Town hall meetings across the country that have showcased national strife over a repeal of the Affordable Care Act have also revealed something else this month: a lack of consensus among Republicans over the timing of replacing the law.
In a meeting with constituents in Douglas County on Tuesday, Colorado Congressman Ken Buck said he believes that fully implementing a replacement could take years after the vote to repeal the law. His fellow Colorado U.S. Rep. Mike Coffman, though, told constituents in a video message last week that he would not vote to repeal the law without “a concurrent replacement.”
At town halls and in public comments, some Republicans have backed a quick repeal, while House Speaker Paul Ryan has spoken of a “step by step” approach. One representative talked of wanting the law, “repealed and repaired.” The muddled message was featured most prominently Thursday, when former House Speaker John Boehner said at a health care conference in Florida that he doesn’t believe a full repeal and replacement of the Affordable Care Act will happen.
“Republicans never, ever agree on health care,” said Boehner, who is retired.
Boehner’s spokesman later walked back the remarks, saying that Boehner meant to say “that the process of doing it from start to finish will not be an instantaneous one.”
That echoes what Buck, a Republican from Windsor, said in an interview Thursday. Buck said he believes that a repeal of the heath care law will occur “soon” but will have its effective date delayed. Crafting, passing and fully implementing the replacement plan, he said, “will take a while to formulate.”
“I think other Republicans are expressing their optimism that something can happen concurrently,” Buck said. “I think realistically, if we do the process the right way, replacement is going to take a period of time.”
“There won’t be a change that happens next month that is going to completely alter the health care system,” he said.
The possibility of a repeal without clear plans for a replacement has alarmed some health analysts. Currently, about 175,000 Coloradans buy health care coverage from private insurers through the state’s Affordable Care Act exchange. Those insurers are right now deciding what to charge for plans on the exchange in 2018 — or if they want to sell plans on it at all. They must file those decisions with the state in May.
Uncertainty now about an Obamacare replacement could cause insurers to charge more or withdraw from the market, leaving consumers with fewer — and perhaps no — choices.
“Repeal of our existing framework, without a clear picture of what will replace it, is a recipe for disaster for health care in America,” Adela Flores-Brennan, the executive director of the Colorado Consumer Health Initiative, told the Grand Junction Daily Sentinel this year.
Buck dismissed those concerns.
“I don’t think they’re interested in cratering the health insurance market,” Buck said of insurers.
Buck represents Colorado’s 4th Congressional District, which includes all of eastern Colorado and edges into the southeast metro area. During the session break this week, Buck has held relatively small, unpublicized meetings with constituents. At one such meeting in Castle Pines this week, Buck faced angry constituents who shared stories of how the Affordable Care Act has helped them and who expressed concerns that a GOP replacement plan will be less effective.
“We cannot go backward,” one doctor in the crowd told Buck, according to the Colorado Independent, which first reported details of Buck’s views on the timing of repealing and replacing the health care law.
In the interview Thursday, Buck said he wants a replacement plan to cover as many people as possible but stopped short of committing — as President Donald Trump has — that everyone who is currently covered will remain covered. Buck said he opposes requiring people to buy health insurance.
On the expansion of Medicaid, which in Colorado covered an additional 400,000 people, Buck said he believes that anybody who is “able-bodied” should work instead of receiving government-funded health care. Asked about those on Medicaid who already work — the Kaiser Family Foundation has estimated that nearly 60 percent of adult, non-disabled Medicaid enrollees do — Buck said he wants to study the issue more.
“We’ve got to figure out a way that people are consumers in the marketplace,” he said.
