G.O.P. Plans to Replace Health Care Law With ‘Universal Access’

By Robert Pear and Thomas Kaplan
The New York Times, December 15, 2016

House Republicans, responding to criticism that repealing the Affordable Care Act would leave millions without health insurance, said on Thursday that their goal in replacing President Obama’s health law was to guarantee “universal access” to health care and coverage, not necessarily to ensure that everyone actually has insurance.

“Our goal here is to make sure that everybody can buy coverage or find coverage if they choose to,” a House leadership aide told journalists on the condition of anonymity at a health care briefing organized by Republican leaders.

The House leadership aide said that lowering the cost of insurance was a much better way to encourage people to opt in.

“We would like to get to a point where we have what we call universal access, where everybody is able to access coverage to some degree or another,” the aide said.


After an unrelenting campaign of promising to repeal and replace Obamacare, the Republicans are now in a position, having won the election, that they will have to deliver on that promise, or at least appear to do so. But it is the replacement that they are stumbling over.

The options they have been considering will leave many individuals worse off, particularly those who are most vulnerable because of medical needs or financial limitations. Realizing that most people, other than the very wealthy, will be unhappy with their proposals, they are searching for a framing that they might use to try to convince us that their proposals would result in a better system.

The Republican House leadership sent out an aide to the media to float the concept of “universal access” as a replacement program. Since their proposals would increase the number of uninsured, instead of promoting universal coverage they suggest that our goal should be to ensure that everyone has access to health care and health care coverage.

Since being released almost two weeks ago, the concept has not gained traction. Access to health insurance does not mean anything if a person cannot pay for it. If the insurance is made affordable by stripping out most of its benefits then access to actual health care becomes unaffordable. This particular concept of “universal access” will certainly face ridicule if they push it much further.

It appears that they will be exiting through the back door with their most likely strategy. They will take immediate action to appear to fulfill their promise of repealing Obamacare “on day one” or close to that. They will not actually repeal ACA but they will merely pass a resolution stating the intent to repeal it at some later date, preferably after the next presidential election. They will claim that they need the time to enact replacement legislation, though they will be reluctant to pass anything that may cause individuals to lose their current adequate coverage, which is what their proposals would do, especially those that they could move forward through the reconciliation process.

Another possible strategy that they could use would be to bring forth unacceptable legislation that must clear a Democratic filibuster. Then when it is blocked they can claim that it is the Democrats who are obstructing the replacement process. They can then move on to their other transformative legislative goals knowing that voters likely will forget about repeal and replace by the next presidential election.