After six years of promising to repeal Obamacare, Republicans are the verge of actually doing just that. With sweeping victories up and down the ballot this November, they have been entrusted with tremendous political power, and delivering on this promise is critical to validating voters’ trust.
Given the importance of healthcare, the sweeping nature of the law, and the historical rarity of voters supporting the rollback of a major entitlement, it is critical that the repeal is done properly to allow for a smooth transition to a healthcare system that works better for Americans.
While Senator Rand Paul and others are arguing Congress should replace Obamacare at the same time it is repealed, Republican leadership appears focused on a “repeal and delay” strategy in which Congress would repeal Obamacare but not pass a replacement bill for some time, disaffecting those who relied on it for as long as it takes for a replacement to take effect.
That would be a catastrophic mistake. Republicans must listen to Paul, members of the Freedom Caucus, and others, and replace Obamacare at the same time they repeal it. It keeps their promise, will make the transition smoother, and is feasible.
Since the start of his campaign, President-elect Donald Trump railed against “all talk, no action” politicians, but repealing Obamacare while punting on its replacement would be just that. Repeal without replacement achieves the talking point but doesn’t actually solve the problem of healthcare that is unaffordable for too many - it just accelerates Obamacare’s costly collapse.
Republicans have several months to craft legislation because Americans are already locked into 2017 healthcare insurance, giving them time to craft a replacement for 2018.
Repealing without replacing would only make sense if you lack a plan. This has been a Democratic talking point for years, and just this week Senate Minority Leader Chuck Schumer said Republicans “don't know what to do" - a logical attack line that paints Republicans as dogs who caught the car.
But Republicans shouldn’t fall prey to this talking point because it is a lie. Tom Price, Trump’s pick to head the Department of Health and Human Services, first proposed an Obamacare alternative on July 30, 2009 and has been reintroducing the legislation in subsequent congresses. Speaker Ryan’s “A Better Way” policy path offers a detailed layout of GOP healthcare policy.
Republicans already have a blueprint for a healthcare alternative that gives consumers choice by allowing competition across state lines, comprehensive plans, a cheap alternative for the young and healthy, and allowing small businesses or individuals pool together to reduce premiums while providing tax credits for the working and middle class.
Similarly, conservative thinking has been clear on pursuing tort reform to bring down malpractice costs and to reduce defensive medicine that unnecessarily strains the system’s capacity, thereby raising prices on all while moving towards outcome-based pricing to align the interests of consumers, insurers, and providers.
Rather than a one-size fits all approach, we give states, the laboratories of our republic, flexibility to craft their own high-risk and Medicaid solutions with federal block grants. Republicans do have detailed healthcare policy plans and have been offering them for years. Building off these plans, there is no reason a replacement can’t be passed before the August recess, making repeal and replacement an unnecessary political liability.
It is critical Republicans get the hand-off to a patient-choice focused healthcare solution right to ensure its permanence. Already, Democrats are crowing how “disruptive” the repeal will be. Of course, Obamacare itself was extremely disruptive to the healthcare sector, and Democrats didn’t seem dismayed by disruptiveness then. By definition, replacing a sweeping, disruptive law is disruptive - that is why having the replacement in hand is critical to make the transition smooth.
Getting the transition and replacement rate is more than just politics; it is about bettering people’s lives.
The Affordable Care Act just isn’t working. It was supposed to control costs, yet according to the November Consumer Price Index report, health insurance premiums are up 6% year over year while hourly wages are rising less than 3%. Based on announced premium increases on the Obamacare exchanges, that number will likely rise further in 2017.
The law has done a poor job of controlling other costs, with prescription drug prices also rising 6%. Costs are rising faster than wages, squeezing an already strained middle class. 16 of 23 Obamacare co-ops have failed, and fourteen state exchanges are down to 2 or fewer insurers, eliminating competition and raising prices.
Delaying new policies after repealing Obamacare risks faster premium growth, more insurer failures, and even less competition.
It is no wonder Obama urged Democrats to make Republicans own healthcare, suggesting they dub it “Trumpcare,” but Republicans should be elated to own healthcare. As Democrats have learned, owning policies that fail is very costly, having lost over 1,000 seats at the state and federal level in the Obama era. It is no wonder then Obama wants Democrats to pass the hot potato to Republicans on this issue.
But when a party owns an issue that gets better, they enjoy electoral reward. “Reaganomics” proved an asset as the economy roared in the 1980s, generating landslide victories in 1984 and 1988. Republicans should want to fully own the results of patient-centered, free-market healthcare because it will generate better results for the public and eventually pay political dividends.
This is a defining moment for Republicans. They have the power to execute on their top promise, extricate government from our lives to make healthcare more affordable, and take ownership of a major success story. Now is not the time to shy away. It is time to embrace plans that have been methodically developed for seven years.
Repealing and replacing Obamacare together this year is the best way for Republicans to keep their word and have a smooth transition to a functioning healthcare sector. President-elect Trump should urge Republican leadership to back away from the potentially chaotic, drawn-out “repeal and delay” strategy.
We believe we have better ideas, and the American people agree. Let’s implement them, not delay them.