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Medicare Is Simple
Thursday, July 21, 2016
RNC: And Now for a Different Take on Obamacare ACA
Reform, not repeal, urged by former HHS Secretary by Shannon Firth
Washington Correspondent, MedPage Today
CLEVELAND -- Could a Republican
administration repeal Obamacare? That was the topic up for discussion at a
briefing Tuesday, held outside the Republican National Convention.
"I do not believe ... that my
political party is going to be able to put together a complete repeal, and I
don't think it should," said Tommy Thompson, JD, a fellow of the Council on Foreign
Relations, who served as Secretary of Health and Human Services under President
George W. Bush, and four terms as governor of Wisconsin.
He said attempting full repeal would create
"real chaos. The Affordable Care Act has got lots of problems, but there's
some good parts of it, and most Republicans will recognize the good
parts," he told reporters after the briefing.
Republicans should focus on fixing
Obamacare, by reducing its taxes, lowering premiums, and giving people an
incentive to buy health insurance, he said.
"Why is it that you and I don't get a
tax deduction when we pay for health insurance, but the company that employs us
does?" he said at the briefing.
Thompson argued for giving everyone a
refundable tax credit to incentivize more people to buy into plans. He also
said that the government should maintain parity laws, so that sick people
aren't charged more or kicked off their health plans -- he called the latter
When asked who the best person would be to
navigate these "meaningful changes", Thompson didn't hesitate:
"Without a doubt, Donald Trump."
"Donald Trump would be well-advised to
outsource the making of policy to [Speaker] Paul Ryan (R-Wisc.)," said Lanhee Chen,
PhD, JD, a research fellow at the conservative think tank, the Hoover
Institution at Stanford University in Stanford, Calif. Chen was also the policy
director for the Romney-Ryan 2012 campaign.
"Presumably, that's what would
happen," he said, and then clarified "In an ideal world for
conservatives, I think that's what would happen."
"I think we are in a phase of the
conversation now, where we're trying to do our best to imagine what a Trump
administration would look like, when in reality, none of us really knows. This
is like a freak wild card," he stated.
Chen told MedPage Today, that full
repeal would be "tough" but "a large amount of repeal"
could happen through the budget reconciliations process, which requires fewer
votes -- a path that has already been tested.
If Trump wins the election, Chen
anticipates a Republican administration would attempt repeal.
"It's important for him to realize
that just saying you're going to repeal Obamacare alone is not enough, that
there has to be a coherent plan to replace it," he said, which is where
turning to Ryan's blueprint
makes sense. "Otherwise, politically I think he's in very
If repeal weren't achieved, Chen argued for
developing more tailored plans to fit people's needs that cost less, made
possible by loosening some of the essential benefits requirements; paring back
subsidies; developing a more "open architecture" to create a more
competitive marketplace; and giving states more flexibility around Medicaid
expansion on the front-end, instead of relying on the back-door 1115 waiver
If Secretary Hillary Clinton wins the
presidency and Republicans maintain a majority in Congress, "they'll want
to try to work together," Chen said. "It will be incumbent on [Senate Majority
Leader] Mitch McConnell (R-Ky.) and Paul Ryan to lead that
negotiation with her."