Don’t Repeal Obamacare Without Replacement Plan, Conservative Scholar Implores


If Republicans repeal key elements of Obamacare without enacting a replacement plan, the health insurance exchanges may fall apart before they get a chance to legislate new reforms.

That’s the assessment of conservative scholar James Capretta, who works for the free-market oriented American Enterprise Institute. Capretta spoke at a recent AEI briefing on priorities for President-elect Donald Trump and Republicans who will run the White House and Congress in 2017.

Republicans have pledged they will repeal and replace the Affordable Care Act since it was signed into law by President Barack Obama in 2010. But they would probably need a 60-vote majority under Senate rules to enact replacement measures proposed by some Republicans, such as House Speaker Paul Ryan (R-Wis.).

Senate Republicans are likely to have a 52-48 majority in 2017, which means they will only be able to pass legislation that has a budget impact. They are expected to move forward with legislation similar to what the House and Senate passed in 2015 that would have repealed key elements of the ACA had it not been vetoed by Obama.

The bill would have rolled back subsidies received by low- and moderate-income people to buy health insurance through the ACA exchanges, repealed the law’s Medicaid expansion as well as the individual and employer mandates to buy or provide health insurance, and it would have repealed taxes imposed under the ACA.

But while Republicans are likely to delay implementation of a repeal law by a couple of years, health insurers may drop out of the ACA health insurance exchanges, which are already financially unstable, Capretta said.

Some 20 million people have gained coverage under the ACA, and it’s far from certain that there would be agreement on a replacement two years down the line, Capretta argued. Republicans need to get some Democratic support to move forward with a replacement plan, he said.

“That’s not going to be free of any political controversy,” he said. “Some people might lose their seats because they vote for it. That’s just the way it is.”

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