From a leaked secret recording of the Republican retreat in January to Senator Bob Corker’s remarks yesterday, more and more evidence is surfacing to suggest Republicans don’t have a concrete plan for replacing the Affordable Care Act.
The tape from the retreat shows Republican representatives grappling with big questions surrounding cost, coverage, Planned Parenthood, and the health insurance market, while Senator Corker said “There’s not any real discussion taking place right now.”
According to Medical Ethicist Art Caplan, these public snafus indicate a larger problem beneath the surface.
“The Republican party [and] Trump have come up against a rock and a particularly hard place, which is they don’t have anything,” he said. “They have no idea how they’re going to repair or replace this program.”
The Affordable Care Act (ACA) has faced opposition since its first day of implementation; three representatives filed three separate bills calling for its repeal the day after it was signed in 2010.
Opposition by Republicans has continued for the last seven years, despite the fact that the ACA has reduced the number of people without health insurance and has lowered overall healthcare spending.
Caplan said Republicans struggle to create an alternative because the ACA was a moderate plan with good coverage, similar to the one adopted by Massachusetts.
“To go in any other direction would take them either toward Democratic ideas about single payer which... I think are politically impossible right now, or back to more market approaches, which have no chance of continuing the same level of coverage for the same number of people,” he said. “There are too many sick, at risk, and pre-existing condition folks.”
Caplan conceded the ACA had financing troubles, while defending the act as the most viable healthcare option.
“If you have very sick people, a lot in Medicaid, a lot with preexisting conditions, the only way to move ahead in terms of continuing their coverage and not chopping out benefits, is to basically keep something like [the ACA] that’s funded properly,” he said. “There’s no other option, and the Republicans will see that soon enough.”
Art Caplan is the Drs. William F. and Virginia Connolly Mitty Chair, and director of the Division of Medical Ethics at NYU Langone Medical Center. He’s also the co-host of the Everyday Ethics podcast.
