Don't Repeal Obamacare
Secretary Tom Price:
Congratulations on your confirmation and the honor of serving the American people as head of the Health and Human Services Department. The decision over what to do about the Affordable Care Act is coming at you fast. Millions of Americans are waiting to understand if their health coverage and protections will continue, while insurance companies need to know whether the Obama-era health care law's major market reforms, like requiring coverage of people with pre-existing conditions and subsidizing health insurance for moderate-income families, will continue.
It's important for all Americans to know that you will step back from the rhetoric of campaign season and look at what is working, what isn't and how people's lives have been impacted since the law has taken effect. Today, more than 20 million Americans have coverage thanks to Medicaid expansion, the health insurance marketplace and other provisions of the Affordable Care Act. Over 100 million more Americans with pre-existing conditions also depend on the protections of the law. Americans overwhelmingly say they don't want to go back to a time when health plans could play "gotcha" with denials, lifetime caps and exclusions.
There should be no pride of authorship in making changes to the Affordable Care Act that improve coverage, quality and affordability. But Americans reject the notion that the health care law can be repealed without an immediate replacement. Governors of both parties, care providers, actuaries and increasingly congressmen and senators in your own party seem to agree. So how do you step back from this course that we're on?
First, the most important thing you can do to is promise right now that you will not repeal the Affordable Care Act without a comprehensive bipartisan replacement that maintains or improves on its gains in access, quality and affordability as measured by nonpartisan observers like the Congressional Budget Office. Even if you don't love everything about the health care law, the gamble you would take by repealing it – and in parallel – defunding it, would imperil the gains made with the risk that at a later date you wouldn't find the money and the votes for a new plan. That's too big a gamble with the coverage of 30 million people and the health and security of tens of millions more.
Second, having taken repeal off the table, you should shift your focus to improving the health care system, measuring changes by how much they strengthen access, affordability and quality, rather than by whether they overhaul or align with the Affordable Care Act. That shift will make it possible to start identifying common ground – like reducing the cost of care and increasing competition. I would also recommend launching a bipartisan process to identify incremental changes that will improve the health care law and our health care system.
This will not only be good for the country, but useful for you. I can tell you from experience, having one party "own" everything that happens in the health care system wasn't good for the Democrats, and it won't be good for Republicans. With Medicare, because Republicans and Democrats feel a joint sense of ownership, I had the ability to talk to Republican congressmen about what was working and not working and make improvements. Consumers, hospitals and physicians need to know that, when challenges arise, both sides will work together, not devolve into finger-pointing.Third, you must clarify that, until there are bipartisan changes passed, you will enforce the law – whether by enforcing the individual coverage mandate or continuing to inform consumers about the coverage and financial assistance available to them. After one-time rate increases for 2017, the health insurance marketplaces are stable and poised to become more competitive – as judged by tough analysts like Standard & Poor's, as well as the insurers themselves. But markets require consistency and clarity. Uncertainty generated by the president's executive order, as well as by discussions of repealing the Affordable Care Act without a comprehensive replacement, has left companies at a loss as to how to set rates, which are due in a matter of months. Now is the moment to confirm the rules of the road for 2018 and demonstrate your commitment to a stable, growing market.
The president and some Republicans leaders have promised that under their plans for health reform, no American will lose coverage, the process won't pull the rug out from under people and care will be more affordable and better. These are important promises and you will need everybody – Democrats and Republicans and an engaged private sector – to help you get there. The only way for that to happen is to step back from repeal and focus on the incremental improvements that will make the health care system work better for more Americans.
Congratulations on your confirmation and the honor of serving the American people as head of the Health and Human Services Department. The decision over what to do about the Affordable Care Act is coming at you fast. Millions of Americans are waiting to understand if their health coverage and protections will continue, while insurance companies need to know whether the Obama-era health care law's major market reforms, like requiring coverage of people with pre-existing conditions and subsidizing health insurance for moderate-income families, will continue.
It's important for all Americans to know that you will step back from the rhetoric of campaign season and look at what is working, what isn't and how people's lives have been impacted since the law has taken effect. Today, more than 20 million Americans have coverage thanks to Medicaid expansion, the health insurance marketplace and other provisions of the Affordable Care Act. Over 100 million more Americans with pre-existing conditions also depend on the protections of the law. Americans overwhelmingly say they don't want to go back to a time when health plans could play "gotcha" with denials, lifetime caps and exclusions.
There should be no pride of authorship in making changes to the Affordable Care Act that improve coverage, quality and affordability. But Americans reject the notion that the health care law can be repealed without an immediate replacement. Governors of both parties, care providers, actuaries and increasingly congressmen and senators in your own party seem to agree. So how do you step back from this course that we're on?
First, the most important thing you can do to is promise right now that you will not repeal the Affordable Care Act without a comprehensive bipartisan replacement that maintains or improves on its gains in access, quality and affordability as measured by nonpartisan observers like the Congressional Budget Office. Even if you don't love everything about the health care law, the gamble you would take by repealing it – and in parallel – defunding it, would imperil the gains made with the risk that at a later date you wouldn't find the money and the votes for a new plan. That's too big a gamble with the coverage of 30 million people and the health and security of tens of millions more.
Second, having taken repeal off the table, you should shift your focus to improving the health care system, measuring changes by how much they strengthen access, affordability and quality, rather than by whether they overhaul or align with the Affordable Care Act. That shift will make it possible to start identifying common ground – like reducing the cost of care and increasing competition. I would also recommend launching a bipartisan process to identify incremental changes that will improve the health care law and our health care system.
This will not only be good for the country, but useful for you. I can tell you from experience, having one party "own" everything that happens in the health care system wasn't good for the Democrats, and it won't be good for Republicans. With Medicare, because Republicans and Democrats feel a joint sense of ownership, I had the ability to talk to Republican congressmen about what was working and not working and make improvements. Consumers, hospitals and physicians need to know that, when challenges arise, both sides will work together, not devolve into finger-pointing.Third, you must clarify that, until there are bipartisan changes passed, you will enforce the law – whether by enforcing the individual coverage mandate or continuing to inform consumers about the coverage and financial assistance available to them. After one-time rate increases for 2017, the health insurance marketplaces are stable and poised to become more competitive – as judged by tough analysts like Standard & Poor's, as well as the insurers themselves. But markets require consistency and clarity. Uncertainty generated by the president's executive order, as well as by discussions of repealing the Affordable Care Act without a comprehensive replacement, has left companies at a loss as to how to set rates, which are due in a matter of months. Now is the moment to confirm the rules of the road for 2018 and demonstrate your commitment to a stable, growing market.
The president and some Republicans leaders have promised that under their plans for health reform, no American will lose coverage, the process won't pull the rug out from under people and care will be more affordable and better. These are important promises and you will need everybody – Democrats and Republicans and an engaged private sector – to help you get there. The only way for that to happen is to step back from repeal and focus on the incremental improvements that will make the health care system work better for more Americans.
