Ryan’s ‘repeal and delay’ plan for Obamacare

House Speaker Paul Ryan seems to be feeling the heat from members of Congress and the press.

House Speaker Paul Ryan, R-Wis., seems to be feeling the heat from members of Congress, the press and outside groups (such as hospitals) who object to pulling the plug on Obamacare and not telling Americans, health-care providers and insurance companies what comes next.

In an obviously defensive email blast, Ryan’s office asserts:

Obamacare is hurting families, and before things get worse, we will act to repeal it so that we can bring relief as soon as possible.

Once Obamacare is repealed, we will make sure there is a stable transition period so that people don’t have the rug pulled out from under them. One key to ensuring a smooth transition is getting House Budget Committee Chairman Tom Price, M.D., R-Ga., confirmed as Secretary of Health and Human Services. Working together, we will focus on delivering relief and a better system for people struggling under Obamacare.

The rest of the email goes on to describe the wonders of Ryan’s replacement plan set out in his “Better Way” policy initiative. (“Well, last spring, as part of the Better Way agenda, House Republicans offered a unified health care plan to show the American people what we would do differently. It included a number of common-sense ideas and principles.”)

Ryan’s office has just made the case against repeal and delay.

If you have a terrific plan and Obamacare is hurting people (hurting them so much that they won’t mind losing it without knowing what they will get instead), then repeal and replace it now. Moreover, Republicans are whistling through the graveyard if they think President-elect Donald Trump will go along with this once the letters come pouring in detailing the hardship and uncertainty Trump’s working-class voters are experiencing as Ryan promises to repeal what they have but won’t tell them what they’ll get.

We know Trump lacks ideological coherence; that makes him particularly susceptible to individual horror stories and complaints from his fans that those mean Republicans (whom Trump vilified in the campaign) are mistreating them — again.

The GOP charade will become unsustainable at some point. You either have something better than Obamacare that you can pass, or you don’t. If not, why go through the phony and destabilizing “repeal Obamacare” exercise?

We have already seen health care providers warn the administration: Hospitals and physicians are having a hard time grasping how the Affordable Care Act can be repealed by the Trump administration without a plan to replace or continue coverage for the nearly 20 million Americans who are now insured on the exchanges or through Medicaid expansion in 31 states and the District of Columbia.

“It’s our hope that, with the election behind us, our newly elected leaders in Washington will come together to ensure 100 percent access and 100 percent affordable coverage for every American,” said Ascension CEO Anthony Tersigni.

St. Louis-based Ascension is the nation’s largest not-for-profit hospital system with about $20.5 billion in revenue.

Donald Trump’s election has thrown the entire industry into “uncertainty,” said Robert Annas, senior managing director of Solic Capital, a private equity company that owns a hospitalist staffing unit and a telemedicine business.

Rather than send out specious emails to get through the news cycle, Ryan should be straight with his members.

Is he expecting them to face the voters in 2018 with no replacement plan passed? If so, this is political suicide.

And he should answer the real concern of patients, doctors and hospitals: Why not pass what you think is better than Obamacare at the same time you repeal it? It is unreasonable to expect insurance companies, medical providers and ordinary Americans to operate on the hope and the prayer that there will be something better, cheaper and more sustainable — sometime in the future.