Repeal or Replace: Healthcare on the Mind as Midterm Elections Approach

Despite continued Republican opposition to the Affordable Care Act (ACA), sentiment is shifting from repeal to replace. Still, the fact that open enrollment on HealthCare.gov begins after the midterm elections does not seem like a coincidence to the GOP.

Although the new version of HealthCare.gov should be in much better condition than last year, the administration has not posted premium rates on the website, and will not do so until after the midterm elections. Open enrollment begins just a week later. Republicans would undoubtedly prefer for the rates to be posted before the election in case the numbers are detrimental to supporters of the healthcare law.

At the America’s Health Insurance Plans’ National Conferences on Medicare and Medicaid, and Dual Eligibles Summit, Avik Roy, senior fellow at the Manhattan Institute, discussed how healthcare will affect the midterm elections and how the Republican Party will address the issue during campaigns.

He said that Republicans are not campaigning on repealing specific provisions of the ACA. While the party is happy to campaign against the law, it is not “necessarily as comfortable talking to specific voters in their states about how they would actually take coverage away from them,” Mr Roy explained.

According to Politico, Republicans are also coming to the realization that even if they want to repeal the entire law, it is likely not feasible. Rep. Bill Cassidy in Louisiana is calling to “replace Obamacare” and Sens. Orrin Hatch and Tom Coburn proposed their own replacement plan.

Mr Roy has published his own proposal to “transcend” Obamacare. Instead of repeal and replace, he believes market-based approaches can be applied to the law. The Manhattan Institute published his paper outlining his plan in which Republicans can take advantage of the insurance exchanges that are already in place. The plan would migrate Medicaid and future Medicare populations onto the exchanges so that everyone is on a unified system.

However, as Politico pointed out, even if the GOP wins the Senate, it is unlikely to accomplish anything with President Obama still in the White House. And by the time he’s gone, the healthcare law will have been in place for 3 enrollment periods, which will make it difficult to repeal or replace.

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