Tennessee native: Fix Obamacare, don't rip it apart

WASHINGTON – An East Tennessee native who was one of the key architects of the Affordable Care Act urged Congress on Thursday to repair what’s wrong with the landmark health care law – and even rebrand it if necessary – but implored lawmakers not to decimate the protections it has provided to millions of Americans.

“Don’t strip away the essential health care that people have gotten now,” said Nancy-Ann DeParle, who was a top health care adviser to former President Barack Obama. “That would be a terrible mistake.”

DeParle blasted the House Republican bill that passed on a narrow 217 to 213 vote last week and that would repeal and replace major parts of the law. “It was a depressing day the day that it passed,” she said.

Among the parts of the House legislation she finds the most egregious is a provision that would let states seek a waiver so that insurance companies could eliminate required coverage of “essential benefits,” such as maternity care, mental health care and prescription drugs.

States also could ask for a waiver to allow insurers to charge higher premiums to the elderly and people with pre-existing conditions.

“The whole thing just seems to be going in the wrong direction,” DeParle said.

DeParle, who grew up in Rockwood, Tenn., and graduated from the University of Tennessee, worked as the director of the White House Office of Health Care Reform under Obama and was one of the pivotal players in crafting the Affordable Care Act, also known as Obamacare.

Working mostly behind the scenes, DeParle helped write the law and then spent weeks on Capitol Hill helping Congress members understand the labyrinthine components of the health delivery system. She also was heavily involved in the final, crucial negotiations to get reluctant lawmakers on board.

Obama singled her out as one of the “unsung heroes” of his health reform team when he signed the legislation into law during a ceremony in the White House East Room.

“The law isn’t perfect – we knew that when the president signed it,” DeParle said. “But we always thought we’d be working together to improve and fix its deficiencies. Instead of going in that direction, I think (Congress members) are going in the opposite direction.”

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DeParle, now a partner in New York private equity firm that focuses on health care, is especially critical of House Republicans for ramming the latest version of their bill through the chamber without holding hearings on the legislation, without a Congressional Budget Office score saying how much it would cost and with some lawmakers readily admitting they hadn’t read the bill.

“That is just a terrible process,” she said. “It’s not a good bill. They don’t have a real sense of what it’s going to do.”

When the Obama White House set out to reform health care, the consensus was that everyone should have health insurance and that health care should be more readily available, DeParle said.

Under Obamacare, “we now have a market that has been improved in many ways,” she said.

Millions of Americans are insured for the first time, including people who had been unable to buy a policy in the past because they have a pre-existing condition. Still, “in the absence of a more robust enrollment, the market still isn’t as healthy as it needs to be,” DeParle said.

But instead of ripping the health care law apart, “you could repair it and rebrand it and make it better,” she said.

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Before he came to the White House, President Trump made a career out of marketing everything from steaks to luxury resorts, so he could use those same skills to highlight the benefits of health insurance coverage, DeParle said.

Trump also could work to persuade governors and legislatures to expand Medicaid in the 19 states that haven’t already done so, she said.

Now that the House has passed its legislation, the debate shifts to the Senate, which plans to start from scratch and write its own bill.

DeParle is hoping senators like Lamar Alexander, the Tennessee Republican who chairs the Senate health committee, will look for ways to fix the existing law, that the legislative process will be bipartisan and more transparent than it was in the House, and that the Senate won’t vote on any bill without knowing how much it costs.

“If he approaches it that way, they can come up with something much better,” DeParle said.

Reach Michael Collins at 703-854-8927, at mcollins2@gannett.com or follow him on Twitter at @mcollinsNEWS.