Since President Obama first signed the Affordable Care Act into law, Republicans have been itching to dismantle it. And come January 20 — the day Trump takes the oath of office and Republicans have a majority in the House and the Senate — they will actually have the capacity to do so.
In other to expedite the process, Senate Republicans have one strategy in mind: repeal and delay. They want to repeal Obamacare quickly and give themselves a two to three year grace period to create an alternative policy.
But experts caution that repealing the ACA without having another plan in its place is dangerous. On January 3, in a piece for Health Affairs, Joe Antos and James Capretta of the right-leaning American Enterprise Institute warned that this strategy would leave many people without insurance.
“The most likely end result of ‘repeal and delay’ would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services,” they wrote.
Some Senate Republicans agree. Sen. Rand Paul (R-KY) told MSNBC that “it’s a huge mistake for Republicans if they do not vote for replacement on the same day we vote for repeal.” And he’s not alone. Sen. John McCain (R-AZ), Sen, Bob Corker (R-TN), and Sen. Tom Cotton (R-AR) have also cautioned against this strategy.
Transcript:
VICTORIA FLEISCHER, ThinkProgress: Since the day it was signed into law, Obamacare has been on the defense. And in a Trump administration, it could actually be left in tatters. Only the Republicans don’t exactly have a health care plan to enact in its place.
Their strategy: repeal and delay. They want to repeal Obamacare as quickly as possible, while giving themselves a two to three year grace period to come up with an alternative plan.
In order to expedite the vote, House Republicans are taking advantage of the budget process, which eliminates the Democrats ability to filibuster.
So what does that mean for health care?
The GOP plans are scarce on information, but there are two major issues with the Republican approach.
1) Fewer people will buy insurance.
Obamacare created the individual mandate, which requires everyone — healthy and sick — to buy insurance. Remember: healthy people balance out costs and keep premiums low. Republicans want to abolish the mandate. That means healthy people are less likely to buy coverage and sick people would get stuck with higher and higher premiums.
2) Fewer insurance companies will offer plans.
Insurance companies have adjusted their plans to Obamacare, but without a replacement, they don’t know how to prepare for the future. This uncertainty would likely lead companies to pull out of Obamacare’s state-level marketplaces. With fewer companies in the marketplace, premiums will rise.
And so begins the spiral: competition decreases, premiums rise, more healthy people leave, and on and on and on…until the whole system collapses.
Repeal and delay isn’t final yet, and there are some Republicans who don’t want it to be. But in the meantime, at least 20 million people’s access to health care hangs in the balance.