Obama calls GOP plan to repeal ACA without replacement, 'reckless'

President Barack Obama called the Republicans' plan to repeal the Affordable Care Act without an immediate replacement, "reckless" and "irresponsible" in a perspective piece published Friday in the New England Journal of Medicine.

"If a repeal with a delay is enacted, the health care system will be standing on the edge of a cliff, resulting in uncertainty and, in some cases, harm beginning immediately," Obama said, two weeks before he leaves office. "Insurance companies may not want to participate in the health insurance marketplace in 2018 or may significantly increase prices to prepare for changes in the next year or two, partly to try to avoid the blame for any change that is unpopular."

[Also: Obamacare repeal without replace would cost $140 billion in funding, kill more than 2 million jobs]

President-elect Donald Trump has promised to make the repeal and replacement of Obamacare a priority.

While the GOP agrees, Sen. Bob Corker, R-Tennessee, is among a growing number of Senate Republicans calling into question any strategy that would repeal Obamacare without a replacement plan, according to The Hill.

[Also: GOP pushes Affordable Care Act repeal for January]

Republican congressional leaders have said they would repeal the ACA early this year with a promise to replace it in subsequent legislation, Obama said. Republicans have yet to introduce a replacement bill.

"Instead, they say that such a debate will occur after the ACA is repealed," he said. "They claim that a 2- or 3-year delay will be sufficient to develop, pass, and implement a replacement bill."

This approach is irresponsible, and could slowly bleed the health care system, he said. Further, there is no guarantee of getting a second vote.

[Also: 8.8M sign up for Obamacare coverage]

The president also voiced his support for the Centers for Medicare and Medicaid Services Innovation Center.

"Physician practices may stop investing in new approaches to care coordination if Medicare's Innovation Center is eliminated," he said. "Hospitals may have to cut back services and jobs in the short run in anticipation of the surge in uncompensated care that will result from rolling back the Medicaid expansion."

Rising healthcare costs could affect employer hiring, or reduce raises, he said.

"And people with preexisting conditions may fear losing lifesaving healthcare that may no longer be affordable or accessible," he said.
A GOP replacement plan that maintains protections for people with preexisting conditions without requiring the individual mandate for insurance that's now in place would cause premiums to rise and cost millions of Americans their coverage, Obama said.

"A recent Urban Institute analysis estimated that a likely repeal bill would not only reverse recent gains in insurance coverage, but leave us with more uninsured and uncompensated care than when we started," he said.

Improvements to the ACA are needed to address a lack of choice in some health insurance markets, premiums that remain unaffordable for some families, and high prescription-drug costs, Obama said.

For example, allowing Medicare to negotiate drug prices could both reduce seniors' spending and give private payers greater leverage.

"But, persistent partisan resistance to the ACA has made small as well as significant improvements extremely difficult, he said.

This week, the Senate Budget Committee put the means to gut Obamacare in a budget resolution that enables Republicans to repeal the Affordable Care Act with a simple majority vote. A floor vote in the Senate is expected next week.

The budget resolution has a budget reconciliation bill that includes language repealing major parts of the ACA.

"What the past 8 years have taught us is that health care reform requires an evidence-based, careful approach, driven by what is best for the American people," Obama said. "That is why Republicans' plan to repeal the ACA with no plan to replace and improve it is so reckless."

Twitter: @SusanJMorse