GOP risks chaos

Maryland Independent - - Community Forum -

Repub­li­cans are gear­ing up to re­peal Oba­macare — what House Speaker Paul Ryan calls “the first or­der of busi­ness” for the new Congress and the Trump ad­min­is­tra­tion.

House and Se­nate com­mit­tees will be un­der in­tense dead­line pres­sure to write leg­is­la­tion be­fore the end of the month that would un­der­cut ma­jor pil­lars of Oba­macare as part of a bud­get bill. Yes, the GOP is in a hurry to rid the na­tion of Oba­macare.

But re­mem­ber the sec­ond half of the Repub­li­can mantra — “re­place.” Where is the de­tailed GOP plan to help mil­lions of Amer­i­cans who have cov­er­age now un­der Oba­macare? Where is the plan that is locked and loaded for leg­isla­tive pas­sage, the one a Pres­i­dent Trump will sign? Where is the pro­posal that dis­cour­ages in­sur­ers from bolt­ing the in­di­vid­ual mar­ket, leav­ing more peo­ple un­able to find af­ford­able health cov­er­age? Nowhere in sight. Sure, Ryan said re­cently that law­mak­ers would ad­vance leg­is­la­tion to re­place Oba­macare this year. And yes, there are reams of pro­pos­als and blue­prints. One of them, part of Ryan’s “A Bet­ter Way” agenda, is im­pres­sive. For­mer Rep. Tom Price, nom­i­nated to be Health and Hu­man Ser­vices sec­re­tary, has an “Em­pow­er­ing Pa­tients First” plan. The House Repub­li­can Study Com­mit­tee re­cently un­veiled an­other Oba­macare al­ter­na­tive.

There are good ideas in these pro­pos­als to make in­sur­ance more af­ford­able and ex­pand ac­cess for Amer­i­cans. But so far Repub­li­cans haven’t co­a­lesced around a com­pre­hen­sive plan, nor per­suaded any Democrats to join them in what should be a bi­par­ti­san ef­fort.

But Repub­li­cans in a rush to jet­ti­son the law with­out first spell­ing out a su­pe­rior al­ter­na­tive in­vite mar­ket chaos — and a po­lit­i­cal back­lash.

If mil­lions of Amer­i­cans lose cov­er­age, whether by GOP in­ac­tion or ac­tion, guess who takes the blame? That’s why Vice Pres­i­dent Mike Pence says an Oba­macare re­place­ment must be done “in a way that doesn’t work a hard­ship on Amer­i­can fam­i­lies who have gained in­sur­ance through this pro­gram (and) doesn’t work a hard­ship on our econ­omy.”

About the econ­omy: The non­par­ti­san Com­mit­tee for a Re­spon­si­ble Fed­eral Bud­get warns that re­peal­ing Oba­macare could cost up to $350 bil­lion through 2027. That’s not chump change. All the more rea­son to care­fully cre­ate a more flex­i­ble and fru­gal plan that de­liv­ers bet­ter cov­er­age be­fore scut­tling the old law.

Congress is likely to de­lay the ul­ti­mate elim­i­na­tion of Oba­macare for at least a cou­ple of years. But in­sur­ers work months ahead to craft plans and set prices. Pa­tients with com­plex con­di­tions need cer­tainty about their cov­er­age. Oba­macare has deep ten­ta­cles in many states’ laws as well.

Con­gres­sional Repub­li­cans can’t shrug and say to Amer­i­cans, just wait, give us a few years, we’ll have a great new plan. These law­mak­ers have had years to hone a re­place­ment that can muster White House and con­gres­sional sup­port. If they can’t agree now, why would any­one be­lieve they’ll agree a year or two from now?

The longer Repub­li­cans de­bate, the greater the chances that Oba­macare hob­bles along. Any­one re­mem­ber how the “doc fix” — a fed­er­ally im­posed cut in doc­tors’ Medi­care fees — kept get­ting post­poned year af­ter year be­cause Congress couldn’t reach a res­o­lu­tion? The same could hap­pen with Oba­macare.

Demo­cratic lead­ers rammed Oba­macare through Congress with­out a sin­gle Repub­li­can vote. ThenHouse Speaker Nancy Pelosi fa­mously (and fool­ishly) told mem­bers they’d have to vote for the bill be­fore they could learn what was in it. That’s called hubris.

Repub­li­cans can learn from that de­ba­cle or re­peat it. The GOP can cre­ate a bi­par­ti­san health care bill that im­proves on Oba­macare’s key re­forms and prom­ises. It can give pa­tients, doc­tors, in­sur­ers and yes, law­mak­ers, time to eval­u­ate it.

Mil­lions of Amer­i­cans have cov­er­age now that they won’t — and shouldn’t — gladly sur­ren­der. Repub­li­cans, you promised some­thing bet­ter, more af­ford­able.

Now de­liver.

This ed­i­to­rial orig­i­nally ap­peared in the Chicago Tribune on Jan. 9.

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