KHN Morning Briefing

Summaries of health policy coverage from major news organizations

full issue

Thoughts On Repeal: Obama Warns GOP That Rushing Ahead Without Replacement Could Do Harm

Across the country, opinions writers, including the president, offer perspectives on the debate in Washington over the future of the federal health law.

The New England Journal of Medicine: Repealing The ACA Without A Replacement — The Risks To American Health Care
I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans know the security of health care in a system that is more effective and efficient. At the same time, there is more work to do to ensure that all Americans have access to high-quality, affordable health care. What the past 8 years have taught us is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people. That is why Republicans’ plan to repeal the ACA with no plan to replace and improve it is so reckless. ... This approach of ... could slowly bleed the health care system that all of us depend on. (And, though not my focus here, executive actions could have similar consequential negative effects on our health system.) If a repeal with a delay is enacted, the health care system will be standing on the edge of a cliff, resulting in uncertainty and, in some cases, harm beginning immediately. (President Barack Obama, 1/6)

Bloomberg: What's The Rush To Kill Obamacare?
For seven years, Republicans have yearned to dismantle the Affordable Care Act. Now that they have the chance, they seem wholly unprepared to do it right. Much work is still needed to figure out how to avoid destabilizing the health-insurance system. Yet, in their hurry, leaders in Congress seem to want to skip that part. What’s the rush? (1/5)

Los Angeles Times: Some Obamacare Advice For Republicans: First Do No Harm
[House Speaker Paul] Ryan promised “bold action” to make things better, but he and other Republican lawmakers can’t be more specific about their plans because they don’t know themselves. All they’re saying now is that they’ll take apart Obamacare in bits and pieces, and they’ll come up with a replacement in perhaps a few years. The insurance industry and most major medical groups say this is crazy. They’ve warned that all this uncertainty will destabilize insurance markets and will push many insurers to stop selling coverage to individuals, putting lives at risk. (David Lazarus, 1/5)

The Wall Street Journal: Lessons From Obama’s Failure
True enough, eight years ago congressional Republicans were clueless about health-care policy. But a great deal has changed in that time—in ideas, education and the quality of the GOP caucus. Witness Rep. (and Dr.) Tom Price, the nominee to be the next secretary of health and human services, who offered in Congress his own detailed replacement plan. Republicans already agree on the general contours of a free-market proposal—one based on tax credits, entitlement reform, freer insurance markets, portable policies and fewer mandates. The internal debates are over scope and details, not approach. (Kimberley A. Strassel, 1/5)

The Washington Post: Trump’s Health-Care Plan Has Already Been Tried. It Was A Disaster.
We don’t have the full details of Trump’s plan — or any Republican health-care plan, for that matter — but we are starting to see its bones develop. There will be no individual mandate or similar mechanism to bring healthy Americans into the system, but Trump has indicated he wants to retain the requirement that insurers cover everyone, including patients with serious preexisting conditions. Trump is telling Americans what he thinks they want to hear: that they can have all their dessert — consumer protections — without eating their vegetables — an individual mandate. This might be an effective rhetorical technique, but it is not the truth. The reality is that such an approach would result in devastation to the health-care system. (Jim McDermott, 1/5)

WSJ: Full Obamacare Repeal Has High Cost
Item number one on the Republican agenda is repealing Obamacare. Senate Budget Committee Chairman Michael Enzi has already introduced a budget resolution that includes reconciliation instructions to repeal President Barack Obama’s signature health law, the Affordable Care Act, and the House is planning to take it up next week. We still have no idea how much this will cost – or even if it will add to or subtract from the national debt. There are a number of approaches to repealing the law – all with differing price tags. (Maya MacGuineas, 1/5)

The New York Times: The Complex Mess Of Health Insurance
Obamacare looks the way it does because its designers wanted to cause the least possible disruption to the status quo while providing insurance to many more people. By that measure — and others, as a new Times editorial notes — the law has been a big success. But if it’s too complicated to have assured its own political survival and Republicans really do repeal it — throwing millions of people off of health insurance — the next push for health reform should probably be simpler. It should probably revolve around expanding the government programs that already exist. (David Leonhardt, 1/5)

The Washington Post: Questions For The ‘Repeal And Delay’ Crowd
Republicans are patting themselves on the back for “keeping their promise” and moving to repeal Obamacare with no replacement in sight. Is this really what they promised? Republicans ran on repeal and replace, not repeal and we’ll get back to you. They did not run on adding debt or on defunding coverage without an alternative. At times it is almost comical. (Jennifer Rubin, 1/5)

Los Angeles Times: Obamacare Repeal: A Bad Goal That’s Proving Hard To Achieve
Repealing the law is bad enough, but doing so without an alternative that could preserve coverage for the estimated 20 million Americans who gained it through Obamacare would be reckless and irresponsible. And that’s just one problem. Here’s another: Some Republicans are now questioning whether it’s wise to revoke all the tax increases in the Affordable Care Act, which offset some of the cost of the healthcare subsidies for lower-income and elderly Americans. In fact, there are at least two compelling reasons to leave those tax hikes in place. (1/5)

The New England Journal of Medicine: The End Of Obamacare
Donald Trump’s triumph in the 2016 presidential election marks the beginning of an uncertain and tumultuous chapter in U.S. health policy. In the election’s aftermath, the immediate question is this: Can Republicans make good on their pledge to repeal Obamacare? The Affordable Care Act (ACA) has persisted largely thanks to President Barack Obama’s protection. With Trump in the White House and Republicans maintaining House and Senate majorities, that protection is gone. (Jonathan Oberlander, 1/5)

Los Angeles Times: Obama’s Enduring Legacy: The Concept Of Universal Coverage
Donald Trump’s Republicans have vowed to repeal Obama’s healthcare law, abolish his financial reform law, and undo his executive orders on immigration and clean energy. ... But their No. 1 target, Obamacare, may be safer than it seems. The reason is simple but underappreciated: Because of Obamacare, Republicans have inherited an obligation to ensure access to affordable health insurance for every American — a duty the federal government didn’t have before. They could disavow the burden — but they haven’t. Indeed, Trump has embraced it. (Doyle McManus, 1/4)

Bloomberg: Republicans Should Save These 3 Unpopular Parts Of Obamacare
As Republicans consider repealing Obamacare, what bits should they be looking to keep? A lot of people will have different answers to this, of course, but to my mind the most important and unobjectionable bits of Obamacare are payment reform, comparative-effectiveness research and the tax on gold-plated health-care plans. These are not, you will notice, the most popular bits of Obamacare, the one that President-elect Donald Trump seems to favor. Nor are they the most famous. But all three attempt to tackle the biggest problem with our health-care system: its exorbitant cost. (Megan McArdle, 1/5)

Huffington Post: Public Wary Of GOP Plan To Repeal Obamacare Without A Replacement, Poll Shows
Americans have complicated feelings about Obamacare, according to a new poll, with voters divided over whether to keep the law, but only a minority supporting the Republican strategy of trying to eliminate it quickly. ... even many Republican voters seem unenthusiastic about eliminating the law before Congress crafts a replacement, as House Speaker Paul Ryan (R-Wis.) and other GOP leaders have proposed. Overall, according to the poll, just 20 percent of Americans say that is their preferred strategy for eliminating Obamacare. (Jonathan Cohn, 1/6)

The Washington Post: What Do Working Class White Trump Voters Really Want From Our Health System? Not What You Think.
As the Republicans set about dismantling the Affordable Care Act, they face a number of dangers, one of which is that they may have overestimated their own supporters’ commitment to their particular free-market version of health care. Most signs are that Donald Trump will sign a bill repealing the ACA, but in the debate over what Republicans will replace it with, a question presents itself: What do working-class Trump supporters really want from our health care system? (Paul Waldman, 1/5)

The Washington Post: Make Obamacare Great Again — Call It Trumpcare
Believe it or not, Americans like Obamacare. They just don’t know they like Obamacare. That is, the law known as “Obamacare” and “the Affordable Care Act” is relatively unpopular. But most of the things that this disreputable law does are incredibly popular. Consider the prohibition on denying insurance coverage due to preexisting conditions. Seven in 10 Americans, including 6 in 10 Republicans, support this provision, according to a recent Kaiser Family Foundation poll. (Catherine Rampell, 1/5)

Bloomberg: Republicans Really Can Pretend To Repeal Obamacare 
That is, instead of "repeal and delay," Republicans would try "pretend and delay" -- pass a nonbinding resolution and hail it as Mission Accomplished. Could Donald Trump and congressional Republicans really get away with such a brazen maneuver? I don't see why not. Democrats wouldn't complain much; they care more about preserving the substance of the policy than about drawing attention to the hypocrisy of a symbolic move. And most Republican voters care more about the symbolism. To avoid getting mired in repealing and replacing a complicated law in a complicated policy area, Trump and the Republicans in Congress could opt for ways to make the issue go away -- not unlike slapping your name on a building but not owning it. (Jonathan Bernstein, 1/5)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.