Ever since the Affordable Care Act — colloquially known as “Obamacare” — was signed into law in March 2010, the primary goal of congressional Republicans has been to repeal the law and replace it with a market-based solution that they say works for all Americans.
For years, Republicans were only able to pass repeal measures in the GOP-controlled House of Representatives, only to be struck down in the Senate, which until 2014 was controlled by a Democratic majority. After Republicans regained majority control in the Senate, any bill repealing Obamacare that made its way to President Barack Obama’s desk was killed with a veto.
But today, Republicans boast a majority in the Senate, as well as a large majority in the House and will have a Republican once again at 1600 Pennsylvania Ave. beginning Friday at noon.
It's the day that Republicans and tens of millions of Americans have been looking forward to for the last seven years — and now GOP voters say it’s time for Republicans to make good on their promise to repeal and replace Obamacare.
But what does that mean? What will the process look like? And what exactly will Republicans replace Obamacare with?
Health care policy expert Sally Pipes, told TheBlaze that if President-elect Donald Trump and congressional Republicans want to make good on their promises then they need to repeal and replace Obamacare as quickly as possible — or face “disastrous” consequences.
Pipes is president and CEO of the Pacific Research Institute, a think tank advocating the free market and limited government, and worked closely with Rep. Tom Price (R-Ga.), Trump’s nominee for secretary of health and human services.
"Delaying Obamacare's repeal and replacement would be disastrous," she said. "If the delay is two to three years, it is likely that Obamacare will never be replaced."
Pipes explained: "A years-long replacement process would also only accelerate the death spiral of Obamacare's exchanges while frustrating consumers with high priced premiums, high deductibles, small networks of doctors and hospitals, and fewer insurance companies offering exchange plans.”
Vice President-elect Mike Pence told the Wall Street Journal last week that he and Trump expect to have a very busy and ambitious first 100 days in office. And that will include a full repeal and replacement of Obamacare, Pence promised.
In recent weeks, there has been some disagreement between Republicans on Capitol Hill about how to replace the ailing law. Some argued that the law should be repealed first and then a replacement passed later. However, an increasingly large group of lawmakers, led by Kentucky Sen. Rand Paul, say that Obamacare must be replaced almost as quickly as it’s repealed unless Republicans want to be culpable for the law’s failures.
Kentucky Republican Sen. Rand Paul (Alex Wong/Getty Images)
Pipes told TheBlaze that Paul has a point: "The GOP should repeal and replace, not delay. If not simultaneously, the replacement plan should at least take effect a few days after repealing Obamacare through the budget reconciliation."
Republicans argue that Obamacare, between its skyrocketing premiums and lack of consumer options, has been a nightmare for the average American and much different than what Obama promised in 2009. According to Pipes, though, if Republican lawmakers follow through with all of the promises they’ve made on health care, Americans again will have confidence in their health insurance and the health-care market as they search for the insurance plan that best suits the needs of their families.
"The Republican replacement plan would transfer power from the federal government to the consumer," she said. "Instead of forcing people to sign up for health insurance and burdening insurers with costly mandates, it uses the power of the free market and healthy competition to encourage consumers to sign up for health insurance that they want and can afford. Insurers will offer a variety of plans for different needs and price points, stimulating the market and stabilizing costs for everyone.”
The goal of a market-based health insurance solution, Pipes told TheBlaze, is for Americans to shop for insurance across state lines, which is currently prohibited by federal law. This would allow insurance companies expand their consumer bases from coast to coast.
"The replacement plan should get rid of restrictions on the interstate sale of health insurance," she said. "Individuals who live in high-cost states would be able to buy coverage from lower-cost states, encouraging healthy competition among insurers across the nation. This is also advantageous for insurers — a national market would allow companies to expand their consumer base."
By opening up the market and allowing Americans to choose the plan that best fits their needs, Pipes said that a domino effect of sorts will happen, which will begin to drive down the costs of health care and “stabilize” the market.
"By eliminating Obamacare's 'essential health benefits,' insurers can offer cheaper plans with basic coverage to healthy Americans. Many of them, who opted out of health insurance because of Obamacare's skyrocketing premiums, would now be able to afford a plan that makes sense for them,” she explained. "This influx of healthy enrollees would balance out the costs of sicker enrollees, stabilizing health insurance costs for everyone."
And while Pipes said that the GOP is on the right track with their ideas, there is at least one place where she disagrees strongly with Trump on health-care reform.
Trump said in an interview over the weekend that he wants the government to directly negotiate drug prices with pharmaceutical companies to reduce costs for Americans. But Pipes argues that government intervention is not the solution to rising costs, and having the government negotiate with private companies like Trump described would be “disastrous” for the health care market.
"Allowing the government to negotiate drug prices with drug companies would be disastrous for medical innovation and jobs in this sector. A buyer the size of the federal government doesn’t negotiate prices, it dictates them,” Pipes explained. "Trump has previously claimed he could save $300 billion — more than the entire nation spends on drugs annually, which is simply not feasible."
In the end, Pipes told TheBlaze that with the GOP’s likely replacement plan, there are at least four tangible benefits the average American family will see: Lower premiums and deductibles, direct tax credits versus indirect subsides, more options to find a plan that best suits an individual's needs and Health Savings Accounts.
Still, Pipes stressed that for Republicans, the time to act is now.
“We need to start the reform right away. Too many Americans have lost their health insurance coverage because of the skyrocketing costs of premiums and deductibles,” Pipes said. "Insurers have already lost billions of dollars on the exchanges and in many instances, have pulled out."
"However, with the right policy moves going forward, we can rebuild America's healthcare market and make America great,” she said.