Many conservatives are amping up their push for a quick repeal of the ACA, even if it means coming up with a replacement plan later. Meanwhile, those who are still working on a replacement are having a hard time answering how they will maintain coverage for those who purchased insurance from the ACA's exchanges and protect those with preexisting conditions.
That's because it will be extremely difficult — if not impossible — to maintain these gains without certain foundational elements of the current health reform law, such as the individual mandate, according to Jonathan Gruber, PhD, an MIT economist who worked as a consultant to the Obama administration during the creation of the ACA.
"You don't like the mandate? That's cool," said Dr. Gruber, according The Boston Globe. "How are we going to [subsidize the sick?] What's your answer for that? Current alternative plans have no answer for that."
Here are three thoughts from Dr. Gruber on the GOP's ACA repeal and replace efforts, according to The Boston Globe.
1. Dr. Gruber and other healthcare experts who spoke at a forum at the Harvard Kennedy School on Monday said an ACA replacement plan will take a minimum of several months to go through Congress and years to fully implement, according to the report.
2. He said health insurance could be expanded to the newly insured under the ACA without the individual mandate if there was a reinsurance program that paid insurers for covering the nation's sickest. "That could work, if you spend enough money," said Dr. Gruber, according to the report, "But we're going to have to increase the deficit to do that."
3. While some argue that health savings accounts could help low-income families afford health insurance, Dr. Gruber disagrees because he said the poor don't have much money to set aside for them.