After six years of resisting legislative changes to Obamacare, President Obama and Democrats now say they’re ready to work on fixes to the massive health law — so long as they expand the federal government’s role in health care.
With Republicans about to control all the levers of political power and moving to repeal the Affordable Care Act, Democrats are searching for ways to defend the law.
For many of them, that means admitting to flaws in the six-year-old law, and saying they can work with the GOP on fixes — as long as they don’t undermine the central achievements of Obamacare.
Mr. Obama said that means boosting the amount of money the government doles out to help people buy health insurance, and offering government-run plans to compete with the private sector.
“I’d sign on to a Republican plan that said we’re going to give more subsidies to people to make it even cheaper, and we’re going to have a public option where there isn’t an option,” the president said Friday in an interview with the Vox media outlet. “Here’s the problem: I don’t think that’s the thing that they want to do.”
He’s right. Leading Republicans say the kinds of proposals Mr. Obama is floating are designed to paper over the law’s failures, which have become more acute as Obamacare has matured.
While the number of uninsured is the lowest ever, Obamacare exchange customers are seeing their insurance premiums skyrocket, and many of them have only one option when they go to pick a health care plan.
Senate Majority Leader Mitch McConnell said those flaws are endemic in the system Mr. Obama designed.
“You can’t fix Obamacare by piling on more Obamacare,” said Mr. McConnell, Kentucky Republican.
The Senate is speeding to set up a process for repeal, even though there is no GOP agreement on what would replace Obamacare. Republicans won two initial test-votes last week on a 2017 budget that would allow them to repeal Obamacare without having to face a Democratic filibuster. More votes are expected throughout the spring.
By the end of the process, GOP leaders say they’ll have a bill that ends Obamacare and phases in a new system over time — all while trying not to send health insurance markets into a tailspin.
Democrats said repealing Obamacare will lead to chaos, which is why they want to see Obamacare expanded.
A group of 13 self-proclaimed moderates said last week they would be willing to negotiate with Republicans as long as the GOP slows down its repeal push. The 13, however, are looking at the same kinds of fixes Mr. Obama called for, such as more generous taxpayer-funded subsidies and expanded government plans.
Mr. Obama said Friday that the rush to repeal his signature law without having a firm replacement is a “huge disservice to the American people” that imperils real lives.
Indeed, Sen. Rand Paul and a handful of other Senate Republicans are skittish about forging ahead without a replacement in hand.
“I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it. The time to act is now,” Mr. Paul, Kentucky Republican, said Friday on Twitter.
Mr. McConnell wouldn’t commit Sunday to a firm timetable for replacing Obamacare, telling “Face the Nation” on CBS it would occur “very quickly” after its repeal this year.
The Senate majority leader also didn’t say whether everyone covered by the Affordable Care Act would still have insurance under a GOP plan, pivoting to the fact that 25 million Americans still lack insurance under Mr. Obama’s reforms.
Mr. Obama 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,” Mr. Obama said. “But I want to see it first.”
During the 2009-10 health care debate, Mr. Obama shirked the government-run, single-payer system that progressives wanted and pushed to have private insurers compete for market share on web-based exchanges in every state.
Yet many healthy people have resisted joining the program, the administration has fallen short of sign-up projections, and insurance companies have responded by hiking premiums and cutting their offerings.
Instead of a government-run option, the 2010 law promoted nonprofit “co-ops” that would offer plans to compete with for-profit insurers. But despite generous government assistance, only a handful of the 23 initial co-ops have survived.
This year, as the presidential campaign heated up, Mr. Obama acknowledged “growing pains” in the law. He reignited calls for a full government-run public option plan, particularly in rural areas with few insurers, and called for more taxpayer-funded subsidies to help people afford coverage in the face of rising premiums.
Republicans have rejected those plans, saying Democrats cannot use Obamacare’s stumbles to pull a bait-and-switch and move the system further to the left.
“Let’s face it, they never play fair. They’re so used to having it their way,” Senate Finance Committee Chairman Orrin G. Hatch, Utah Republican, said minutes after Congress had confirmed Mr. Trump as the next president with 304 electoral votes. “They’re not going anywhere with it; it’s just constant whining about what’s going on.”