President Obama on Friday openly dared Republicans to craft a better health care plan than his signature overhaul, saying he will concede the mantle of reform if they can cover as many people, keep costs down and produce a stable marketplace.
“I will publicly support repealing Obamacare and replacing it with your plan. But I want to see it first,” Mr. Obama told the Vox media outlet in a live White House interview two weeks before he leaves office.
Mr. Obama’s offer targeted congressional GOP leaders and President-elect Donald Trump, who’ve vowed to repeal the Affordable Care Act and then devise legislation that unleashes market forces to entice people into any health plan they want, rather than forcing Americans to buy comprehensive insurance or pay a tax.
The departing president said Republicans can call it whatever they like, be it “TrumpCare” or “McConnellCare” or “RyanCare,” but they should put their final plan on paper.
“If it works, I’m for it,” Mr. Obama said.
Republicans are moving rapidly to set up their Obamacare repeal by debating a budget resolution that would pave the way for a final vote later this year without having to overcome a Democratic filibuster. The GOP has prevailed in two early test votes already.
Yet Capitol Hill Republicans haven’t said how long it will take to forge their replacement plan, as they wait for the Trump administration to get rolling.
Mr. Obama said the repeal-and-delay strategy “is, simply put, irresponsible,” and will put millions at risk.
“Ultimately this is not a political game. This is really something that affects people in the most personal ways,” Mr. Obama said
In an opinion piece for the New England Journal of Medicine, Mr. Obama said there is no guarantee that Republicans will vote on a replacement once they head over the repeal cliff — unforeseen events could overtake it — and that overhauling a federal health care budget that exceeds that of the Defense Department is not easy.
Hospitals could trim services in anticipation of providing care without payment, more insurers might pull out of Obamacare’s web-based exchanges and the sickest Americans will fear losing hard-won coverage while the GOP settles on a new plan.
“Do not rush this process,” Mr. Obama said.
Muscled into law by Democratic majorities in 2010, Obamacare slashed the uninsured rate to an historic low by mandating coverage and offering taxpayer subsidized coverage on the exchanges, expanding Medicaid in 31 states and D.C. and allowing young adults to stay on their parents’ plans until age 26.
Yet many healthy people have resisted joining the program, the administration has fallen short of sign-up projections, and insurance companies have responded by spiking premiums and cutting their offerings.
Mr. Obama admitted that many Americans still face unaffordable premiums and few coverage options, but he blamed many of the law’s problems on GOP lawmakers and governors who’ve resisted his plans, saying his program could be fixed with more generous subsidies or a “public option” that competes with private plans.
Republicans say that amounts to “more Obamacare,” so it’s time to start over.
Still, a handful of Senate Republicans are skittish about forging ahead without a replacement in hand, and whether their plans could jack up federal deficits.
Even Mr. Trump has warned Republicans to “be careful” and force Democrats to own Obamacare’s problems, after stumbles in the early rounds caused insurers to hike premiums for popular “benchmark” plans by an average of 22 percent across all states in 2017.
An election-year GOP blueprint proposed a health program that uses aged-based tax credits and market reforms in place of the “individual mandate” designed to forcefully prod healthy people in the marketplace and keep premiums down.
Mr. Obama, though, said his successor will find it hard to cover people with pre-existing medical conditions without the unpopular mandate.
“I was initially against this Republican idea, but we learned from Massachusetts that individual responsibility, alongside financial assistance, is the only proven way to provide affordable, private, individual insurance to every American,” Mr. Obama wrote, referring to state-level reforms that paved the way for his federal law.
The phased-in mandate tax was relatively weak in the early rounds, resulting in higher premiums and fewer offerings on the exchanges.
Still, Obamacare’s supporters insist that the penalty is a critical tool, now that it’s ramped up to a floor of $695 per year.
” ‘Repeal and replace’ is a deceptively catchy phrase — the truth is that health care reform is complex with many interlocking pieces, so that undoing some of it may undo all of it,” Mr. Obama wrote.