Health and Human Services Secretary Sylvia Mathews Burwell warned Monday of widespread damage to the nation’s health-care system if the Republican-led Congress and incoming Trump administration repeal the Affordable Care Act before they define a sequel.
American health care risks “going over a cliff,” with serious consequences for the industry as well as for state budgets and economies, Burwell said in a speech at the National Press Club.
Her remarks were part of an unprecedented campaign by the Obama administration to use its final days to try to protect the centerpiece of its domestic-policy legacy from a Republican wrecking ball.
They came just after President Obama issued a two-pronged warning Friday, followed by an appearance on a Sunday talk show. If the GOP moves preemptively to kill the far-reaching health-care law without a replacement, the president said on ABC’s “This Week,” “suddenly 20 million people or more don’t have health insurance.”
These stern warnings from the highest reaches of an outgoing administration are a highly unusual strategy during a season in which most presidents are winding down and helping their successors prepare for office.
The last-minute activism reflects “a very unusual set of circumstances, with an incoming Congress beginning the process of trying to dismantle the outgoing president’s signature domestic policy initiative while he’s still in office,” said Larry Levitt, senior vice president of the Kaiser Family Foundation, a health-policy organization. “Perhaps ironically, the timing allows the Obama administration to start to mount a defense of the Affordable Care Act while it still controls the machinery of the government.”
Burwell listed three questions she said lawmakers should ask when considering replacement legislation for the ACA: Does it cover as many people, maintain the quality of coverage and “keep bending the health-care cost curve in the right direction?”
Her speech matched the theme the president has laid out in recent months: The 2010 law may not be perfect, but the better course is to fix it rather than dismantle it.
In a “perspective” piece that appeared Friday in the New England Journal of Medicine, Obama wrote: “This approach of ‘repeal first and replace later’ is, simply put, irresponsible — and could slowly bleed the health care system that all of us depend on.”
“ ‘Repeal and replace’ is a deceptively catchy phrase,” he continued. “The truth is that health care reform is complex with many interlocking pieces, so that undoing some of it may undo all of it.”
He cited one of ACA’s most popular features, a ban on the once-widespread practice of insurers refusing to cover people who had preexisting medical problems or charging them more. President-elect Donald Trump and most Republicans in Congress have said they favor preserving the ban. But Obama noted that it would place a large burden on insurers unless they also kept an unpopular aspect of the law that requires most Americans — including healthy ones who are inexpensive to insure — to carry coverage.
Such defense efforts by Obama and his top aides parallel the concerns of a growing cadre of medical industry groups, consumers, a coalition of medical students and even some congressional Republicans. They also are warning that repealing the ACA without a clear new plan would disrupt the health-care system and care for many patients.
On Sunday, Senate Majority Leader Mitch McConnell (R-Ky.) said Congress “will be replacing it rapidly after repealing it,” although he provided no details on a potential replacement.
Speaking on CBS’s “Face the Nation,” McConnell said the Senate plans to take the first step by the end of this week by passing a budget resolution that sets in motion procedures to rescind the law. He did not specifically address the criticism that Congress should wait to repeal the legislation until it has a replacement mapped out, although he said that there “ought not to be a great gap between the first step and the second.”Pressed to define how long that might be, McConnell said, “Quickly.”
[Source:-The Washington Post]