With a Trump administration at the helm, Republicans may be inclined to jump in headfirst and repeal the Affordable Care Act. After all, the simple majority in the Senate allows for repeal through the reconciliation process, without the need for Democrat support. This would be a mistake for a number of reasons.
“Republicans now have an opportunity to make their mark once again on social policy.”
For starters, the Republican majority in congress will resemble what it was during the last major bipartisan health care reform in 2003, which gave Medicare beneficiaries prescription drug coverage. This coverage, as opposed to the Affordable Care Act, has been widely popular and successful. This alone should be a lesson for reformers on the advantages of bipartisanship.
Moreover, repealing the law will be seen as a purely partisan move, and will throw millions off of their insurance plans – not only in blue states, but in red states like Ohio that have expanded their Medicaid programs. Not only would millions lose coverage, but it would be a waste of political capital. Most conservative "replace" plans will have elements resembling those of the current law: some combination of tax credits to purchase insurance and some basic "rules of the road" for how insurance gets sold to consumers. Wholesale repeal is entirely unnecessary.
Instead, reformers should focus on making smart changes to the law, while expanding opportunities for states to go their own way experimenting in the great "laboratories of democracy." As it turns out, the Affordable Care Act already has built-in escape hatches – so-called "state innovation waivers" – designed precisely to foster these experiments. Innovation waivers permit states to waive various regulations including the individual mandate and subsidy structures.
Unfortunately, guidance issued last year makes implementing these waivers much more onerous and less attractive to states, as the Government Accountability Office recently noted. Fortunately, there are "day one" changes that the Trump administration could make...
Read the entire piece here at U.S. News & World Report
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Yevgeniy Feyman is an adjunct fellow at the Manhattan Institute and a senior research assistant at the Department of Health Policy and Management at the Harvard School of Public Health. Previously, he was MI's deputy director of health policy. Follow him on Twitter here.
This piece originally appeared in U.S. News and World Report