Showdown likely over health care after inauguration

If the devil is in the details, one of the toughest tasks about repealing and replacing the 2010 Affordable Care Act may be the timeline.

Some congressional Republicans want to repeal the bill now, and then spend two years instituting a replacement. During the transition period, they’ve said, no one would lose benefits.

But President-elect Donald Trump last week threw a wrench into that plan, saying he wants movement quickly and concurrently.

That creates a tricky situation for Republicans such as Rep. Pat Tiberi, a central Ohio lawmaker who chairs the House Ways and Means Committee’s Subcommittee on Health. In an interview in early January, Tiberi said he preferred that Congress immediately repeal the law while instituting a transition period to ensure no one loses coverage.

That transition period could take two to three years, said Tiberi, R-Genoa Twp.

Trump’s desire to speed up the timeline could put the health care architects in Congress on a hot seat, or at least in uneven terrain. How do you replace a six-year-old almost overnight without kicking massive numbers of people off the rolls? In an interview with the New York Times last week, Trump made clear he does not want Republicans to take years to create a replacement law.

“You’re going to be very, very proud of what we put out on health care,” Trump said.

Tiberi and Sen. Rob Portman, R-Ohio, will be in the thick of whatever replacement bill Congress writes.

Portman joined other lawmakers last week to push an amendment that would extend the target date for committees to write a repeal bill to March 3. The current target is Jan. 27. Portman ultimately withdrew that amendment, and the Senate moved forward on what is to the first step of repealing the bill Wednesday night. The House followed suit on Friday.

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In a statement, Portman said he remains “committed to working with my colleagues to ensure we enact a smart, responsible plan to replace ObamaCare as quickly as possible.”

Republicans have never liked Obamacare, and not a single one supported it when it passed Congress. According to Tiberi, one-third of the counties in Ohio and one-third of the counties in the United States will have one insurer participating in the exchanges this year – meaning less competition for much of the country and, presumably, higher rates.

Though Tiberi offered no specifics of what a new bill would be like, he envisions “a partnership but not a centralized top-down system that dictates and mandates and quite frankly makes insurance more expensive.”

Tiberi also said two popular facets of the law – one allowing children to stay on their parents’ insurance until they’re 26 and another saying that insurance companies can’t deny offering coverage because of pre-existing conditions – will not be repealed.

Can GOP craft an affordable alternative to the Affordable Care Act?

Just how popular parts of the law can be maintained at the same time prices are lowered is not clear. Sen. Sherrod Brown, D-Ohio, called the move to repeal the health care law “reprehensible,” particularly since there is no replacement plan.

“Opponents have had seven years to come up with a replacement plan and they haven’t produced anything yet,” he said. “Throwing Ohioans off of their health care and asking them to simply trust that everything will be alright is outrageous.”

White House senior advisor Valerie Jarrett said that despite complaints, health care inflation is going up at the slowest rate it has in 50 years. Millions of Americans, she said, have access to health care coverage that didn’t before the law passed.

“If they can figure out a way to provide these essential benefits and tweak it in a way that makes it better than that, that’s great,” she said. “But to say it’s not working, well, ask the people who are benefiting from it right now.”

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