Count U.S. Sen. Rob Portman among the Republicans in Congress for slowing the pace of repealing and replacing the Affordable Care Act. The Ohio Republican joined those arguing more responsibly that the repeal should not go forward without a clear idea about what would come in its place.
For now, Republican leaders, including President-elect Trump, lack even a framework, unless they are prepared to advance the Empowering Patients First Act, the work of U.S. Rep. Tom Price, the president-elect’s choice to lead the Department of Health and Human Services. Yet Price awaits confirmation, not to mention enough support to form around his plan, which would shrink benefits.
Unfortunately, the president-elect and Republican congressional leaders are in a hurry. Not long after Portman and others advised delay, Trump talked about repeal with replacement coming quickly, even “simultaneously.”
The president-elect contends speed is necessary because “Obamacare has been a catastrophic event.” Actually, flaws and all, the changes to the health care system have beneficial. Hard to see as ruinous an additional 930,000 Ohioans with health coverage, and 20 million people nationwide. Americans now have protection from such things as discrimination for preexisting illnesses and lifetime limits on coverage.
Hospitals face less financial strain from uncompensated care, and young people up to age 26 can remain on their parents’ coverage.
More than 230,000 Ohioans have purchased coverage for this year through the federal exchange.
One House Republican leader told reporters this week: “No one who has coverage because of Obamacare today will lose that coverage. We’re providing relief.” For instance, Republicans cite unreasonably high deductibles. Yet they have yet to provide a realistic path to easing such costs, not when they want to end the individual mandate and reduce subsidies, both of which help to make coverage more affordable.
On Wednesday, U.S. Sen. Sherrod Brown highlighted how a repeal would harm the effort to fight the opioid epidemic in Ohio and elsewhere — as much as $5.5 billion a year at risk. The Ohio Democrat noted that separate legislation enacted last year by Congress provides by comparison $1.1 billion for the next two years to address the epidemic.
Policy Matters Ohio issued an analysis showing that repeal in 2019 would see 964,000 Ohioans lose their health coverage. More, the state would face a loss of $3.5 billion in federal funding, and households would see $535 million less. Uncompensated care at hospitals would increase $15 billion.
These and other figures provide a reminder of the high stakes, and the deeper problems before the Affordable Care Act, which built on the complexities of the current system, as part of limiting the disruption. No surprise the act requires repairs, starting with more generous subsidies, less cumbersome regulations and improved incentives for healthy people to buy in the exchange. Such steps could be achieved through Democrats and Republicans working together.
The president-elect even appears to back something Sherrod Brown embraces — the federal government finally using more of its clout to negotiate better drug prices for Medicare.
What would be careless is the Trump White House and Republican allies acting too swiftly, jeopardizing advances in the quality of many lives. In his press conference this week, the president-elect again promised something better and cheaper, “terrific,” as he likes to put it. Let’s see it, before launching any type of repeal.