solution.

About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans.

The Supreme Court upheld the Affordable Care Act in 2012

Two days after November&nbsp;6 The US&nbsp;congressional elections, a Reuters/Ipsos national opinion poll found that healthcare was the top issue Americans wanted the US&nbsp;Congress to address.

'Silly, Irresponible'

On Friday, O'Connor ruled that after the enactment last year by Trump of a landmark tax bill, the ACA's individual mandate requiring most Americans to obtain health insurance or pay a tax could no longer be considered constitutional.

He said because the individual mandate was an "essential" part of Obamacare, the entire law, rather than just the individual mandate, was unconstitutional.

Timothy Jost, a health law expert and emeritus professor at Washington and Lee University School of Law in Virginia, said it was “silly” and “irresponsible” for O’Connor to find that the individual mandate could not be separated from the rest of the ACA. He said judges who find that portions of laws are invalid are required “to do as little damage as possible” to the rest of the law, and O’Connor had ignored that principle.

Jost noted that the 5th US Circuit Court of Appeals, which will hear an appeal in the case, is considered the most conservative federal appeals court in the country. But, “O’Connor is so far off the reservation here that virtually any (appeals) panel will reverse him,” Jost said.

Jost noted that in the 2012 case in which the Supreme Court upheld the ACA, a lower appeals court had found the individual mandate unlawful, but ruled it could be severed from the rest of the law. That ruling by the 11th U.S. Circuit Court of Appeals “is at least as persuasive and probably more persuasive than a decision by a single judge in Wichita Falls, Texas,” Jost said.

He said the US&nbsp;Supreme Court’s conservative wing has been sceptical in the past of striking down entire laws because of a single problematic provision, and at least a bare majority of five justices would likely agree that O’Connor was wrong.

President Donald Trump on Saturday hailed a court decision against Obamacare as "a great ruling for our country," while a US government official said the decision by a Texas judge would have no immediate impact on health coverage.

President Donald Trump on Saturday hailed a court decision against Obamacare as "a great ruling for our country," while a US government official said the decision by a Texas judge would have no immediate impact on health coverage. US District Judge Reed O'Connor in Fort Worth, Texas, on Friday, said that Obamacare, known formally as the 2010 Affordable Care Act (ACA), was unconstitutional based on its mandate requiring that people buy health insurance. In a decision that could reach the US Supreme Court, O'Connor sided with a coalition of 20 states that argued requiring people to pay for insurance coverage is illegal because a change in tax law last year eliminated a penalty for not having health insurance. "It's a great ruling for our country. We will be able to get great healthcare. We will sit down with the Democrats if the Supreme Court upholds," Trump told reporters during a visit to Arlington National Cemetery in Virginia on a rainy Saturday. Trump offered no details on the potential for healthcare talks with the Democrats, who are poised to take majority control of the US House of Representatives in early January. The Senate will remain in Republican hands. O'Connor's decision was issued the day before the end of a 45-day sign-up period for 2019 health coverage under the law. The head of the federal Centers for Medicare and Medicaid Services (CMS), which oversees the Affordable Care Act, said there were no changes and exchanges were open for business. "We expect this ruling will be appealed to the Supreme Court," CMS Administrator Seema Verma wrote on Twitter on Saturday. "Pending the appeal process, the law remains in place.” "There is no impact to current coverage or coverage in a 2019 plan,” she said late on Friday. High Political Stakes Since the law's formative stages amid concern about millions of Americans lacking health insurance, Republicans have opposed Obamacare, calling it a costly and unneeded government intrusion into Americans' lives. Trump campaigned against it in 2016. They have repeatedly tried but failed, to repeal the law, which was the signature domestic policy achievement of former Democratic President Barack Obama. Even with control of both chambers of Congress and the White House in 2017, Republicans could not push through a repeal. The O'Connor ruling underscored the high political stakes involved in the divide over healthcare, especially for Trump and his fellow Republicans ahead of the 2020 presidential election. If the Supreme Court were to uphold O'Connor's ruling, it would go a long way toward dismantling Obamacare. That would be a political victory for Republicans, but it would also likely strip millions of Americans of their health coverage, a policy problem for which Republicans have offered no clear solution. About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans. The Supreme Court upheld the Affordable Care Act in 2012 Two days after November 6 The US congressional elections, a Reuters/Ipsos national opinion poll found that healthcare was the top issue Americans wanted the US Congress to address. 'Silly, Irresponible' On Friday, O'Connor ruled that after the enactment last year by Trump of a landmark tax bill, the ACA's individual mandate requiring most Americans to obtain health insurance or pay a tax could no longer be considered constitutional. He said because the individual mandate was an "essential" part of Obamacare, the entire law, rather than just the individual mandate, was unconstitutional. Timothy Jost, a health law expert and emeritus professor at Washington and Lee University School of Law in Virginia, said it was “silly” and “irresponsible” for O’Connor to find that the individual mandate could not be separated from the rest of the ACA. He said judges who find that portions of laws are invalid are required “to do as little damage as possible” to the rest of the law, and O’Connor had ignored that principle. Jost noted that the 5th US Circuit Court of Appeals, which will hear an appeal in the case, is considered the most conservative federal appeals court in the country. But, “O’Connor is so far off the reservation here that virtually any (appeals) panel will reverse him,” Jost said. Jost noted that in the 2012 case in which the Supreme Court upheld the ACA, a lower appeals court had found the individual mandate unlawful, but ruled it could be severed from the rest of the law. That ruling by the 11th U.S. Circuit Court of Appeals “is at least as persuasive and probably more persuasive than a decision by a single judge in Wichita Falls, Texas,” Jost said. He said the US Supreme Court’s conservative wing has been sceptical in the past of striking down entire laws because of a single problematic provision, and at least a bare majority of five justices would likely agree that O’Connor was wrong.

Trump hails judge's ruling against Obamacare as 'great'

A US federal judge in Texas ruled on Friday that the<a href="http://www.wionews.com/world/trump-administration-halts-billions-in-insurance-payments-under-obamacare-149904"> Affordable Care Act, commonly known as Obamacare</a>, is unconstitutional, a decision that was likely to be appealed to the Supreme Court.

US&nbsp;District Judge Reed O'Connor in Fort Worth agreed with a coalition of 20 states that a change in tax law last year eliminating a penalty for not having health insurance invalidated the entire Obamacare law.

O'Connor's decision was issued the day before the end of a 45-day sign-up period for 2019 health coverage under the law.

About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans, according to the US government's Centers for Medicare and Medicaid Services.

The coalition of states challenging the law was led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, both Republicans.

Republicans have opposed the 2010 law, the signature domestic policy achievement of President Donald Trump's Democratic predecessor <a href="http://www.wionews.com/world/us-to-extend-skimpy-health-insurance-outside-of-obamacare-33538">Barack Obama</a>, since its inception and have repeatedly tried and failed to repeal it.

The White House hailed Friday's ruling, but said the law would remain in place pending its expected appeal to the Supreme Court.

"Once again, the president calls on Congress to replace Obamacare and act to protect people with preexisting conditions and provide Americans with quality affordable healthcare," White House spokeswoman Sarah Sanders said in a statement.

In June, the Justice Department declared the healthcare law's "individual mandate" unconstitutional in federal court. The decision was a break with a long-standing executive branch practice of defending existing statutes in court.

A year ago, Trump signed a $1.5 trillion tax bill that included a provision eliminating the individual mandate.

A US federal judge in Texas ruled on Friday that the Affordable Care Act, commonly known as Obamacare, is unconstitutional, a decision that was likely to be appealed to the Supreme Court.

A US federal judge in Texas ruled on Friday that the Affordable Care Act, commonly known as Obamacare, is unconstitutional, a decision that was likely to be appealed to the Supreme Court. US District Judge Reed O'Connor in Fort Worth agreed with a coalition of 20 states that a change in tax law last year eliminating a penalty for not having health insurance invalidated the entire Obamacare law. O'Connor's decision was issued the day before the end of a 45-day sign-up period for 2019 health coverage under the law. About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans, according to the US government's Centers for Medicare and Medicaid Services. The coalition of states challenging the law was led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, both Republicans. Republicans have opposed the 2010 law, the signature domestic policy achievement of President Donald Trump's Democratic predecessor Barack Obama, since its inception and have repeatedly tried and failed to repeal it. The White House hailed Friday's ruling, but said the law would remain in place pending its expected appeal to the Supreme Court. "Once again, the president calls on Congress to replace Obamacare and act to protect people with preexisting conditions and provide Americans with quality affordable healthcare," White House spokeswoman Sarah Sanders said in a statement. In June, the Justice Department declared the healthcare law's "individual mandate" unconstitutional in federal court. The decision was a break with a long-standing executive branch practice of defending existing statutes in court. A year ago, Trump signed a $1.5 trillion tax bill that included a provision eliminating the individual mandate.

Entire 'Obamacare' unconstitutional, declares federal judge in Texas

Minnesota's rural northeast has sent Democrats to the US&nbsp;Congress for all but two of the past 71 years, but its political shift can be seen in roadside billboards thanking Republican President Donald Trump for imposing tariffs on imported steel.

The state's 8th District has become a rare bright spot on the map for congressional Republicans ahead of Tuesday's elections, made rosier thanks to the decision by three-term Democratic incumbent Rick Nolan not to run again after winning his last election in 2016 by less than 1 percentage point.

That has left Democrat Joe Radinovich trying to hold on to the region's miners and farmers.

Forecasts show Republican St. Louis County Commissioner Pete Stauber with a good shot of flipping the district to the Republicans in a year Democrats are expected to easily pick up the additional 23 House of Representative seats they would need for a majority. Republicans, however, are favouredCHISHOLM to hold on to the Senate.

A former police officer, Stauber is running as a moderate Republican, focusing on promoting economic growth, supporting gun rights and expanding mining in the District's national parks. He has broken from his party to say he would not repeal the Affordable Care Act, former President Barack Obama's signature healthcare program, but praised Trump's tariffs.

"The steel dumping in this country should have been stopped decades ago. I'm happy the Trump administration has acted," Stauber, 52, said in a Tuesday night debate. "I know that those steel tariffs were good for the Iron Range and the families on the Iron Range."

A New York Times/Siena College poll taken October 11 to 14 showed Stauber ahead by 15 percentage points.

Iron range

Minnesota's Iron Range has all the making of "Trump Country" - a rugged, rural region studded with iron taconite mines that feed much of the nation's steel production. Highway billboards thank Trump for imposing 25 per cent tariffs on foreign steel.

Unhappy miners - including coal and iron ore workers - were a central piece of Trump's electoral coalition. During his 2016 presidential campaign, Trump's promises to revitalize the metals industry helped pave the way for wins in the former industrial heartlands of Pennsylvania, Ohio and West Virginia.

Trump failed to win Minnesota, but carried its 8th District by 15 percentage points - flipping a district that voted for Democrats in the four previous presidential election cycles.

Brandy Fraser, 70, of Two Harbors, Minnesota, said she has raised a Democrat but became a Republican after watching the party move to the left.

Fraser said she liked Stauber's support of Trump's immigration platform, including building a wall on the U.S.-Mexico border and ending birthright citizenship.

"He's going to help do it," Fraser said.

'Underdog'

Radinovich, 32, has raised $1.9 million, while Stauber had raised $1.6 million, as of Oct. 17. Super PACs and other outside groups have tipped the balance for the Republican, pouring in about $6 million, compared with about $670,000 by Democratic outside groups.

"They have spent enough money against me to make us the underdog in this race," Radinovich told supporters on Tuesday night. "This isn't the first time in my life I've been an underdog."

Democrat Hillary Clinton did strongly in parts of the Iron Range in 2016 and Radinovich aims to generate enough enthusiasm in those areas to keep the district Democratic.

On Wednesday, two of his supporters, Cary Pershern, 40, and Dave Smith, 42, took a break from knocking on doors in Hibbing to grab lunch with Radinovich.

Dressed in a United Steel Workers jacket, Pershern said he had faced an uphill battle in persuading fellow miners who credit Trump for their current economic prosperity.

"You get both sides - people who are pro-Trump and think he did everything single-handedly, you also have people who know that these tariffs that are being put in are against the wrong countries," he said.

Minnesota's rural northeast has sent Democrats to the US Congress for all but two of the past 71 years, but its political shift can be seen in roadside billboards thanking Republican President Donald Trump for imposing tariffs on imported steel.

Minnesota's rural northeast has sent Democrats to the US Congress for all but two of the past 71 years, but its political shift can be seen in roadside billboards thanking Republican President Donald Trump for imposing tariffs on imported steel. The state's 8th District has become a rare bright spot on the map for congressional Republicans ahead of Tuesday's elections, made rosier thanks to the decision by three-term Democratic incumbent Rick Nolan not to run again after winning his last election in 2016 by less than 1 percentage point. That has left Democrat Joe Radinovich trying to hold on to the region's miners and farmers. Forecasts show Republican St. Louis County Commissioner Pete Stauber with a good shot of flipping the district to the Republicans in a year Democrats are expected to easily pick up the additional 23 House of Representative seats they would need for a majority. Republicans, however, are favouredCHISHOLM to hold on to the Senate. A former police officer, Stauber is running as a moderate Republican, focusing on promoting economic growth, supporting gun rights and expanding mining in the District's national parks. He has broken from his party to say he would not repeal the Affordable Care Act, former President Barack Obama's signature healthcare program, but praised Trump's tariffs. "The steel dumping in this country should have been stopped decades ago. I'm happy the Trump administration has acted," Stauber, 52, said in a Tuesday night debate. "I know that those steel tariffs were good for the Iron Range and the families on the Iron Range." A New York Times/Siena College poll taken October 11 to 14 showed Stauber ahead by 15 percentage points. Iron range Minnesota's Iron Range has all the making of "Trump Country" - a rugged, rural region studded with iron taconite mines that feed much of the nation's steel production. Highway billboards thank Trump for imposing 25 per cent tariffs on foreign steel. Unhappy miners - including coal and iron ore workers - were a central piece of Trump's electoral coalition. During his 2016 presidential campaign, Trump's promises to revitalize the metals industry helped pave the way for wins in the former industrial heartlands of Pennsylvania, Ohio and West Virginia. Trump failed to win Minnesota, but carried its 8th District by 15 percentage points - flipping a district that voted for Democrats in the four previous presidential election cycles. Brandy Fraser, 70, of Two Harbors, Minnesota, said she has raised a Democrat but became a Republican after watching the party move to the left. Fraser said she liked Stauber's support of Trump's immigration platform, including building a wall on the U.S.-Mexico border and ending birthright citizenship. "He's going to help do it," Fraser said. 'Underdog' Radinovich, 32, has raised $1.9 million, while Stauber had raised $1.6 million, as of Oct. 17. Super PACs and other outside groups have tipped the balance for the Republican, pouring in about $6 million, compared with about $670,000 by Democratic outside groups. "They have spent enough money against me to make us the underdog in this race," Radinovich told supporters on Tuesday night. "This isn't the first time in my life I've been an underdog." Democrat Hillary Clinton did strongly in parts of the Iron Range in 2016 and Radinovich aims to generate enough enthusiasm in those areas to keep the district Democratic. On Wednesday, two of his supporters, Cary Pershern, 40, and Dave Smith, 42, took a break from knocking on doors in Hibbing to grab lunch with Radinovich. Dressed in a United Steel Workers jacket, Pershern said he had faced an uphill battle in persuading fellow miners who credit Trump for their current economic prosperity. "You get both sides - people who are pro-Trump and think he did everything single-handedly, you also have people who know that these tariffs that are being put in are against the wrong countries," he said.

Democrat struggles to keep hold on teetering Minnesota district

An angry President Donald Trump railed Tuesday against dissenters in his party who dashed his months-long effort to dismantle Barack Obama&#39;s landmark health care law.

Trump fired off a series of early morning tweets complaining about how he was &quot;let down&quot; by Democrats &quot;and a few Republicans,&quot; who announced their opposition the previous night to the latest leadership plan to repeal and replace the 2010 Affordable Care Act, also known as Obamacare.

With four Republicans now lined up against Senate Majority Leader Mitch McConnell&#39;s health overhaul, the plan has flatlined in the 100-member chamber, where the party could afford only two defectors in order to get the measure passed.&nbsp;

The dramatic implosion effectively means Trump, who marks his first six months in office later this week, has no major legislative victory under his belt, squandering months of political capital.

Trump had campaigned relentlessly on a pledge to abolish most of the Affordable Care Act, proclaiming at an October campaign rally that it would be &quot;so easy&quot; to immediately repeal and replace the law.

But on Monday night he ran into the uncompromising reality of American politics: even with a president&#39;s party enjoying a majority in both chambers, crafting and passing landmark legislation can be difficult in the US Congress.

The failure suggests an inability by Trump -- a political neophyte who often highlighted his lack of connections to establishment Washington -- to get members of his own party to fall into line.

Nevertheless Trump put on a brave face, insisting on Twitter that &quot;we will return!&quot;

&quot;As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned,&quot; he added.

&nbsp;

&#39;Time to start over&#39;

McConnell was by no means giving up. He told colleagues Tuesday that despite &quot;regret&quot; that&nbsp;the effort failed, &quot;I believe we must continue to push forward now&quot;.

In the coming days, McConnell will introduce a bill that repeals Obamacare outright, but with a two-year delay of implementation, in order to allow Congress time to craft a replacement.

A straight repeal bill passed Congress in 2015. But that was during Obama&#39;s presidency, and Republicans knew they would pay no political price for their votes, as Obama vetoed the measure.

Trump would likely sign such legislation, putting Republicans on the hook for any ensuing disruption to the health care system.

Two years ago, the nonpartisan Congressional Budget Office warned that simply repealing Obamacare would essentially kick 18 million people off health care in the first year compared to current law, a figure that would balloon to 32 million by 2026. That is far above the 22 million that CBO forecast would lose coverage under the latest repeal-and-replace legislation.

Nevertheless, Vice President Mike Pence said Tuesday he and Trump &quot;fully support&quot; McConnell&#39;s decision to move ahead with an Obamacare repeal.

But with a number of Senate Republican moderates voicing concern about how the latest bill could adversely impact millions of people insured through Medicaid, the health coverage program for the poor and the disabled, it appeared unlikely that McConnell&#39;s repeal bid would win enough support.

&quot;I can not vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians,&quot; Republican Senator Shelley Moore Capito said in a statement.

House Speaker Paul Ryan, whose chamber passed its own health reform bill in May, appeared to recognise the quandary the Senate was in, but stressed the commitment Republicans have made to voters over the past seven years. &quot;We&#39;ve got a promise to keep,&quot; he told reporters.

But Ryan hesitated to map out the way forward, because it remained unclear what repeal effort, if any, could pass the Senate.&nbsp;

While Democrats celebrated, Senate Minority Leader Chuck Schumer extended an olive branch to his Republican rivals. &quot;It&#39;s time to move on. It&#39;s time to start over&quot; on health care, he said.

Schumer called on Republicans to &quot;work with Democrats on a bill that lowers premiums, provides longterm stability to the markets and improve our health care system.&quot;

 
&nbsp;

Trump complained about how he was 'let down' by Democrats 'and a few Republicans' who opposed the latest Republican effort to repeal Obamacare

An angry President Donald Trump railed Tuesday against dissenters in his party who dashed his months-long effort to dismantle Barack Obama's landmark health care law. Trump fired off a series of early morning tweets complaining about how he was "let down" by Democrats "and a few Republicans," who announced their opposition the previous night to the latest leadership plan to repeal and replace the 2010 Affordable Care Act, also known as Obamacare. With four Republicans now lined up against Senate Majority Leader Mitch McConnell's health overhaul, the plan has flatlined in the 100-member chamber, where the party could afford only two defectors in order to get the measure passed. The dramatic implosion effectively means Trump, who marks his first six months in office later this week, has no major legislative victory under his belt, squandering months of political capital. Trump had campaigned relentlessly on a pledge to abolish most of the Affordable Care Act, proclaiming at an October campaign rally that it would be "so easy" to immediately repeal and replace the law. But on Monday night he ran into the uncompromising reality of American politics: even with a president's party enjoying a majority in both chambers, crafting and passing landmark legislation can be difficult in the US Congress. The failure suggests an inability by Trump -- a political neophyte who often highlighted his lack of connections to establishment Washington -- to get members of his own party to fall into line. Nevertheless Trump put on a brave face, insisting on Twitter that "we will return!" "As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned," he added. 'Time to start over' McConnell was by no means giving up. He told colleagues Tuesday that despite "regret" that the effort failed, "I believe we must continue to push forward now". In the coming days, McConnell will introduce a bill that repeals Obamacare outright, but with a two-year delay of implementation, in order to allow Congress time to craft a replacement. A straight repeal bill passed Congress in 2015. But that was during Obama's presidency, and Republicans knew they would pay no political price for their votes, as Obama vetoed the measure. Trump would likely sign such legislation, putting Republicans on the hook for any ensuing disruption to the health care system. Two years ago, the nonpartisan Congressional Budget Office warned that simply repealing Obamacare would essentially kick 18 million people off health care in the first year compared to current law, a figure that would balloon to 32 million by 2026. That is far above the 22 million that CBO forecast would lose coverage under the latest repeal-and-replace legislation. Nevertheless, Vice President Mike Pence said Tuesday he and Trump "fully support" McConnell's decision to move ahead with an Obamacare repeal. But with a number of Senate Republican moderates voicing concern about how the latest bill could adversely impact millions of people insured through Medicaid, the health coverage program for the poor and the disabled, it appeared unlikely that McConnell's repeal bid would win enough support. "I can not vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians," Republican Senator Shelley Moore Capito said in a statement. House Speaker Paul Ryan, whose chamber passed its own health reform bill in May, appeared to recognise the quandary the Senate was in, but stressed the commitment Republicans have made to voters over the past seven years. "We've got a promise to keep," he told reporters. But Ryan hesitated to map out the way forward, because it remained unclear what repeal effort, if any, could pass the Senate. While Democrats celebrated, Senate Minority Leader Chuck Schumer extended an olive branch to his Republican rivals. "It's time to move on. It's time to start over" on health care, he said. Schumer called on Republicans to "work with Democrats on a bill that lowers premiums, provides longterm stability to the markets and improve our health care system."

'Let ObamaCare fail,' Trump fumes as health bill collapses

By: Claire Snell-Rood and Cathleen Willging

Much has been made of the distress and discontent in rural areas during the 2016 U.S. presidential election. Few realise, however, this is also felt through unequal health.

Researchers call it the &ldquo;rural mortality&nbsp;penalty.&rdquo; While rates of mortality have steadily fallen in the nation&rsquo;s <a href="http://www.pnas.org/content/113/7/E815.full">urban areas</a>, they have actually climbed for rural Americans. And the picture is even bleaker for specific groups, such as rural white women and people of colour, who face persistent disparities in health outcomes. In every category, from suicide to unintentional injury to heart disease, rural residents&rsquo; health has been declining since the 1990s.

While some have blamed these gaping disparities on &ldquo;culture&rdquo; or &ldquo;lifestyle&rdquo; factors &ndash; such as a supposed fatalism or overconsumption of unhealthy products like Mountain Dew &ndash; the truth is that the biggest culprit is limited access to health care and challenging economic circumstances.

The passage of the Affordable Care Act (ACA) in 2010 began to change this as more rural Americans gained insurance coverage and the government invested more money into regional health facilities and training.

This progress is now at risk, however, as the Republican Congress inches closer to repealing Obamacare and replacing it with a feeble alternative that greatly weakens rural health care access. As researchers who study the mental and physical health of rural Americans, we believe this would have disastrous consequences.

The travails of rural America

Even as <a href="https://theconversation.com/where-is-rural-america-and-what-does-it-look-like-72045?sr=1">rural America</a> feeds the country, <a href="http://www.npr.org/sections/thesalt/2017/05/22/529493413/in-some-rural-counties-hunger-is-rising-but-food-donations-arent">hunger is on the rise</a> in rural areas.

Some <a href="https://www.iatp.org/files/258_2_98043.pdf">98 percent of rural residents</a> live in food deserts &ndash; defined as counties in which one must drive more than 10 miles to get to the nearest supermarket. This makes it challenging to maintain healthy and nutritious diets, leading to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481194/">higher rates of obesity in rural areas</a> that greatly increase the risk for diabetes, heart disease and certain cancers.

As rural workers struggle to <a href="https://www.wsj.com/articles/rural-america-struggles-as-young-people-chase-jobs-in-cities-1395890099">sustain employment</a> in a <a href="https://www.washingtonpost.com/news/wonk/wp/2016/05/22/a-very-bad-sign-for-all-but-americas-biggest-cities/?utm_term=.174ccab19701">shifting economy</a>, the increasing poverty is contributing to mental distress and <a href="http://journals.sagepub.com/doi/abs/10.1177/002204260703700302">substance use</a>. On a larger scale, the economic changes that have hit rural areas have resulted in a declining tax base, lower incomes and strained educational institutions. Together, they challenge rural residents&rsquo; health not just in the immediate term but cumulatively over their lives.

<figure class="align-center "><img alt="" src="https://cdn.theconversation.com/files/175505/width754/file-20170625-13475-1udmu6z.jpg" />
<figcaption>
&nbsp;

Like many other rural hospitals in the U.S., Evans Memorial in Claxton, Georgia, has struggled to keep its doors open while treating patients who tend to be older, poorer and often uninsured. AP Photo/Russ Bynum
</figcaption>
</figure>

Barriers to accessing health care

Yet, despite all these medical issues, rural residents have a tough time getting the health care they need.

The nature of rural employment, for example, is characterised by <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2005.tb00058.x/epdf">self-employment, seasonal work and lower-than-average pay</a>. This means rural workers are <a href="https://www.ruralhealthinfo.org/pdf/research_compendium.pdf">less likely to get insurance through their jobs and thus face higher premiums</a> when buying their own policies.

The lack of public transportation in most rural areas is also a major hurdle to seeing a doctor, particularly as residents <a href="https://www.ncbi.nlm.nih.gov/pubmed/16606425">have to travel much farther</a> than those in urban areas to reach health care providers.

Rural residents get most of their services through primary care providers, who take on the work of other practitioners, like behavioural health clinicians, due to longstanding specialist shortages. When handling numerous complaints during a single medical encounter, primary care providers may concentrate on the acutest health concerns of their patients, undermining the ability to diagnose all their conditions and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609543/">meaningfully discuss their larger health risks</a>, such as exercise, weight and substance use. When providers are rushed or deliver sub-par care, rural residents may wonder if seeking it out is worth the challenge, <a href="https://www.ncbi.nlm.nih.gov/pubmed/27322157">opting to struggle on their own</a>.

These and other constraints make it tougher for rural Americans to get the screenings necessary to spot serious diseases such as <a href="http://www.tandfonline.com/doi/abs/10.1300/J013v42n02_06">cancer</a> early or to maintain adequate follow-up on conditions like <a href="https://www.ncbi.nlm.nih.gov/pubmed/24183213">hearing loss</a>. Finding the regular medical care necessary to manage chronic conditions, such as diabetes, depression or opioid disorders, is even more challenging.

Rural health care has at times been <a href="https://www.ncbi.nlm.nih.gov/pubmed/18709749">characterised as patchwork</a>. In part, that&rsquo;s because the costs of sustaining health care infrastructure in rural areas<a href="https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/30/10/36/rural-health-goals-guaranteeing-a-future"> are higher</a> thanks to the large service areas, the inability to negotiate bulk pricing and lack of financial incentives to fill in provider gaps.

The ACA and the AHCA

The ACA, intended to turn this around, has in fact led to dramatic gains in insurance coverage among rural Americans.

Broadly speaking, insurance rates in rural areas <a href="http://hrms.urban.org/quicktakes/Substantial-Gains-in-Health-Insurance-Coverage-Occurring-for-Adults-in-Both-Rural-and-Urban-Areas.html">reached almost 86 percent</a> in early 2015, up from an estimated 78 percent in 2013.

In Kentucky &ndash; a state with high poverty, a large rural population (42 percent of residents) and a successful <a href="https://theconversation.com/love-it-or-hate-it-obamacare-has-expanded-coverage-for-millions-66472?sr=2">Medicaid expansion</a> initiative &ndash; <a href="http://www.cbpp.org/blog/medicaid-at-50-kentuckys-experience-highlights-benefits-of-medicaid-expansion">tens of thousands of newly insured low-income adults</a> began using preventative services after previously being unable to afford it. The state&rsquo;s uninsured fell by half and, as a result, <a href="http://content.healthaffairs.org/content/35/1/96.abstract">fewer people skipped taking their medications</a> due to financial hardships relative to other states that didn&rsquo;t expand Medicaid.

The ACA also <a href="http://www.scholarsstrategynetwork.org/brief/how-obamacare-repeal-would-harm-rural-america">strengthened rural health care institutions</a> by investing in upgrades to hospitals and clinics, preventative health programs and support for providers to stay in rural areas. While rural hospitals are often laden with the expense of providing extensive care without payment to indigent patients, rural hospitals in states that expanded Medicaid under the ACA <a href="http://www.cbpp.org/research/health/house-passed-bill-would-devastate-health-care-in-rural-america?utm_source=CBPP+Email+Updates&amp;utm_campaign=d303d5c441-EMAIL_CAMPAIGN_2017_05_16&amp;utm_medium=email&amp;utm_term=0_ee3f6da374-d303d5c441-110964945">finally was able to better balance their books when caring for this vulnerable group</a>. At the same time, the ACA supported innovative models ideal for rural areas that prioritised <a href="https://www.ncbi.nlm.nih.gov/pubmed/18709749">outreach</a>, <a href="http://content.healthaffairs.org/content/29/5/852.abstract">integration of services</a> and <a href="http://nashp.org/wp-content/uploads/2016/09/Rural-Opioid-Primer.pdf">collaboration between safety-net players</a>.

Both the <a href="https://www.washingtonpost.com/graphics/2017/politics/obamacare-senate-bill-compare/">House and Senate</a> bills to repeal and replace Obamacare would <a href="http://www.scholarsstrategynetwork.org/brief/how-obamacare-repeal-would-harm-rural-america">drastically reduce rural Americans&rsquo; insurance coverage</a> and significantly threaten the ability of <a href="http://www.npr.org/sections/health-shots/2017/06/22/533680909/republicans-proposed-medicaid-cuts-would-hit-rural-patients-hard">many rural hospitals and clinics to keep their doors open</a>. <a href="http://www.cbpp.org/research/health/house-passed-bill-would-devastate-health-care-in-rural-america">Analysts show</a> that the bill would provide insufficient tax credits to pay for rural premium costs, drastically increase the price of rural premiums and increase uncompensated care in rural hospitals.

What rural areas need from health care reform

Previous efforts at health care reform show us that rural areas are uniquely vulnerable. Efforts need to take account not only of coverage and access &ndash; as has been the focus of the current debate &ndash; but also how reform affects rural health care institutions and the larger social factors shaping overall health.

The particular economic factors affecting rural health care institutions <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415203/">make rural areas particularly vulnerable to political shifts</a> that disrupt services for existing patients and for those newly insured, creating immense challenges for rural providers. Steps that fail to account for the impact of financial hardship on these institutions not only hurt their bottom line but contribute to <a href="https://www.ncbi.nlm.nih.gov/pubmed/22229021">poor morale and workforce turnover</a> and larger-scale decisions to reduce services, which decrease their ability to address patient needs.

At the same time, commitment to improving the health of rural Americans requires attention to the so-called upstream factors shaping rural health. That means <a href="http://www.prnewswire.com/news-releases/medicaid-plays-a-more-significant-role-in-small-towns-and-rural-communities-than-in-metro-areas-300469734.html">preserving the safety net programs so vital in rural areas</a> with underemployment and low-paying jobs, <a href="http://www.soar-ky.org/about-us">strengthening rural economies</a> and investing in <a href="https://www.brookings.edu/blog/brown-center-chalkboard/2017/01/04/a-better-future-for-rural-communities-starts-at-the-schoolhouse/">high-quality education</a>.

<img alt="The Conversation" height="1" src="https://counter.theconversation.edu.au/content/78018/count.gif?distributor=republish-lightbox-basic" width="1" />If our leaders are serious about reform that will lessen the rural-urban mortality gap, they should recognise the unique needs of rural America and ensure health care policy reflects how vital access to quality care is to their financial success &ndash; not to mention their well-being.

<a href="https://theconversation.com/profiles/claire-snell-rood-378593">Claire Snell-Rood</a>, Assistant Professor of Public Health, University of California, Berkeley and Cathleen Willging, Adjunct Associate Professor of Anthropology, University of New Mexico

This article was originally published on <a href="http://theconversation.com">The Conversation</a>. Read the <a href="https://theconversation.com/ahca-would-make-rural-americas-already-distressed-health-care-worse-78018">original article</a>.

Researchers who study the mental and physical health of rural Americans, believe this repealing Obamacare would have disastrous consequences

By: Claire Snell-Rood and Cathleen Willging Much has been made of the distress and discontent in rural areas during the 2016 U.S. presidential election. Few realise, however, this is also felt through unequal health. Researchers call it the “rural mortality penalty.” While rates of mortality have steadily fallen in the nation’s urban areas, they have actually climbed for rural Americans. And the picture is even bleaker for specific groups, such as rural white women and people of colour, who face persistent disparities in health outcomes. In every category, from suicide to unintentional injury to heart disease, rural residents’ health has been declining since the 1990s. While some have blamed these gaping disparities on “culture” or “lifestyle” factors – such as a supposed fatalism or overconsumption of unhealthy products like Mountain Dew – the truth is that the biggest culprit is limited access to health care and challenging economic circumstances. The passage of the Affordable Care Act (ACA) in 2010 began to change this as more rural Americans gained insurance coverage and the government invested more money into regional health facilities and training. This progress is now at risk, however, as the Republican Congress inches closer to repealing Obamacare and replacing it with a feeble alternative that greatly weakens rural health care access. As researchers who study the mental and physical health of rural Americans, we believe this would have disastrous consequences. The travails of rural America Even as rural America feeds the country, hunger is on the rise in rural areas. Some 98 percent of rural residents live in food deserts – defined as counties in which one must drive more than 10 miles to get to the nearest supermarket. This makes it challenging to maintain healthy and nutritious diets, leading to higher rates of obesity in rural areas that greatly increase the risk for diabetes, heart disease and certain cancers. As rural workers struggle to sustain employment in a shifting economy, the increasing poverty is contributing to mental distress and substance use. On a larger scale, the economic changes that have hit rural areas have resulted in a declining tax base, lower incomes and strained educational institutions. Together, they challenge rural residents’ health not just in the immediate term but cumulatively over their lives. Like many other rural hospitals in the U.S., Evans Memorial in Claxton, Georgia, has struggled to keep its doors open while treating patients who tend to be older, poorer and often uninsured. AP Photo/Russ Bynum Barriers to accessing health care Yet, despite all these medical issues, rural residents have a tough time getting the health care they need. The nature of rural employment, for example, is characterised by self-employment, seasonal work and lower-than-average pay. This means rural workers are less likely to get insurance through their jobs and thus face higher premiums when buying their own policies. The lack of public transportation in most rural areas is also a major hurdle to seeing a doctor, particularly as residents have to travel much farther than those in urban areas to reach health care providers. Rural residents get most of their services through primary care providers, who take on the work of other practitioners, like behavioural health clinicians, due to longstanding specialist shortages. When handling numerous complaints during a single medical encounter, primary care providers may concentrate on the acutest health concerns of their patients, undermining the ability to diagnose all their conditions and meaningfully discuss their larger health risks, such as exercise, weight and substance use. When providers are rushed or deliver sub-par care, rural residents may wonder if seeking it out is worth the challenge, opting to struggle on their own. These and other constraints make it tougher for rural Americans to get the screenings necessary to spot serious diseases such as cancer early or to maintain adequate follow-up on conditions like hearing loss. Finding the regular medical care necessary to manage chronic conditions, such as diabetes, depression or opioid disorders, is even more challenging. Rural health care has at times been characterised as patchwork. In part, that’s because the costs of sustaining health care infrastructure in rural areas are higher thanks to the large service areas, the inability to negotiate bulk pricing and lack of financial incentives to fill in provider gaps. The ACA and the AHCA The ACA, intended to turn this around, has in fact led to dramatic gains in insurance coverage among rural Americans. Broadly speaking, insurance rates in rural areas reached almost 86 percent in early 2015, up from an estimated 78 percent in 2013. In Kentucky – a state with high poverty, a large rural population (42 percent of residents) and a successful Medicaid expansion initiative – tens of thousands of newly insured low-income adults began using preventative services after previously being unable to afford it. The state’s uninsured fell by half and, as a result, fewer people skipped taking their medications due to financial hardships relative to other states that didn’t expand Medicaid. The ACA also strengthened rural health care institutions by investing in upgrades to hospitals and clinics, preventative health programs and support for providers to stay in rural areas. While rural hospitals are often laden with the expense of providing extensive care without payment to indigent patients, rural hospitals in states that expanded Medicaid under the ACA finally was able to better balance their books when caring for this vulnerable group. At the same time, the ACA supported innovative models ideal for rural areas that prioritised outreach, integration of services and collaboration between safety-net players. Both the House and Senate bills to repeal and replace Obamacare would drastically reduce rural Americans’ insurance coverage and significantly threaten the ability of many rural hospitals and clinics to keep their doors open. Analysts show that the bill would provide insufficient tax credits to pay for rural premium costs, drastically increase the price of rural premiums and increase uncompensated care in rural hospitals. What rural areas need from health care reform Previous efforts at health care reform show us that rural areas are uniquely vulnerable. Efforts need to take account not only of coverage and access – as has been the focus of the current debate – but also how reform affects rural health care institutions and the larger social factors shaping overall health. The particular economic factors affecting rural health care institutions make rural areas particularly vulnerable to political shifts that disrupt services for existing patients and for those newly insured, creating immense challenges for rural providers. Steps that fail to account for the impact of financial hardship on these institutions not only hurt their bottom line but contribute to poor morale and workforce turnover and larger-scale decisions to reduce services, which decrease their ability to address patient needs. At the same time, commitment to improving the health of rural Americans requires attention to the so-called upstream factors shaping rural health. That means preserving the safety net programs so vital in rural areas with underemployment and low-paying jobs, strengthening rural economies and investing in high-quality education. If our leaders are serious about reform that will lessen the rural-urban mortality gap, they should recognise the unique needs of rural America and ensure health care policy reflects how vital access to quality care is to their financial success – not to mention their well-being. Claire Snell-Rood, Assistant Professor of Public Health, University of California, Berkeley and Cathleen Willging, Adjunct Associate Professor of Anthropology, University of New Mexico This article was originally published on The Conversation. Read the original article.

Trump's health care policy is disastrous for rural America

At least 40 people were arrested for protesting the Trump administration&#39;s anticipated cuts to Medicaid. Yesterday, US Senate leaders unveiled a draft of the legislation they want to replace the Afforcable Care Act, informally known as Obamacare.

It proposes to kill a tax on the wealthy that pays for it, and reduces aid to the poor, Reuters reports.

Dozens of disabled men and women were arrested after their pariticpation in a &quot;die-in&quot; protest outside Senate Majority Leader Mitch McConnel&#39;s Washington office, the <a href="http://www.latimes.com/politics/washington/la-na-essential-washington-updates-43-protesters-arrested-in-die-in-at-1498161963-htmlstory.html" target="_blank">LA Times</a> reports. The demonstration was organised by the national disability group ADAPT in response to the GOP&#39;s healthcare plan which proposes to drastically cut Medicaid.

<div class="ui-state-default" contenteditable="false">
<div class="twitter-block" draggable="false">
<blockquote class="twitter-tweet" data-lang="en">
A picture is worth a 1000 soulless words... <a href="https://twitter.com/hashtag/AHCA?src=hash">#AHCA</a> <a href="https://t.co/TjK04aboPE">pic.twitter.com/TjK04aboPE</a>
&mdash; Jeffrey Lieber (@JeffLieber) <a href="https://twitter.com/JeffLieber/status/877976665065889792">June 22, 2017</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script></div>
<a class="close-mark close-div" href="#" id="jqclosemark">&times;</a></div>

Here is footage of one&nbsp;woman forcibly&nbsp;removed from her wheelchair:

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<blockquote class="twitter-tweet" data-lang="en">
A horrific metaphor for Trumpcare: this disabled woman literally being ripped from her wheelchair. <a href="https://twitter.com/hashtag/StopTrumpcare?src=hash">#StopTrumpcare</a> <a href="https://t.co/F5kmz8rnCv">pic.twitter.com/F5kmz8rnCv</a>
&mdash; Matt McDermott (@mattmfm) <a href="https://twitter.com/mattmfm/status/877932005593300993">June 22, 2017</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script></div>
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President Barack Obama, whose legacy is the&nbsp;Affordable Care Act, weighed in with a Facebook post that has gone viral. He began by appealing to the non-partisan nature of access to&nbsp;healthcare&nbsp;before explicitly calling the Republican&#39;s proposed plan: &quot;a&nbsp;massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else&quot;.&nbsp;

&nbsp;

<iframe allowtransparency="true" frameborder="0" height="281" scrolling="no" src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fbarackobama%2Fposts%2F10154996557026749&amp;width=500" style="border:none;overflow:hidden" width="500"></iframe>

<h3>Also read:&nbsp;<a href="http://www.wionews.com/world/republicans-unveil-meaner-senate-health-bill-but-lack-votes-to-pass-it-17172" target="_blank">Republicans unveil &#39;meaner&#39; Senate health bill, but lack votes to pass it</a></h3>

&nbsp;

The draft is unlikely to succeed: Senator Rand Paul and three other conservative Republicans said they were &quot;not ready&quot; to vote for it. Democrats need only three Republicans to nix the measure in the Republican-led chamber.

The proposal, worked on in secret by Senate Majority Leader Mitch McConnell and other Republicans, was welcomed by Donald Trump, Reuters reports.

&nbsp;

As the first draft of the ACA's replacement was released, President Barack Obama criticised it harshly

At least 40 people were arrested for protesting the Trump administration's anticipated cuts to Medicaid. Yesterday, US Senate leaders unveiled a draft of the legislation they want to replace the Afforcable Care Act, informally known as Obamacare. It proposes to kill a tax on the wealthy that pays for it, and reduces aid to the poor, Reuters reports. Dozens of disabled men and women were arrested after their pariticpation in a "die-in" protest outside Senate Majority Leader Mitch McConnel's Washington office, the LA Times reports. The demonstration was organised by the national disability group ADAPT in response to the GOP's healthcare plan which proposes to drastically cut Medicaid. A picture is worth a 1000 soulless words... #AHCA pic.twitter.com/TjK04aboPE — Jeffrey Lieber (@JeffLieber) June 22, 2017 × Here is footage of one woman forcibly removed from her wheelchair: A horrific metaphor for Trumpcare: this disabled woman literally being ripped from her wheelchair. #StopTrumpcare pic.twitter.com/F5kmz8rnCv — Matt McDermott (@mattmfm) June 22, 2017 × President Barack Obama, whose legacy is the Affordable Care Act, weighed in with a Facebook post that has gone viral. He began by appealing to the non-partisan nature of access to healthcare before explicitly calling the Republican's proposed plan: "a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else". Also read: Republicans unveil 'meaner' Senate health bill, but lack votes to pass it The draft is unlikely to succeed: Senator Rand Paul and three other conservative Republicans said they were "not ready" to vote for it. Democrats need only three Republicans to nix the measure in the Republican-led chamber. The proposal, worked on in secret by Senate Majority Leader Mitch McConnell and other Republicans, was welcomed by Donald Trump, Reuters reports.

US healthcare Bill: 43 protesters arrested, dozens ripped from wheelchairs

A bill passed by US&nbsp;House Republicans would cause 23 million people to lose healthcare coverage by 2026 while de-stabilising health insurance markets in some states and making it hard for sick people to buy insurance, a budget watchdog agency said on Wednesday.

The Congressional Budget Office, a non-partisan group of experts who analyse US&nbsp;legislation, said the bill would reduce federal deficits by $119 billion between 2017 and 2026.

The report could give added ammunition to Democrats who have accused President Donald Trump and congressional Republicans of putting sick and low-income people at risk with their effort to roll back former President Barack Obama&#39;s signature 2010 healthcare law, formally known as the Affordable Care Act but often called Obamacare.

The report also complicates the job of Senate Republicans - some of whom already have doubts about the House bill - as they craft their own healthcare legislation.

Republicans have sought to unravel Obamacare since its passage and Trump promised on the campaign trail to repeal it, saying it is too costly and an overreach by government in the healthcare market.

As Trump and Republican leaders sought to bring wavering lawmakers on board with the House bill, they added a controversial last-minute amendment that would give states leeway to drop an Obamacare requirement that forces insurers to charge sick and healthy people the same insurance rates.

Another change would allow states to decide whether to require insurers to cover health benefits such as maternity care and prescription drugs that are mandatory under current law.

But the CBO report said the amendment would make it difficult or impossible for people in poor health to purchase comprehensive coverage in some states.

&quot;People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all,&quot; the CBO report said.

The CBO said markets for people to buy individual insurance plans could then become &quot;unstable&quot; in states that choose to waive the Obamacare requirements for coverage of pre-existing medical conditions and essential health benefits.

Even before the report, many Republican senators were wary of the House version of the healthcare bill, saying it unraveled Obamacare too much and too quickly. About 20 million people gained insurance under Obamacare.

The House bill would eliminate most Obamacare taxes that help subsidise private health coverage for individuals, roll back the government&#39;s Medicaid health plan for the poor and disabled and replace the law&#39;s income-based tax credits for buying medical coverage with credits based on age.

A group of 13 Republican senators led by Senate Majority Leader Mitch McConnell is expected to draft its own version of the healthcare bill in the coming months. McConnell, however, told Reuters on Wednesday he does not yet know how Republicans will get the necessary votes.

&quot;This is a very challenging undertaking,&quot; McConnell said.

&nbsp;

REPUBLICAN OPPOSITION

After the release of the CBO report, several Republican senators said they could not support the House bill.

&quot;While I am in favor of repealing Obamacare, I am opposed to the American Health Care Act in its current form,&quot; Republican Senator Dean Heller said in a statement.

Republican Senator Susan Collins said too many people would lose insurance and that older and low-income Americans would be hurt.

House Republicans, who argue their healthcare bill would allow insurance markets to function more efficiently, focused on the projected budget savings from it and a finding in the CBO report that said insurance premiums for some people would decline.

Groups representing hospitals, insurers and doctors who opposed the House bill said the CBO report showed the Senate should start fresh with an eye to maintaining coverage and benefits.

Democrats also blasted the bill and said the CBO report proved it would be catastrophic for millions of people who would lose health insurance.

&quot;The report makes clear Trumpcare would be a cancer on the American healthcare system,&quot; Senate Democratic leader Chuck Schumer said at a news conference.

The new CBO score predicts the AHCA would cover 1 million more Americans than Republicans&#39; previous version of the bill, which the agency estimated would have left 24 million more people uninsured than Obamacare in 2026.

To allay concerns about coverage of people with pre-existing illnesses, House Republicans allocated an additional $8 billion over five years in their bill to help sick people pay for insurance premiums but the CBO said the money would not be enough to help them afford coverage.

The CBO said premiums would fall for younger people and rise for older people in states that did not waive Obamacare requirements for an overall decline of about 4 per cent. In states that made moderate changes to their markets, representing about one-third of the US&nbsp;population, premiums would fall 20 per cent on average.

Reaction on Wall Street was muted, with shares of hospitals affected by the cuts to Medicaid, like Community Health Systems, and health insurers specialising in Medicaid, such as Molina Healthcare&nbsp;and Centene Corp&nbsp;unchanged in light after-hours trading.

The Republicans&#39; first attempt at undoing Obamacare this year resulted in a setback for the Trump agenda in March. Conservative and moderate Republican factions in the House were opposed to the initial legislation and the leadership decided not to put it up for a vote.

(Reuters)

'...Trumpcare would be a cancer on the American healthcare system,' said Senate Democratic leader Chuck Schumer

A bill passed by US House Republicans would cause 23 million people to lose healthcare coverage by 2026 while de-stabilising health insurance markets in some states and making it hard for sick people to buy insurance, a budget watchdog agency said on Wednesday. The Congressional Budget Office, a non-partisan group of experts who analyse US legislation, said the bill would reduce federal deficits by $119 billion between 2017 and 2026. The report could give added ammunition to Democrats who have accused President Donald Trump and congressional Republicans of putting sick and low-income people at risk with their effort to roll back former President Barack Obama's signature 2010 healthcare law, formally known as the Affordable Care Act but often called Obamacare. The report also complicates the job of Senate Republicans - some of whom already have doubts about the House bill - as they craft their own healthcare legislation. Republicans have sought to unravel Obamacare since its passage and Trump promised on the campaign trail to repeal it, saying it is too costly and an overreach by government in the healthcare market. As Trump and Republican leaders sought to bring wavering lawmakers on board with the House bill, they added a controversial last-minute amendment that would give states leeway to drop an Obamacare requirement that forces insurers to charge sick and healthy people the same insurance rates. Another change would allow states to decide whether to require insurers to cover health benefits such as maternity care and prescription drugs that are mandatory under current law. But the CBO report said the amendment would make it difficult or impossible for people in poor health to purchase comprehensive coverage in some states. "People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all," the CBO report said. The CBO said markets for people to buy individual insurance plans could then become "unstable" in states that choose to waive the Obamacare requirements for coverage of pre-existing medical conditions and essential health benefits. Even before the report, many Republican senators were wary of the House version of the healthcare bill, saying it unraveled Obamacare too much and too quickly. About 20 million people gained insurance under Obamacare. The House bill would eliminate most Obamacare taxes that help subsidise private health coverage for individuals, roll back the government's Medicaid health plan for the poor and disabled and replace the law's income-based tax credits for buying medical coverage with credits based on age. A group of 13 Republican senators led by Senate Majority Leader Mitch McConnell is expected to draft its own version of the healthcare bill in the coming months. McConnell, however, told Reuters on Wednesday he does not yet know how Republicans will get the necessary votes. "This is a very challenging undertaking," McConnell said. REPUBLICAN OPPOSITION After the release of the CBO report, several Republican senators said they could not support the House bill. "While I am in favor of repealing Obamacare, I am opposed to the American Health Care Act in its current form," Republican Senator Dean Heller said in a statement. Republican Senator Susan Collins said too many people would lose insurance and that older and low-income Americans would be hurt. House Republicans, who argue their healthcare bill would allow insurance markets to function more efficiently, focused on the projected budget savings from it and a finding in the CBO report that said insurance premiums for some people would decline. Groups representing hospitals, insurers and doctors who opposed the House bill said the CBO report showed the Senate should start fresh with an eye to maintaining coverage and benefits. Democrats also blasted the bill and said the CBO report proved it would be catastrophic for millions of people who would lose health insurance. "The report makes clear Trumpcare would be a cancer on the American healthcare system," Senate Democratic leader Chuck Schumer said at a news conference. The new CBO score predicts the AHCA would cover 1 million more Americans than Republicans' previous version of the bill, which the agency estimated would have left 24 million more people uninsured than Obamacare in 2026. To allay concerns about coverage of people with pre-existing illnesses, House Republicans allocated an additional $8 billion over five years in their bill to help sick people pay for insurance premiums but the CBO said the money would not be enough to help them afford coverage. The CBO said premiums would fall for younger people and rise for older people in states that did not waive Obamacare requirements for an overall decline of about 4 per cent. In states that made moderate changes to their markets, representing about one-third of the US population, premiums would fall 20 per cent on average. Reaction on Wall Street was muted, with shares of hospitals affected by the cuts to Medicaid, like Community Health Systems, and health insurers specialising in Medicaid, such as Molina Healthcare and Centene Corp unchanged in light after-hours trading. The Republicans' first attempt at undoing Obamacare this year resulted in a setback for the Trump agenda in March. Conservative and moderate Republican factions in the House were opposed to the initial legislation and the leadership decided not to put it up for a vote. (Reuters)

Under US Republican bill, 23 million would lose health coverage: Watchdog

Two Congressional Democrats mocked US&nbsp;Vice President Mike Pence for posting a picture of all men&nbsp;on&nbsp;Twitter from a House Freedom Caucus meeting proposing doing away with&nbsp;women&#39;s healthcare initiatives, <a href="http://thehill.com/blogs/blog-briefing-room/news/325562-dem-lawmaker-shreds-house-gop-over-lack-of-women-in-maternity" target="_blank">The Hill</a> reports.

Here is the Tweet from Vice President Mike Pence:&nbsp;

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Appreciated joining <a href="https://twitter.com/POTUS">@POTUS</a> for meeting with the Freedom Caucus again today. This is it. <a href="https://twitter.com/hashtag/PassTheBill?src=hash">#PassTheBill</a> <a href="https://t.co/XG6lQIy5a6">pic.twitter.com/XG6lQIy5a6</a>
&mdash; Vice President Pence (@VP) <a href="https://twitter.com/VP/status/844977432713146370">March 23, 2017</a></blockquote>
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The House Freedom Caucus&nbsp;gathered seeking ways to pass the Republican bill to repeal-and-replace the Affordable Care Act, also known as Obamacare. Proposed was doing away with &quot;essential health benefits&quot;, which require insurance plans to cover basic health services females need, like maternity care and mammograms.

At least two Democrats seised on this&nbsp;picture without women in it to mock the Republicans for making laws about women&#39;s health in a meeting wit

That the Republicans would make legislation that so impacted women&#39;s health in a meeting without women it and&nbsp;post a picture of it, was seised on by two Democrats.

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This is outrageous: Not a single woman in the room as <a href="https://twitter.com/mike_pence">@Mike_Pence</a> and <a href="https://twitter.com/HouseGOP">@HouseGOP</a> propose removing maternity coverage in <a href="https://twitter.com/hashtag/Trumpcare?src=hash">#Trumpcare</a>. <a href="https://t.co/wwY6WsN206">pic.twitter.com/wwY6WsN206</a>
&mdash; Jim McGovern (@RepMcGovern) <a href="https://twitter.com/RepMcGovern/status/844991898850877443">March 23, 2017</a></blockquote>
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A rare look inside the GOP&rsquo;s women&rsquo;s health caucus. <a href="https://t.co/SgLmvSpeSM">https://t.co/SgLmvSpeSM</a>
&mdash; Senator Patty Murray (@PattyMurray) <a href="https://twitter.com/PattyMurray/status/845001919034732544">March 23, 2017</a></blockquote>
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No women are in the House Freedom Caucus, but it was reported that top Trump aide Kellyanne Conway was in attendance, as was the president and vice president.

(WION)

&nbsp;

The meeting discussed repealing ObamaCare 'essential health benefits', requiring insurance companies to cover mammograms and maternity care

Two Congressional Democrats mocked US Vice President Mike Pence for posting a picture of all men on Twitter from a House Freedom Caucus meeting proposing doing away with women's healthcare initiatives, The Hill reports. Here is the Tweet from Vice President Mike Pence: Appreciated joining @POTUS for meeting with the Freedom Caucus again today. This is it. #PassTheBill pic.twitter.com/XG6lQIy5a6 — Vice President Pence (@VP) March 23, 2017 × The House Freedom Caucus gathered seeking ways to pass the Republican bill to repeal-and-replace the Affordable Care Act, also known as Obamacare. Proposed was doing away with "essential health benefits", which require insurance plans to cover basic health services females need, like maternity care and mammograms. At least two Democrats seised on this picture without women in it to mock the Republicans for making laws about women's health in a meeting wit That the Republicans would make legislation that so impacted women's health in a meeting without women it and post a picture of it, was seised on by two Democrats. This is outrageous: Not a single woman in the room as @Mike_Pence and @HouseGOP propose removing maternity coverage in #Trumpcare. pic.twitter.com/wwY6WsN206 — Jim McGovern (@RepMcGovern) March 23, 2017 × A rare look inside the GOP’s women’s health caucus. https://t.co/SgLmvSpeSM — Senator Patty Murray (@PattyMurray) March 23, 2017 × No women are in the House Freedom Caucus, but it was reported that top Trump aide Kellyanne Conway was in attendance, as was the president and vice president. (WION)

Republicans mocked for posting photo of healthcare meeting with 0 women in it: The Hill

US&nbsp;President Donald Trump and House of Representatives leaders pushed on Wednesday for votes for their plan to overhaul Obamacare and said they were making progress in their efforts to win over conservative Republicans who have demanded changes to the legislation.

With a vote on the bill scheduled for Thursday evening, members of the House Freedom Caucus, a conservative Republican faction, said they had been negotiating possible concessions from the White House.

&quot;I can tell you that we&#39;re making great progress,&quot; Mark Meadows, chairman of the Freedom Caucus, told reporters. &quot;We&#39;re not there yet. But we&#39;re hopeful.&quot;

Repealing and replacing Democratic former President Barack Obama&#39;s 2010 Affordable Care Act, unofficially known as &quot;Obamacare&quot;, is a first major test of Trump&rsquo;s legislative ability and whether he can keep his big promises to business.

Plans aired by Trump during his election campaign and his first two months in office have lifted US&nbsp;stock markets to new highs. But stocks fell back sharply on Tuesday as investors worried that a rough ride for the healthcare legislation could affect his ability to deliver on other big pieces of his agenda, from cutting taxes and regulation to boosting infrastructure.

Major stock indexes wobbled on Wednesday, with the Dow Jones Industrial Average ending slightly down and the S&amp;P 500 slightly higher. Investors are eagerly awaiting Thursday&rsquo;s healthcare vote, which could be pivotal for Trump&#39;s broader plans.

The Freedom Caucus has objected to the bill because its members believe it is still too close to Obamacare.

Representative Steve King, a conservative who was among lawmakers who met Trump on Wednesday morning at the White House, said he would now vote for the bill because he got a commitment from Trump to publicly advocate for a Senate amendment to the legislation that would eliminate insurance coverage benefits put in place under Obamacare.

&quot;I have a full and firm commitment with many witnesses from President Trump,&quot; King said in a video statement on YouTube.

King said the amendment would be put forward by Senate Majority Leader Mitch McConnell. A spokesman for McConnell did not immediately respond to a request for comment.

Earlier on Wednesday, a Freedom Caucus aide said more than 25 of its members were opposed, enough to stop the bill from passing. Republicans cannot afford to lose more than 20 votes from their own party, since Democrats are united in opposition.

&nbsp;

HEADWAY

White House spokeswoman Sarah Sanders also gave signs negotiations were making headway late on Wednesday. 
Trump fights for healthcare bill, makes headway with conservatives. &quot;We are continuing to move forward and adding new supporters constantly,&quot; she said. &quot;As we have indicated previously we are open to changes to the bill that make it better and grow its support.&quot;

But even if Trump is able to get conservatives on board, he still faces a struggle in pushing the bill through the House. While conservatives say the House bill is too similar to Obamacare, moderate Republicans are concerned that it will provoke a backlash by increasing the number of uninsured Americans.

The primary aim of Obama&#39;s signature legislation, passed in 2010, was reducing the numbers of Americans with no health coverage. Twenty million people gained insurance under the law.

The nonpartisan Congressional Budget Office estimated 14 million people would lose coverage under the Republican plan by next year. It also said 24 million fewer people would be insured by 2026.

Obamacare mandates that insurance plans must cover trips emergency room trips, maternity and newborn care, and mental health services. Conservatives say reducing or scrapping the mandates would bring down insurance premiums.

The Republican plan would rescind taxes created by Obamacare, repeal a penalty against those who do not buy coverage, slash funding for the Medicaid programme for the poor and disabled, and modify subsidies that help individuals buy plans.

In the two weeks since the healthcare plan was unveiled, shares of some hospital operators and health insurers have fallen more than 10 percent, due to concerns about the fate of the benefits companies gained from coverage expansion.

If the healthcare bill passes the House, the Senate could take it up next week. Republican leaders are hoping that if the Senate acts quickly, the bill could go back to the House for a final vote by mid-April, possibly allowing Trump to sign it into law by Easter, April 16.

Trump has put considerable effort into building support for the Republican healthcare bill, called the American Health Care Act, and on Tuesday warned Republicans that failure could have sharp repercussions in next year&#39;s congressional elections.

&nbsp;

PROTESTS

Opponents of the overhaul have been fiercely vocal, and on Wednesday protesters, many in wheelchairs or with serious medical conditions, blocked the Capitol rotunda for about an hour.

&quot;Rather go to jail than die without Medicaid,&quot; they chanted.

Capitol police said they made 54 arrests and later released the protesters.

(Reuters)

The nonpartisan Congressional Budget Office estimated 14 million people would lose coverage under the Republican plan by next year

US President Donald Trump and House of Representatives leaders pushed on Wednesday for votes for their plan to overhaul Obamacare and said they were making progress in their efforts to win over conservative Republicans who have demanded changes to the legislation. With a vote on the bill scheduled for Thursday evening, members of the House Freedom Caucus, a conservative Republican faction, said they had been negotiating possible concessions from the White House. "I can tell you that we're making great progress," Mark Meadows, chairman of the Freedom Caucus, told reporters. "We're not there yet. But we're hopeful." Repealing and replacing Democratic former President Barack Obama's 2010 Affordable Care Act, unofficially known as "Obamacare", is a first major test of Trump’s legislative ability and whether he can keep his big promises to business. Plans aired by Trump during his election campaign and his first two months in office have lifted US stock markets to new highs. But stocks fell back sharply on Tuesday as investors worried that a rough ride for the healthcare legislation could affect his ability to deliver on other big pieces of his agenda, from cutting taxes and regulation to boosting infrastructure. Major stock indexes wobbled on Wednesday, with the Dow Jones Industrial Average ending slightly down and the S&P 500 slightly higher. Investors are eagerly awaiting Thursday’s healthcare vote, which could be pivotal for Trump's broader plans. The Freedom Caucus has objected to the bill because its members believe it is still too close to Obamacare. Representative Steve King, a conservative who was among lawmakers who met Trump on Wednesday morning at the White House, said he would now vote for the bill because he got a commitment from Trump to publicly advocate for a Senate amendment to the legislation that would eliminate insurance coverage benefits put in place under Obamacare. "I have a full and firm commitment with many witnesses from President Trump," King said in a video statement on YouTube. King said the amendment would be put forward by Senate Majority Leader Mitch McConnell. A spokesman for McConnell did not immediately respond to a request for comment. Earlier on Wednesday, a Freedom Caucus aide said more than 25 of its members were opposed, enough to stop the bill from passing. Republicans cannot afford to lose more than 20 votes from their own party, since Democrats are united in opposition. HEADWAY White House spokeswoman Sarah Sanders also gave signs negotiations were making headway late on Wednesday. Trump fights for healthcare bill, makes headway with conservatives. "We are continuing to move forward and adding new supporters constantly," she said. "As we have indicated previously we are open to changes to the bill that make it better and grow its support." But even if Trump is able to get conservatives on board, he still faces a struggle in pushing the bill through the House. While conservatives say the House bill is too similar to Obamacare, moderate Republicans are concerned that it will provoke a backlash by increasing the number of uninsured Americans. The primary aim of Obama's signature legislation, passed in 2010, was reducing the numbers of Americans with no health coverage. Twenty million people gained insurance under the law. The nonpartisan Congressional Budget Office estimated 14 million people would lose coverage under the Republican plan by next year. It also said 24 million fewer people would be insured by 2026. Obamacare mandates that insurance plans must cover trips emergency room trips, maternity and newborn care, and mental health services. Conservatives say reducing or scrapping the mandates would bring down insurance premiums. The Republican plan would rescind taxes created by Obamacare, repeal a penalty against those who do not buy coverage, slash funding for the Medicaid programme for the poor and disabled, and modify subsidies that help individuals buy plans. In the two weeks since the healthcare plan was unveiled, shares of some hospital operators and health insurers have fallen more than 10 percent, due to concerns about the fate of the benefits companies gained from coverage expansion. If the healthcare bill passes the House, the Senate could take it up next week. Republican leaders are hoping that if the Senate acts quickly, the bill could go back to the House for a final vote by mid-April, possibly allowing Trump to sign it into law by Easter, April 16. Trump has put considerable effort into building support for the Republican healthcare bill, called the American Health Care Act, and on Tuesday warned Republicans that failure could have sharp repercussions in next year's congressional elections. PROTESTS Opponents of the overhaul have been fiercely vocal, and on Wednesday protesters, many in wheelchairs or with serious medical conditions, blocked the Capitol rotunda for about an hour. "Rather go to jail than die without Medicaid," they chanted. Capitol police said they made 54 arrests and later released the protesters. (Reuters)

Trump fights to overhaul Obamacare, makes headway with conservatives

Republican US lawmakers expect to unveil this week the text of long-awaited legislation to repeal and replace the Obamacare healthcare law, one of President Donald Trump&#39;s top legislative priorities, a senior Republican congressional aide said on Sunday.

Since taking office in January, Trump has pressed his fellow Republicans who control Congress to act quickly to dismantle former Democratic President Barack Obama&#39;s Affordable Care Act and pass a plan to replace it, but lawmakers in the party have differed on the specifics.

Democrats have warned that Republicans risk throwing the entire U.S. healthcare system into chaos by repealing the 2010 law that was passed by congressional Democrats over united Republican opposition. Republicans condemn it as a government overreach, and Trump has called it a &quot;disaster.&quot;

The aide cited progress in meetings and phone calls starting on Friday and lasting through the weekend involving House of Representatives Speaker Paul Ryan, Health and Human Services Secretary Tom Price, White House budget chief Mick Mulvaney, Trump domestic policy adviser Andrew Bremberg and others.

&quot;We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week,&quot; said the aide, speaking on condition of anonymity.

The aide called the expected bill a &quot;consensus Republican plan,&quot; but offered no details.

AshLee Strong, a spokeswoman for Ryan, said: &quot;We are now at the culmination of a years-long process to keep our promise to the American people.&quot;

The Obamacare law has proven popular in many states, even some controlled by Republicans, and it enabled about 20 million previously uninsured people to get medical insurance, although premium increases angered some.

(Reuters)

Since taking office, Trump has pressed his fellow Republicans to dismantle Obama's Affordable Care Act and pass a plan to replace it

Republican US lawmakers expect to unveil this week the text of long-awaited legislation to repeal and replace the Obamacare healthcare law, one of President Donald Trump's top legislative priorities, a senior Republican congressional aide said on Sunday. Since taking office in January, Trump has pressed his fellow Republicans who control Congress to act quickly to dismantle former Democratic President Barack Obama's Affordable Care Act and pass a plan to replace it, but lawmakers in the party have differed on the specifics. Democrats have warned that Republicans risk throwing the entire U.S. healthcare system into chaos by repealing the 2010 law that was passed by congressional Democrats over united Republican opposition. Republicans condemn it as a government overreach, and Trump has called it a "disaster." The aide cited progress in meetings and phone calls starting on Friday and lasting through the weekend involving House of Representatives Speaker Paul Ryan, Health and Human Services Secretary Tom Price, White House budget chief Mick Mulvaney, Trump domestic policy adviser Andrew Bremberg and others. "We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week," said the aide, speaking on condition of anonymity. The aide called the expected bill a "consensus Republican plan," but offered no details. AshLee Strong, a spokeswoman for Ryan, said: "We are now at the culmination of a years-long process to keep our promise to the American people." The Obamacare law has proven popular in many states, even some controlled by Republicans, and it enabled about 20 million previously uninsured people to get medical insurance, although premium increases angered some. (Reuters)

US Republicans expected to unveil health care bill this week

US President Donald Trump signed his first executive order on Friday to &quot;ease the burden of Obamacare&quot;, the signature healthcare law introduced by Barack Obama which Trump had pledged to repeal.&nbsp;

Trump&#39;s chief of staff, Reince Preibus&nbsp;directed an immediate regulatory freeze for all government agencies, White House spokesman Sean Spicer said.&nbsp;

Spicer said the order was aimed &quot;to ease the burden of Obamacare as we transition from repeal and replace.&quot;

He did not give any further details.&nbsp;

During the presidential campaign, Trump had vowed to scrap the Affordable Care Act or Obamacare, but Republicans have yet to find a replacement for the healthcare programme which provided health insurance to more than 20 million people.&nbsp;

Trump also confirmed the appointments of&nbsp;his Defence secretary James Mattis and Homeland Security secretary John Kelly.&nbsp;

The Senate voted 98-1 confirming Mattis and 88-11 in favour of Kelly.

&nbsp;Vice President Mike Pence swore Mattis and Kelly in a separate ceremony.

Trump also told reporters, &quot;It was busy, but good. It was a beautiful day.&quot;

(WION with inputs from agencies)

&nbsp;

White House spokesman Spicer said the order was aimed 'to ease the burden of Obamacare as we transition from repeal and replace'

US President Donald Trump signed his first executive order on Friday to "ease the burden of Obamacare", the signature healthcare law introduced by Barack Obama which Trump had pledged to repeal. Trump's chief of staff, Reince Preibus directed an immediate regulatory freeze for all government agencies, White House spokesman Sean Spicer said. Spicer said the order was aimed "to ease the burden of Obamacare as we transition from repeal and replace." He did not give any further details. During the presidential campaign, Trump had vowed to scrap the Affordable Care Act or Obamacare, but Republicans have yet to find a replacement for the healthcare programme which provided health insurance to more than 20 million people. Trump also confirmed the appointments of his Defence secretary James Mattis and Homeland Security secretary John Kelly. The Senate voted 98-1 confirming Mattis and 88-11 in favour of Kelly. Vice President Mike Pence swore Mattis and Kelly in a separate ceremony. Trump also told reporters, "It was busy, but good. It was a beautiful day." (WION with inputs from agencies)

US President Donald Trump signs first executive order on Obamacare

The Republican-led U.S. Congress, under pressure from President-elect Donald Trump to move quickly, took its first concrete step towards dismantling Obamacare on Thursday as the Senate voted to instruct key committees to draft legislation to repeal it.

Trump on Twitter congratulated the Senate for its 51-48 vote in the early hours of Thursday, adding &quot;now it&#39;s onto the House!&quot; Only one Republican, Kentucky&#39;s Rand Paul, joined Senate Democrats in opposing the resolution.

The House of Representatives plans to vote on the measure on Friday, Speaker Paul Ryan said, pushing ahead despite concerns among some Republicans about launching a repeal before building a consensus about how to replace the complicated and far-reaching Affordable Care Act, dubbed Obamacare.

Democrats accused Republicans of rushing forward to scrap outgoing President Barack Obama&#39;s signature legislative accomplishment, a law that has enabled upwards of 20 million previously uninsured Americans to obtain health coverage, without yet having a firm replacement plan.

The resolution passed on Thursday instructs committees of the House and Senate to draft repeal legislation by January&nbsp;27. Both chambers will then need to approve the resulting legislation before any repeal goes into effect.

Obamacare&#39;s fate is a high-stakes political showdown between Republicans and Democrats that potentially jeopardizes medical coverage for millions of Americans and risks causing chaos in the health insurance marketplace.

House Democratic Leader Nancy Pelosi vowed to fight. &quot;I think it&#39;s easier to win a fight when something is going to be taken away from you,&quot; Pelosi said in an appearance with elderly Americans who talked about how they had been helped by the law&#39;s provisions, including lower prescription drug costs.

Republicans have called Obamacare a federal government overreach and have sought to undermine it in Congress and the courts since it was passed by Democratic majorities in the House and Senate in 2010.

They are aggressively pushing towards their goal of killing Obamacare now that they will control Congress and the White House once Trump takes office on January&nbsp;20.

Ryan, speaking to reporters just hours after the Senate vote, said House Republicans would discuss options for replacing Obamacare during an annual retreat at the end of this month in Philadelphia.

Ryan said while Congress will take some replacement steps, the incoming Trump administration will be able to act on its own on some aspects, which he did not detail. Ryan said lawmakers were working on dismantling Obamacare &quot;in sync&quot; with Trump.

&quot;We&#39;re not holding hard deadlines, only because we want to get it right,&quot; Ryan said, indicating it will take some time for several House committees to work on replacement legislation.

&nbsp;

&#39;NO IDEA&#39;

Democrats mocked the Republican effort.

&quot;They want to kill ACA but they have no idea how they are going to bring forth a substitute proposal,&quot; said Senator Bernie Sanders of Vermont, an independent who caucuses with the Democrats.

Indeed, some Republicans have expressed concern about the party&#39;s current strategy of pushing repeal without having a consensus replacement plan ready.

Representative Charlie Dent, a moderate Republican from Pennsylvania, has &quot;major concerns&quot; about the process, according to a spokesman, fearing a repeal vote at the start diminishes the leverage that may be needed to get some lawmakers to back a replacement later.

Trump put new pressure on congressional Republicans on Wednesday when he said Obamacare repeal and replacement should happen &quot;essentially simultaneously&quot;. And an influential conservative group, Heritage Action, late on Wednesday pressed lawmakers to back the resolution.

Trump senior adviser Kellyanne Conway said the replacement effort will likely tackle drug pricing.&nbsp;

Some Americans&nbsp;are worried about what this change will mean to their&nbsp;immediate future.

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May each one of these men experience the anxiety that I as a cancer patient feel right now, knowing I&#39;ll die if care becomes unavailable <a href="https://t.co/ZaOpZI6VKA">https://t.co/ZaOpZI6VKA</a>
&mdash; Xeni Jardin (@xeni) <a href="https://twitter.com/xeni/status/819469147281059840">January 12, 2017</a></blockquote>
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Democrats say Obamacare is working, enabling growing numbers of Americans to get medical insurance and helping slow the rise in healthcare spending. Republicans say the program is collapsing and support giving states more control. The average premium for a private insurance policy obtained through Obamacare is set to rise 25 per cent in 2017.

(Reuters)

Under pressure from Trump, Republicans are rushing to dismantle the Affordable Care Act, which is more commonly known as 'Obamacare'

The Republican-led U.S. Congress, under pressure from President-elect Donald Trump to move quickly, took its first concrete step towards dismantling Obamacare on Thursday as the Senate voted to instruct key committees to draft legislation to repeal it. Trump on Twitter congratulated the Senate for its 51-48 vote in the early hours of Thursday, adding "now it's onto the House!" Only one Republican, Kentucky's Rand Paul, joined Senate Democrats in opposing the resolution. The House of Representatives plans to vote on the measure on Friday, Speaker Paul Ryan said, pushing ahead despite concerns among some Republicans about launching a repeal before building a consensus about how to replace the complicated and far-reaching Affordable Care Act, dubbed Obamacare. Democrats accused Republicans of rushing forward to scrap outgoing President Barack Obama's signature legislative accomplishment, a law that has enabled upwards of 20 million previously uninsured Americans to obtain health coverage, without yet having a firm replacement plan. The resolution passed on Thursday instructs committees of the House and Senate to draft repeal legislation by January 27. Both chambers will then need to approve the resulting legislation before any repeal goes into effect. Obamacare's fate is a high-stakes political showdown between Republicans and Democrats that potentially jeopardizes medical coverage for millions of Americans and risks causing chaos in the health insurance marketplace. House Democratic Leader Nancy Pelosi vowed to fight. "I think it's easier to win a fight when something is going to be taken away from you," Pelosi said in an appearance with elderly Americans who talked about how they had been helped by the law's provisions, including lower prescription drug costs. Republicans have called Obamacare a federal government overreach and have sought to undermine it in Congress and the courts since it was passed by Democratic majorities in the House and Senate in 2010. They are aggressively pushing towards their goal of killing Obamacare now that they will control Congress and the White House once Trump takes office on January 20. Ryan, speaking to reporters just hours after the Senate vote, said House Republicans would discuss options for replacing Obamacare during an annual retreat at the end of this month in Philadelphia. Ryan said while Congress will take some replacement steps, the incoming Trump administration will be able to act on its own on some aspects, which he did not detail. Ryan said lawmakers were working on dismantling Obamacare "in sync" with Trump. "We're not holding hard deadlines, only because we want to get it right," Ryan said, indicating it will take some time for several House committees to work on replacement legislation. 'NO IDEA' Democrats mocked the Republican effort. "They want to kill ACA but they have no idea how they are going to bring forth a substitute proposal," said Senator Bernie Sanders of Vermont, an independent who caucuses with the Democrats. Indeed, some Republicans have expressed concern about the party's current strategy of pushing repeal without having a consensus replacement plan ready. Representative Charlie Dent, a moderate Republican from Pennsylvania, has "major concerns" about the process, according to a spokesman, fearing a repeal vote at the start diminishes the leverage that may be needed to get some lawmakers to back a replacement later. Trump put new pressure on congressional Republicans on Wednesday when he said Obamacare repeal and replacement should happen "essentially simultaneously". And an influential conservative group, Heritage Action, late on Wednesday pressed lawmakers to back the resolution. Trump senior adviser Kellyanne Conway said the replacement effort will likely tackle drug pricing. Some Americans are worried about what this change will mean to their immediate future. May each one of these men experience the anxiety that I as a cancer patient feel right now, knowing I'll die if care becomes unavailable https://t.co/ZaOpZI6VKA — Xeni Jardin (@xeni) January 12, 2017 × Democrats say Obamacare is working, enabling growing numbers of Americans to get medical insurance and helping slow the rise in healthcare spending. Republicans say the program is collapsing and support giving states more control. The average premium for a private insurance policy obtained through Obamacare is set to rise 25 per cent in 2017. (Reuters)

US Senate launches Obamacare repeal process, House to vote