Growing numbers of Republicans showed discomfort Monday over obliterating President Barack Obama’s health care overhaul without having a replacement to show voters. Hoping to capitalize on the jitters, Democrats staged a late-night Senate talk-a-thon to condemn the GOP push.

With Donald Trump just 12 days from entering the White House, Republicans have positioned a repeal and replacement of Obama’s 2010 health care statute atop their congressional agenda. But GOP lawmakers have never been able to rally behind an alternative, and Republican senators are increasingly voicing reluctance to vote to yank health coverage from millions of people without a substitute.

That hesitancy was fed as Sen. Rand Paul, R-Ky., among those who want to delay repeal until a substitute is ready, said Mr. Trump telephoned him Friday night and expressed support for doing both together.

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Sen. Lamar Alexander (R-TN), who chairs the Health, Education, Labor and Pensions Committee, laid out his ideal approach to repealing and replacing the ACA on the Senate floor Tuesday. Alexander argued for repealing the law once specific plans are in place and for giving states more authority. Alexander only wants to see Obamacare repealed once “there are concrete, practicable reforms in place. … It’s not about developing a quick fix. It’s about working toward a long-term recovery that works for everyone,” Alexander said. Alexander seeks to “rescue” those who are currently on the ACA exchanges and ensure that the insurance market is stable, give states more flexibility with their Medicaid programs, expand Health Savings Accounts, and eliminate the employer mandate.  You can watch Sen. Alexander’s speech here.

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A poll conducted by the GS Strategy Group on behalf of the conservative American Action Network, found that 54 percent of likely voters say they would like to see the president’s signature legislative achievement undergo full repeal or major changes.

This week, the U.S. Senate and then the U.S. House of Representatives will consider a budget resolution for FY 2017. It has no purpose whatsoever except to create a vehicle for the repeal of Obamacare.

Congress should pass this budget resolution. It doesn’t commit anyone to any policy choices at this point. All it does is create reconciliation instructions for the chambers to pass Obamacare repeal shortly after President Trump is inaugurated.

This budget resolution has nothing to do with the actual budget, unlike any budget resolution in memory. All it does is create reconciliation instructions for the chambers to pass Obamacare repeal shortly after President Trump is inaugurated.

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By nearly any measure, ObamaCare has failed: It didn’t lower costs, it didn’t increase choice, middle-class families continue to lose health plans they were promised they could keep, and Americans continue to call for ObamaCare’s repeal.

They spoke loudly again this November, and about 8 out of 10 favor changing ObamaCare significantly or replacing it altogether.

We in Congress hear you, and we have already begun to act.

The Senate is currently working to pass the legislative tools to bring relief to the middle class by repealing this partisan law.

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Republicans warned seven years ago that a health care law passed only by Democrats — with no support from the other party — would struggle to survive. The party-line vote to pass Obamacare, they said, was arrogant and reckless.

Now, the GOP is in charge, and poised to run afoul of its own warnings.

As Republican lawmakers begin to dismantle President Barack Obama’s landmark health care law, awaiting the inauguration of President-elect Donald Trump, they face the prospect of overhauling the American health insurance system without any help from across the aisle. Democrats appear increasingly determined to offer Trump’s party as little help as possible.
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Obamacare has made America’s $3.2 trillion health-care system more costly and bureaucratic, while still leaving many millions of Americans uninsured. To lower costs and improve care, a healthy dose of competition and deregulation is urgently needed. Here are four steps that Congress and the new Trump administration can take:

KEY FINDINGS

  1. Repeal Obamacare and transition to catastrophic health-insurance plans linked to expanded Health Savings Accounts
  2. Enact per-capita Medicaid spending caps
  3. Create a new conditional-approval framework at the FDA
  4. Encourage outcomes-based payments

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Official Washington still is struggling to understand and adapt to the populist wave that carried Donald Trump to the White House. Anger and denial linger still, emotions rooted in the social and economic chasm between Trump voters and the political class.

What does this mean for health? The first fight is already shaping up, of course, over Obamacare. The way forward falls on President-Elect Trump, his presumptive HHS Secretary Tom Price (R-GA) and the GOP-controlled Congress to make good on his campaign promise of replacing Obamacare with “something terrific.” This won’t be easy, and the latest reports are that the can might be kicked down the road a few years.

Responding to populist frustrations will require policymakers to recognize that long-held policy assumptions may no longer apply in a rapidly changing economy. These include:

  • The link between jobs and coverage. How workers – and seniors — get coverage will evolve.
  • The broken link between “health” and health insurance. Regulators will at some point give insurers room to innovate, permitting new forms of coverage that promote health and offer new ways to finance care for chronic conditions.
  • The broken link between premium and risk. A health promotion approach will require restoring this link, allowing insurers to encourage and reward healthy behaviors.
  • New technology. Technology will one day penetrate the health care regulatory encrustation and dispel the lingering paternalism that regards consumers as incapable of making informed choices about their medical care.

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Last Wednesday, Vice President-elect Mike Pence told House Republicans that President-elect Donald Trump is ready to sign executive orders when he takes office that would enable an orderly transition away from ObamaCare, even as Congress begins to debate alternatives and replacements.

Both Affordable Care Act (ACA) opponents and supporters tended to exaggerate how much immediate harm Trump would do to the outgoing Obama administration’s legacy healthcare program.

The new president certainly “could” swing a wrecking ball against what remains of the troubled effort to expand insurance coverage under tighter federal government control and substantial taxpayer subsidies. His toolkit of potential executive branch actions is large and varied, but it is not unlimited. The more important questions involve how Trump wants to utilize those powers, and for what objectives.

With patience and care, Trump could initiate new formal rulemaking to partially revise or reverse older, existing regulations, and to create new ones.

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Brandishing a new slogan, “Make America Sick Again” adapted from President-elect Donald Trump’s campaign, Democrats are holding rallies in Ohio, Pennsylvania, and West Virginia, featuring the stories of thousands of the red-state Americans who have benefited from Obamacare. Those rallies will culminate in several nationwide events beginning Jan. 15 where they will warn of the chaos to ensue if the health law is repealed without a replacement plan. They’re also urging followers to bombard lawmakers’ district offices and phone lines with calls against repeal.

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