Dr. Tom Coburn and Paul Howard
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President Trump, the House and the Senate have all taken the first steps toward repealing the Affordable Care Act. Yet many critics (and even supporters) of the move share a common concern: With the ACA gone, what comes next?

We hope any replacement plan engages the states as true partners and allows for greater local accountability. Fortunately, there is already a mechanism to let states take the lead — a shift that would generate bipartisan consensus the ACA never achieved.

The Department of Health and Human Services has discretion under the ACA to offer states waivers from many of the law’s most expensive and onerous regulations. The Trump administration can use the waivers to immediately signal its commitment to promoting market competition and empowering patients and consumers. Along with new reforms to promote transparency on pricing and quality, the administration and Congress can facilitate a health care revolution from the ground up.

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Dr. Tom Coburn and Paul Howard
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