While the budget resolution that congressional Republicans approved last week was designed to speed repeal of the Affordable Care Act (ACA), budget analysts and some lawmakers in both parties have expressed understandable concerns about such hasty action before a replacement health care plan is ready.
Over the weekend President-elect Trump raised further questions when he told The Washington Post he was almost finished with a plan designed to guarantee “insurance for everybody” but provided few details on how such an ambitious goal could be met.
As The Concord Coalition said in an issue brief last week: “As a matter of sound fiscal policy, it makes no sense to reverse the many spending and tax policies of Obamacare without knowing what comes next." Concord added that having a replacement plan ready is “the only way to avoid great fiscal uncertainty, showdowns and risk with regard to Obamacare repeal.”
For one thing, Republicans still have unresolved differences among themselves about what the replacement plan should look like. In addition, developing a serious plan might well take longer than congressional leaders and President-elect Trump have indicated.
They have also indicated that the replacement plan will still include some of the ACA’s more popular provisions. But these “good parts” of the ACA are supported by less popular provisions, as Joshua Gordon, Concord’s policy director, explained in a recent blog post.
It would be a good thing for Congress to have a comprehensive health care proposal from Trump showing how he would meet the very high standard of universal coverage that is “much less expensive and much better.”
In addition, Trump told The Post his plan would result in “much lower deductibles.” Notably, Trump has not made clear whether his plan would keep the ACA tax increases in place to help fund the new system, nor whether the ACA’s Medicare cost savings would remain in place.
While the new budget resolution means Republicans won’t need Democratic help to repeal the current health care law, they will need at least some Democratic support in the Senate to pass a replacement. So eventually there will have to be a greater emphasis on bipartisan cooperation over future health care policies than is currently evident in Washington.