Resting squarely on the shoulders of the newly-minted secretary of health and human services is the GOP's longtime quest of unraveling and replacing the Affordable Care Act. Not only that, but to do it in a way that would keep insurance affordable for millions of Americans, prevent pandemonium in the insurance market and walk back the government’s role in health care.
The task is certainly high-risk, high-reward. The political dividends could be substantial for Republicans if they succeed, but they face the wrath of voters at the ballot box, much as Democrats have since 2010, should they fail. And Democrats appear content to let Republicans face the challenge on their own.
As President Donald Trump’s top health care emissary, a key task for Price will be leveraging his deep ties with congressional Republicans, forged after more than 12 years in the House, to rally them behind a single repeal and replace strategy.
"Having Dr. Tom Price at the helm of HHS gives us a committed ally in our work to repeal and replace Obamacare and finally provide Americans with a better system," Speaker Paul Ryan said of Price on Friday.
Tensions have been running high at local congressional outreach events, including in Georgia, and there’s been much hand-wringing in some Republican circles about moving to repeal Obamacare without a replacement plan ready.
Overall, there's broad agreement among Republicans that Obamacare’s mandates should be replaced with a more market-based system that incentivizes, rather than forces, people to buy health care. From there, the party begins to splinter.
There are more than a dozen replacement plans circulating around Capitol Hill, including one authored by Price. Sen. Rand Paul, R-Ky., recently unveiled a plan that would provide tax credits to people buying insurance and encourage health savings accounts, and his GOP colleagues Bill Cassidy and Susan Collins have another, more patchwork-like proposal that would let states decide how to provide health care, including by keeping Obamacare.
Trump also previously mentioned releasing a proposal of his own after Price got confirmed, and Capitol Hill Republicans appear to be waiting for that before coalescing around any other plans.
Price’s task will be to help find consensus between Trump, conservatives itching to quickly repeal Obamacare and other Republicans worried about not having a replacement plan ready first. Even among Georgia’s 12 Republicans in Congress there are differences in opinion about timing and strategy.
Price hasn't delved into specifics now that he's health secretary (he hasn't spoken publicly since his confirmation hearings or granted an interview since he was nominated). He has generally discussed his desire to bring health care decision-making back toward the states, doctors and their patients and help Americans harmed by Obamacare while also not "pulling the rug out from anybody."
As health secretary, Price also has authority on his own to rewrite or reinterpret the guidelines that help implement the Affordable Care Act, which gives him substantial power over the future of the law.
He could, for example, tweak the benefits that the people receive under Obamacare. Julie Rovner over at Kaiser Health News has a great primer on five quick things Price could do right out of the gate, including tweaking the guidelines related to Obamacare’s birth control directive and Planned Parenthood.
At the top of his list in the short term will likely be some sort of action that provides assurance to the health insurers participating in Obamacare’s exchanges, according to Joseph Antos, a health care expert at the right-leaning American Enterprise Institute. It will take Republicans some time to craft a replacement plan, and people will still need access to insurance in that intermediate period.
Obamacare enrollment in Georgia declined by 16 percent last week.
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