Don't Repeal Obamacare Without a Workable Replacement

President-elect Donald Trump and House and Senate Republicans are on a bullet train toward repealing the Obama administration's centerpiece health care legislative accomplishment but are far from a quick consensus on what will replace it. Senate Republicans this week cleared the way for new legislation with a series of votes that will make it tougher for Democrats to block repeal-and-replace efforts. But even those on the inside aren't clear what repealing and replacing the Affordable Care Act really means. Will the actions occur simultaneously? When? Or will repeal take place soon but implementation be delayed for months or even years? And most of all, what will change mean for the American health care system? As a newspaper that recognizes both the strengths and weaknesses of the ACA, we stand behind the principle that any attempted fix must protect key benefits and reduce overall costs without reducing access. People with pre-existing conditions, for example, must not be excluded from affordable coverage. Adult children should be allowed to stay on family plans until age 26. And GOP lawmakers who want to eliminate the mandate that Americans buy insurance must recognize that this a linchpin of a comprehensive health care. It ensures a large enough pool of healthy people to keep overall prices manageable. And it decreases the effects of uncompensated care on the system. Unless they can find a suitable option, the mandate can't be jettisoned without also jettisoning millions of Americans from insurance coverage, and that is unacceptable.There is also a risk for hospitals, which are legally required to treat patients whether they are insured or not. Uncertainty about what might come next also would send doctors, hospitals, insurers and patients into chaos. The Kaiser Family Foundation estimates that about 52 million Americans have medical conditions that could deny them insurance coverage without the current health care law's protection.The GOP must not rush to repeal a law that has, overall, improved our health care system without a without a replacement that meets these basic standards. Right now, there are bits and pieces of policy changes floating through GOP circles but nothing concrete that would satisfy our concerns or the concerns of patients and insurers.It was easier to shout "repeal Obamacare" as a political slogan when House Republicans could count on Senate Democrats and President Obama stopping the legislation. Now Trump and Congress own health care reform; it is their responsibility not to undermine the parts that work in a rush to fulfill a campaign promise. The way to fix the Affordable Care Act is not to reject it outright, but to focus on ways to better spread the risk. Among other things, that means attracting more healthy Americans, finding ways to address escalating drug costs, and not balancing the costs on the backs of vulnerable Americans. Trump and other Republican leaders should follow the basic health care oath: First, do no harm. In their words"We are going to be submitting, as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan. It will be 'repeal and replace.' It will be, essentially, simultaneously. It will be various segments, you understand, but will most likely be on the same day or the same week, but probably the same day, could be the same hour."President-elect Donald Trump "We simply must have a replacement and not a repeal. Yes, they should be done about the same time. But I don't see a comprehensive [health care] reform bill before the end of this month. That's not feasible." Sen. Susan Collins, R-Maine   Continue reading...

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