Affordable Care Act Repeal Efforts Get Complicated

Republican lawmakers are shifting their terminology and timelines when discussing how to address the law.

Editorial credit: Kim Wilson Photography / Shutterstock, Inc.


American voters have long been divided on the Affordable Care Act. A survey of four recent polls found that 47.3 percent of those surveyed approve of the landmark healthcare law, and 48 percent disapprove of it, according to RealClearPolitics. (Incidentally, another poll found that 35 percent of respondents didn’t know that the Affordable Care Act and Obamacare were the same thing, the New York Times reports.)

It’s unlikely that there has been a scientifically conducted poll of people with diabetes on the Affordable Care Act, but anecdotally it appears the law has elicited strong feelings among this community as well, if Insulin Nation’s Facebook page is to be any judge. Some people with diabetes have argued the law is essential to their well-being because it guarantees that those with preexisting conditions have the option to purchase health care coverage. Others have blamed the law, fairly or unfairly, for rising health insurance costs.

The debate over the Affordable Care Act has intensified after the November 2016 election, as Republicans took control of both the legislative and executive branches of government. Republican lawmakers have long vowed to quickly repeal the law once in control of the presidency; now they seem to be facing their own divisions of how to deal with the law.

In recent months, there have been conflicting signals of whether Republican lawmakers want to repeal and replace the Affordable Care Act at roughly the same time, or pass legislation that would end the law in the future and use that time to craft a replacement law. That debate became glaringly public when an audio recording of a closed door meeting of Republican legislators was leaked to the Washington Post. The recording showed a lack of consensus about next steps and some anxiety about the political fallout of taking on the law.

In the days since that recording was leaked, Senator Orrin G. Hatch (R-Utah) and Senator Lamar Alexander (R-Tennessee) have started to use a new “r” word in connection with the Affordable Care Act: repair. While not every Republican lawmaker agrees with this approach, they took notice of the word choice of these two senators, who wield considerable power in Republican efforts to address the law, according to a Washington Post report.

Meanwhile, President Donald Trump also has sent a signal that the process for replacing Obamacare may take some time. While President Trump declared before taking office that he would like a full repeal of the Affordable Care Act to be on his desk to sign for his first day in office, he didn’t seem overly concerned about the pace of repeal efforts in a more recent interview. He also suggested a more relaxed timeline for replacement efforts, saying that he hoped to have “at least the rudiments” of a replacement plan ready by the end of the calendar year, according to a Fox News report.

This more careful approach comes at a time when several Republican lawmakers have faced angry constituents at packed town hall meetings. Much of the frustration at these meetings has centered on efforts to repeal the Affordable Care Act, according to a CNN report.

Of course, House Speaker Paul Ryan (R-WI) still is publically saying that he wants action on the Affordable Care Act sooner rather than later. Also, Tom Price, a longtime foe of the law, has been confirmed by the Senate as the new Secretary of Health and Human Services. History may remind us, as well, that Democrats faced their own division and angry town hall meetings when they sought to create what was to become the Affordable Care Act.

In other words, it’s still anyone’s guess when the fate of the Affordable Care Act will ultimately be decided, and what health care policy will look like after legislators take action. What is clear, however, is that there’s no public consensus among Republicans about how to address the law.

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Craig Idlebrook is chief editor for Insulin Nation and Información Sobre Diabetes, and was founding editor for Type 2 Nation. You can reach him at cidlebrook@selfrx.com.