“If they are so convinced they can do it better, then they shouldn’t be afraid to make that presentation,” Obama said, even promising to vouch for such a plan.
“I’m saying to every Republican right now, if you in fact can put a plan together that is demonstrably better than what Obamacare is doing, I will publicly support repealing Obamacare and replacing it with your plan.”
Obama made the comments during a live, wonky interview with Ezra Klein and Sarah Kliff of Vox. The interview took place at the Blair House, the residence across the street from the White House where, famously, Obama presided over an eight-hour bipartisan discussion of health policy in early 2010, shortly before Congress passed what would become the Affordable Care Act.
Nearly seven years later, the law has helped more than 20 million people to get health insurance, reducing the number of Americans without coverage to historic lows. But some people now pay higher premiums because of the law’s changes, and in some parts of the country markets are losing insurers and have yet to stabilize.
Those problems have undermined the law’s popularity and now its very existence is in jeopardy. Republicans, who have been pledging to repeal Obamacare since it first became law, have majorities in both chambers of Congress. On Jan. 20, President-elect Donald Trump, who made Obamacare repeal a top priority, will take office.
House Speaker Paul Ryan (R-Wis.), Senate Majority Leader Mitch McConnell (R-Ky.) and other GOP leaders have already laid out their strategy. They plan to act quickly to eliminate Obamacare’s funding, using special fast-track procedures reserved for fiscal issues, while leaving elements of the law in place for a fixed amount of time ― up to four years.
The idea, GOP leaders say, is to make sure the people who now get coverage through Obamacare won’t lose insurance, while giving Republicans time to figure out a new system to take Obamacare’s place.
But it’s not clear that Republicans can actually keep Obamacare’s insurance markets going during a transition period ― nor is it clear that Republicans actually have a way to deliver on their frequent promises to provide better coverage at lower costs.
“If they can come up with something better, I’m for it,” Obama said. “But they have to show it. And that’s not too much to ask.”
One particular problem for Republicans, Obama said, is that providing health care to people ultimately requires money, because many low- and middle-income people simply don’t have enough money to pay for decent insurance ― and virtually nobody except the super-wealthy could pay the bills associated with a serious medical episode on their own.
“If they can come up with something better I’m for it. But they have to show it. And that's not too much to ask." President Barack Obama
Putting more money into the program, by increasing the financial assistance available to people who buy coverage, would be one way to make it work better for more people, Obama said. He also reiterated his support for a “public option” ― that is, a government-run insurance plan that could compete with private plans and offer options in areas where few insurers are now selling.
But, Obama noted, Republicans oppose a public option. And they envision significantly less government spending on health care, not more ― and it’s difficult to square that with a system that would make it easier, not harder, for people to pay their medical bills.
Obama also said that Republicans have been promising to outline their schemes ever since the original health care debate in 2009, including at that Blair House session, but to this day have never settled on a single common vision ― or put out a plan that, according to independent assessments, could provide roughly equal or better levels of coverage at lower costs.
That is why, Obama said, Republicans have an obligation to publish their plans now ― and subject them to independent scrutiny, from a variety of sources ― before dismantling the system that Obamacare put in place, thus jeopardizing the well-being of people who now depend on the program.
“The idea of repeal first and replace later is just a huge disservice to the American people and something that whether you’re a Republican or Democrat you should be opposed to doing,” Obama said. “These are real lives at stake.”
Obama’s interview came on the same day that a new Henry J. Kaiser Family Foundation poll found little enthusiasm for the GOP strategy of repeal before replacement. One day before, Sen. Tom Cotton (Ark.) became the latest in a series of Republican senators to voice their own concerns about the quick repeal strategy.
“You now have Republican governors, some Republican senators, who say we don’t think this is a good idea,” Obama said.