Before repealing the Affordable Care Act, known as Obamacare, lawmakers need to either present the American people with a plan to replace it, which could then be publicly debated, or simply make the case that no replacement is necessary.
On Thursday, Utah’s senior Sen. Orrin Hatch said that “we should repeal Obamacare — including the taxes — and provide for a stable transition period.”
He continued, “I believe that the work to replace Obamacare should also begin immediately."
While this may initially seem like a sensible middle path, it still fails to provide voters or insurance providers with proper clarity and vision about the future of American health care.
Since the Affordable Care Act was passed in 2009, congressional Republicans have taken 54 different votes to try to cripple, defund, delay or repeal it. Each of these votes was little more than an exercise in futility, as President Obama was unwilling to destroy his signature piece of legislation.
Prior to this year, such votes had nothing but political upside. Policymakers could rail against the ACA with all the rhetorical fury they could muster, safe in the knowledge that nothing they were saying would have any real-world impact.
For Utah’s delegation, fiery speeches played well in the Beehive State where the ACA has been largely unpopular since its passage. But things are decidedly different now. The nation has a new president who made the repeal of Obamacare a top priority, and the mantra of “repeal and replace” was a very catchy campaign slogan that contributed to Donald Trump’s victory last November.
The problem with “repeal and replace,” however, is that “repeal” is now looking far easier than “replace.” But a repeal of the ACA without a replacement may turn out to be less popular than initially thought as Americans have grown accustomed to many aspects of the law.
We are not endorsing Obamacare, which has proven to be expensive, inefficient, and increasingly unsustainable. At the same time, it was passed because the health care status quo was also expensive, inefficient and unsustainable. Returning to the mess that preceded passage of the ACA is unlikely to be an appealing alternative for most Americans, regardless of ideological inclination.
While Obamacare as a whole has been largely unpopular, today some of its specific provisions are not. And few lawmakers seem inclined to return to a system where insurance companies can exclude people because of pre-existing conditions, for example.
President Trump has offered repeated assurances that his replacement plan will keep all the good things about Obamacare that everyone likes, while at the same time eliminating all of the things that they don’t like. Unfortunately, Trump has been notoriously fuzzy on the details, which suggests that this may be wishful thinking more than anything else.
That’s unacceptable. Americans deserve a civil dialogue on the best path forward for health care before Obamacare is repealed. Indeed, no law repealing the ACA should be voted before the American people are able to thoroughly debate alternative plans or at least come to terms that repealing the ACA is a wise move even without a viable replacement.
In the end, “repeal and replace” minus the “replace” could end up causing more confusion and consternation than Obamacare. Before repealing, the nation would do well to debate what “replace” really looks like.