EDITORIAL: The Obamacare endgame: Republicans risk chaos if they repeal before they replace the health law

Jan. 08--Republicans are gearing up to repeal Obamacare -- what House Speaker Paul Ryan calls "the first order of business" for the new Congress and the Trump administration.

House and Senate committees will be under intense deadline pressure to write legislation before the end of the month that would undercut major pillars of Obamacare as part of a budget bill. Yes, the GOP is in a hurry to rid the nation of Obamacare.

But remember the second half of the Republican mantra -- "replace." Where is the detailed GOP plan to help millions of Americans who have coverage now under Obamacare? Where is the plan that is locked and loaded for legislative passage, the one a President Trump will sign? Where is the proposal that discourages insurers from bolting the individual market, leaving more people unable to find affordable health coverage?

Nowhere in sight.

Sure, Ryan said Thursday that lawmakers would advance legislation to replace Obamacare this year. And yes, there are reams of proposals and blueprints. One of them, part of Ryan's "A Better Way" agenda, has impressed us. Former Rep. Tom Price, nominated to be Health and Human Services secretary, has an "Empowering Patients First" plan. The House Republican Study Committee recently unveiled another Obamacare alternative.

There are good ideas in these proposals to make insurance more affordable and expand access for Americans. But so far Republicans haven't coalesced around a comprehensive plan, nor persuaded any Democrats to join them in what should be a bipartisan effort.

But Republicans in a rush to jettison the law without first spelling out a superior alternative invite market chaos -- and a political backlash.

If millions of Americans lose coverage, whether by GOP inaction or action, guess who takes the blame? That's why Vice-President-elect Mike Pence says an Obamacare replacement must be done "in a way that doesn't work a hardship on American families who have gained insurance through this program (and) doesn't work a hardship on our economy."

About the economy: The nonpartisan Committee for a Responsible Federal Budget warns that repealing Obamacare could cost up to $350 billion through 2027. That's not chump change. All the more reason to carefully create a more flexible and frugal plan that delivers better coverage before scuttling the old law.

Congress is likely to delay the ultimate elimination of Obamacare for at least a couple of years. But insurers work months ahead to craft plans and set prices. Patients with complex conditions need certainty about their coverage. Obamacare has deep tentacles in many states' laws as well.

Congressional Republicans can't shrug and say to Americans, just wait, give us a few years, we'll have a great new plan. These lawmakers have had years to hone a replacement that can muster White House and congressional support. If they can't agree now, why would anyone believe they'll agree a year or two from now?

The longer Republicans debate, the greater the chances that Obamacare hobbles along. Anyone remember how the "doc fix" -- a federally imposed cut in doctors' Medicare fees -- kept getting postponed year after year because Congress couldn't reach a resolution? The same could happen with Obamacare.

Democratic leaders rammed Obamacare through Congress without a single Republican vote. Then-House Speaker Nancy Pelosi famously (and foolishly) told members they'd have to vote for the bill before they could learn what was in it. That's called hubris.

Republicans can learn from that debacle or repeat it. The GOP can create a bipartisan health care bill that improves on Obamacare's key reforms and promises. It can give patients, doctors, insurers and yes, lawmakers, time to evaluate it.

Millions of Americans have coverage now that they won't -- and shouldn't -- gladly surrender. Republicans, you promised something better, more affordable.

Now deliver.

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