Obamacare: Repair, Repeal, or Replace?

The Trump administration must weigh all options, of repealing, repairing, or replacing Obamacare, instead of acting in haste.

The US President has generated great hue and cry about various policy agendas. Repealing the ACA (Obamacare), the key legacy and chest-thumping policy by Barack Obama, has been one of the significantly debated issues. It comes as no surprise, as Republicans have always been singing the “repeal and replace” song since the inception of ACA. The time of action did finally arrive for them, and it looks harder now than before to twist ACA back to operation. But not many understand that the mere repealing of ACA without any enhanced replacement may not be wise. Another set of critics ask whether there is an essential need to repeal the act or whether a gradual repair is less costly. The Trump administration is fixed in a trilemma of keeping insurance costs low, offering a better replacement to ACA, and insuring all US citizens.

The current administration can repeal ACA with legislative and executive powers, but mere repealing is undemocratic, indicating loss to the insured, the insurers, and the government. Any act to be repealed must have a sound replacement which is comparatively progressive. The replacement must normalise current complexities and defer uncertainty. The Trump administration is yet not equipped with a reliable replacement, indicating their ignorance all the while during their “repeal and replace” propaganda. For time being, it has reduced the enrolment period to half and lowered minimum standards of qualification for getting insured. The new changes, although supress rising uncertainty about the act, assuredly give more time to insurers to align themselves with the ACA’s fate.

But, the eventual replacement is bound to happen; and for that the Republicans must prepare a more affordable and accessible healthcare policy. Until then, the ACA must be repaired in  a way that paves way for a gradual transmission, such that it is less costly for consumers. Lamer Alexander is right in offering a gradual phase out instead of immediate abrupt repealing, unnecessarily raising costs for all stakeholders. The sole idea of a repair or replacement of the act must stand on reducing healthcare costs for all irrespective of their eligibility, eliminating conflict of interests between the insurers, consumers, and government, and on providing healthcare coverage to all citizens.

As a priority to stabilise insurance premium costs, the repaired ACA or a replaced act must ensure attractive offers that invite younger population to enrol in the program.  The bulk of younger insurance holders may provide savings that can be transferred to affordable healthcare to older citizens and households alike. Mandatory fulfilment of previous non-payments of premiums in current enrolments can allow consumers to live with insurance and this can in turn raise revenue collection for the government. Observed carefully, a major overhauling of the healthcare provision has been achieved by Obama when he simplified insurance to the categories of bronze, silver, and gold plans. Obamacare eased the factor of understanding insurance by imposing standardised plans across the US that enhanced enrolment and coverage. Although, with executive and legislative powers, Trump can repeal the ACA, the US Congress indicates a federal budget deficit increase of $137 billion over 2016-2025 period, considering all possible macroeconomic feedback. The anticipated deficit increase, however, considers only repealing ACA and not a replacement.

In proportion to the changes in the healthcare market, a repair or replacement of an old policy is apparent and essential. With a protectionist approach, Trump administration must weigh all consequences of repairing the ACA, repealing with a better replacement, and repealing without replacement, to ensure healthcare affordability and accessibility to all US citizens.

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