Repeal Obamacare? Better to have a replacement first, say Americans.
Just one in five Americans say they think Congress should repeal the Affordable Care Act before hashing out details of a replacement, as Republican leaders plan to do, according to a new poll by Kaiser Health.
A full 47 percent of the public think Congress shouldn't repeal Obamacare at all. A near equal amount, 49 percent, think a repeal is in order. But of the latter group, roughly 60 percent say that lawmakers should wait to vote on whether to sweep away the old one until after they've announced the details of a new plan, a聽sign of the current Republican strategy's unpopularity.
鈥淔or me, the really pertinent question, the big question, is: Is there a mandate for repealing the ACA without a replacement plan?鈥� Drew Altman, president of the Kaiser Family Foundation, . 鈥淲hat we see in our poll and what we see in our focus groups is: If there is, it is a very weak one. It鈥檚 not obvious there鈥檚 a mandate for repealing the ACA without putting a replacement plan on the table.鈥�
But how unsure about the law much of the public remains, although there are聽clearer divides along partisan lines. And the malleability of opinion on the issue 鈥� after hearing messages for or against repeal, anywhere from 60 percent to 27 percent of respondents say they鈥檇 support it 鈥� might suggest that most Americans don鈥檛 see the law as unimpeachable.
Some of that might have to do with outcomes.听As 海角大神聽reported earlier this week, the individual insurance markets created under the law are shrinking in much of the country while premiums rise, leaving people with fewer and more costly choices.
Here鈥檚 what鈥檚 clear: Most Americans (62 percent) prefer giving the federal government a larger role in healthcare if it means guaranteeing coverage and financial help for seniors and the lower-income, while similar proportions say lowering the cost of healthcare for individuals and lowering the cost of prescription drugs should be a 鈥渢op priority.鈥� And 45 percent say dealing with the prescription opioid epidemic should be a top priority, too.
Republicans in the House have drafted a blueprint for a replacement, though their colleagues in the Senate haven鈥檛 coalesced around a plan, as the Monitor's Francine Kiefer reported:
Republicans can repeal with only a majority vote through a special budget process, but legislation to replace the law would have to clear a 60-vote threshold in the Senate, where Republicans hold a narrow 52-to-48 advantage.
That鈥檚 why Senator [Susan] Collins [of Maine] thinks lawmakers need to see a detailed path forward upfront.
鈥淚 don鈥檛 want people falling through the cracks and losing their insurance status because we didn鈥檛 have a replacement ready to go,鈥� she said in an interview, noting from her experience overseeing insurance for Maine that insurance markets 鈥渁re complex and that they cannot turn on a dime.鈥�
Her concern is backed up by a聽聽by the center-left Brookings Institution think tank in Washington.
A repeal effort 鈥渨ould likely destabilize the individual market and very possibly cause it to collapse in some regions of the country during the interim period before any replacement is designed,鈥� the Brookings report found.
Doctors, hospital groups, insurers, and analysts have largely echoed that finding.
"People in this country need to understand what it is they're being asked to substitute for what's there now so they can have an informed opinion about whether it's better or not,鈥� American Medical Association president Andrew Gurman .听
Trump will enter office having made big promises about giving Americans better health care for less money. Much of the public is skeptical, the poll finds: About 51 percent said they were either聽鈥渘ot at all confident鈥� or聽鈥渘ot too confident,鈥� with 29 percent saying they were聽鈥渟omewhat confident鈥� and 19 percent saying they were聽鈥渧ery confident.鈥�
