I’m bound to be biased about anything with a subtitle, “Healthcare economists Austin Frakt, Donald Taylor and Yevgeniy Feyman on the future of healthcare reform,” but I do like Andrew Sprung’s piece on repeal and replace. He’s right that when he interviewed me, I got a bit upset at one point.
Frakt gets exercised, though, at the prospect of the kind of root-and-branch repeal-and-replace that Section 101 of CBH would entail. “That would be the same top-down, government imposing, ‘shove down our throat’ as the ACA [in Republicans’ telling]. Why should Washington come and rip out states’ functioning exchanges? That’s not the way it’s done under a conservative pro-federalism point of view. If you like what you’re doing, keep doing it.” Under repeal, “There would be such a hue and cry from governors, invested insurers, health systems, doctors’ organizations. This thing will have been running for a number of years — I don’t see how Americans are going to accept ripping it up.”
What I’m talking about here is that some states will be, more-or-less, content with the ACA’s reforms. It’d be a shame if a new, federal law shredded it.* However, as I point out elsewhere, it’s very reasonable to consider changes to the ACA to accommodate states that do not find its structure appealing, and therefore aren’t supporting coverage expansion along those lines.
The quotes by Don and Yevgeniy are even better than mine. Go read it all.
* Which is different than a gradual transition to something with broad support. Change of that type is hard to get exercised about. It’s also hard to call it “repeal.”