Sen. Lamar Alexander, R-Tenn., sounded bullish Wednesday on the prospects for repealing and replacing the Affordable Care Act, despite an emerging rift among Republicans over how to overhaul the health care law and put something new in place.
Alexander, chairman of the Senate Committee on Health, Education, Labor and Pensions, said he and other lawmakers will “do most of our legislating on that this year—most of it, perhaps, before summertime.”
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His remarks at a National Association of Health Underwriters conference on Capitol Hill spelled out a quick, ambitious legislative schedule for unwinding the ACA.
Alexander drew a distinction between the pace of the legislative efforts and the actual implementation of the repeal-and-replace plan, saying “the effect of it should take place only when there are concrete, practical alternatives in place for people to choose among.”
“The American people deserve to have Obamacare repaired, but it needs to be done in the right way, in the right amount of time, and not just some quick-fix that makes it look good … but doesn’t really try to improve it,” he said.
“There’s no reason we shouldn’t do the legislative issue,” he said. “We’ve been thinking about it for five or six or seven years.”
“But to implement what we decide to do probably will take several years,” he added, “as we think about the individual market, how we deal with states on Medicaid and whatever we decide to do make adjustments to the employer market.”
Newly emboldened with a Republican in the White House, congressional Republicans have faced pushback at town halls across the country as constituents protest efforts to repeal the Affordable Care Act.
Against the backdrop of those tensions, Republicans are divided over the approach to dismantle the law. House Speaker Paul Ryan has proposed using the budget reconciliation process with several stop-gap replacement provisions, while the conservative Freedom Caucus has advocated for a more aggressive approach that would entail an outright repeal that forces lawmakers who support the ACA to come to the bargaining table.
In her address at the NAHU conference Wednesday, Rep. Kyrsten Sinema, D-Ariz., said “a full repeal without a reasonable and thoughtful replacement would be devastating.”
Alexander appeared to support taking gradual steps to reform the nation’s health care system, beginning with individual markets.
“If your local bridge was very near collapse, what would you do about it?” Alexander asked. “Well, you would send in a rescue team to try and fix it to make sure nobody else was hurt while trying to cross the bridge. And you would immediately start to build a new bridge. And you wouldn’t close the old bridge until the new bridge was completed and safe for people to go across. That’s the way I think about what we’re trying to do. We’re going to have to send in a rescue team on the individual market.”
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