EDITORIAL: Replacing federal health law should be an open, collaborative process

Jan. 10--AS they begin the work of dismantling the Affordable Care Act, perhaps Republicans will take a lesson from House members' missteps in trying to retool the Office of Congressional Ethics. Simply put: strong-arming won't cut it.

Many Republican House members, including some in the Oklahoma delegation, believed the ethics office needed major reform based on how it has operated the past several years. That may well be true. Yet Republicans decided behind closed doors to change it, and wound up reversing course one day later after Democrats cried foul and the media pitched the effort as something nefarious.

Republicans shouldn't make the same mistake with Obamacare. Indeed, Democrats learned with their passage of that bill in 2010 how costly it can be to enact policy without buy-in from the other party. As The Wall Street Journal's Kimberly Strassel noted, "Senior Democrats crafted Obamacare in lobbyist-filled backrooms, forgoing hearings, markups, even input from their own colleagues -- much less Republicans. It was an exercise in secrecy and control."

And while President Barack Obama and other Democrats hailed the law's passage, the process left a bitter taste not just with Republicans in Congress but with the general public. That was reflected in the 2010 midterm elections.

The U.S. Department of Health and Human Services notes that Oklahoma's uninsured rate was 13.9 percent in 2015, compared with 18.9 percent in 2010. That means about 192,000 more people gained insurance under the Affordable Care Act. Some parts of it are popular, such as prohibiting insurance companies from denying coverage for those with pre-existing conditions, and allowing young people to stay on their parents' insurance policies until age 26.

On the other hand, premiums have soared. In Oklahoma, the increase this year is expected to average 76 percent. In addition, those on the federal exchange in Oklahoma have only one insurance company available to them.

Republicans have made "repeal and replace" their battle cry since the election of Donald Trump. The first part of that equation shouldn't be much of a hill to climb; the back half will involve considerable heavy lifting.

What will a repeal plan look like? Opponents of Republicans' plans suggest the GOP has no answer for that question. In fact, the GOP has done plenty of work in this area. Former Oklahoma Sen. Tom Coburn helped produce the original "Patient CARE" act, which included such things as means-tested tax credits that people could use to buy insurance products or deposit into health savings accounts.

Rep. Tom Cole, R-Moore, said last week that his GOP colleagues in the House are set on producing a system that "addresses many of the same challenges that Obamacare attempted to deal with, but failed miserably, including increased access to health care by the uninsured population and lower premiums."

That sounds promising, but Republican members in both chambers should insist on open debate about all proposals, and they should work to gain the support of Democrats -- particularly moderates who face re-election in two years.

"A GOP sales campaign can help make those moderates more comfortable joining up and more fearful of voter backlash if they obstruct free-market reforms," Strassel wrote. "But a bipartisan coalition will require some honest give. If Republicans take the Democrats' approach -- if they are too pure to negotiate -- they will fail."

We'll see what path Republicans choose to follow.

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