“ObamaCare Repeal and Replace” is Now “ObamaCare Repair”

ObamaCare “Repeal and Replace” is now “ObamaCare Repair,” but is this a name change, a policy change, or both? We discuss that.

Insurers don’t price their plans a day before they go to market, they price them early in the year, months in advance. Typically right after open enrollment.

Nothing is going to leave America with higher premiums and worse plan options than an environment of extreme insecurity over healthcare. This is the environment that insurers are in now with the GOP set to make good on their “repeal ObamaCare” promise. Some defunding is already in the works, but no workable plan is on the table.

If one wants to cause a “death spiral,” this would be the way to do it. The laws of probability and the reality of the way the healthcare system works ensure that.

Luckily, it seems as though the reality of how bad an idea taking a sledgehammer to ObamaCare is has sunk in. Recent language used by the GOP hints that the plan will “repair ObamaCare” rather than “repeal, delay, replace.”

Maybe.

A skeptic’s first reaction might be to assume the change is only in wording, that the plan will still be to starve the beast, block grant Medicaid, and starve it some more. Then, when people are ready to tap out, the GOP can come in with a lack-luster fix and call it “saving the day.”

However, from a less skeptic point of view, this may be a signal that the GOP plans to start their process by reforming the parts of the law that need fixing, implementing some conservative alternative solutions, and seeking improvement over a purely ideological win.

I see many members of the GOP seeking to fix, repair, and replace key provisions, and not to blame all problems on the Democrats. This is good news.

As of now, nothing has happened to the ACA except an executive order not to enforce some tax-related provisions to the extent allowed by law, which is an order with very few teeth. The GOP probably won’t be back to the drawing board until insurers have locked in prices for next year.

We are at now at a phase in which “wonks who care sit around and pour through each other’s repair suggestions, hoping we can all get close enough to the same page to pass a bill without everything going to heck.”

There is also this CNN debate of Cruz vs. Sanders on ObamaCare. Perhaps it might help Americans figure out what they want.

I’ve seen a lot of great plans, but no suggestions have offered universal healthcare yet.

The GOP seems determined not to cross the aisle in any single plan, but if you put all the plans together, they have crossed almost every aisle that needs crossing. I’m sure others have noticed this.

For example, you improve coverage significantly if you take the buy-in from HIP and Hatch, the tax credits from Ryan, the HSAs from Price, and add in litigation reform and the few other non-contested provisions like selling over state lines. You might then also add ideas for drug reform from Trump, and consider adding some of the PPACA, Sanders’ plan, as well as Obama’s reform ideas like the public option. If you put it all together, you have a plan that everyone likes because they helped write it.

There will be arguments over block-granting Medicaid and selling health insurance across state lines, and there will be irony when the GOP sets up a Medicare marketplace and swears it isn’t anything like Heathcare.gov. What people will fear is that this is a trick to defund the programs, so I hope that legislators build in safeguards and ease worry as a middle ground.

I believe that it is a giant mistake for the GOP not to try to achieve universal coverage quickly. It is an ongoing embarrassment to the American brand on a global level. It means that when the Pendulum swings as it will, must, and always does, Democrats will come back in and try to do it. Universal care is a milestone we must, as a developed country, reach and one way or another, we will reach it.

The GOP made a mistake in treating ObamaCare like a dirty word rather than a law that has always needed repair.

And perhaps, if nothing else, let’s just start with problems like the family glitch as a show of good faith. THAT is what my executive order to help the middle class would have been. But to know that, one needs to be asking people who know the law instead of just ideologues who still just want the same thing they wanted in 2007, expanded HSAs and sell across state lines. We can’t JUST rehash those points. It isn’t going to be enough.

See our ObamaCare 2017 Repeal and Replace Updates section for all the details you could ever want to know about where things are at and where they are going.