This is a challenge to Republicans President Obama probably doesn't think he'll have to answer. But he's game, if Republicans ever manage to come up with a plan.
President Barack Obama on Friday told Republicans they should be willing to present a replacement plan for Obamacare before they vote to repeal it.
And Obama said he'd be willing to support killing his own landmark health-care law if the GOP offers one that is demonstrably better.
"I am saying to every Republican right now, if you can in fact put a plan together that is demonstrably better than what is Obamacare, I will publicly support repealing Obamacare" and replacing it with the GOP's plan, Obama told Vox during a livestreamed interview from Washington, DC.
"But I want to see it first."
That's the rallying cry for everyone right now: "Show us the plan, Republicans." In a more formal setting, the pages of the New England Journal of Medicine, Obama lays out the dangers of repealing his namesake law without a replacement.
This approach of "repeal first and replace later" is, simply put, irresponsible—and could slowly bleed the health care system that all of us depend on. (And, though not my focus here, executive actions could have similar consequential negative effects on our health system.) If a repeal with a delay is enacted, the health care system will be standing on the edge of a cliff, resulting in uncertainty and, in some cases, harm beginning immediately. Insurance companies may not want to participate in the Health Insurance Marketplace in 2018 or may significantly increase prices to prepare for changes in the next year or two, partly to try to avoid the blame for any change that is unpopular. Physician practices may stop investing in new approaches to care coordination if Medicare's Innovation Center is eliminated. Hospitals may have to cut back services and jobs in the short run in anticipation of the surge in uncompensated care that will result from rolling back the Medicaid expansion. Employers may have to reduce raises or delay hiring to plan for faster growth in health care costs without the current law's cost-saving incentives. And people with preexisting conditions may fear losing lifesaving health care that may no longer be affordable or accessible.
Furthermore, there is no guarantee of getting a second vote to avoid such a cliff, especially on something as difficult as comprehensive health care reform. Put aside the scope of health care reform—the federal health care budget is 50% bigger than that of the Department of Defense. Put aside how it personally touches every single American—practically every week, I get letters from people passionately sharing how the ACA is working for them and about how we can make it better. "Repeal and replace" is a deceptively catchy phrase—the truth is that health care reform is complex, with many interlocking pieces, so that undoing some of it may undo all of it.
Republicans are notoriously bad at complexity. Let's see if they're any better at fending off pitchforks and torches when 30 million people lose their health insurance.