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Guide to Repealing Obamacare

By Dr. Mona Mangat

I shuddered while reading a play-by-play in the WSJ today for how the new health care law should be ‘defanged’ by those who oppose it. Ms. Turner of the Galen Institute suggests the new law be de-funded, dismantled and delayed because there is no way that President Obama would veto it.


De-funding the new law is a popular theme for many conservatives. I can imagine this will be a highly unpopular strategy as many Americans are starting to feel the benefits of these programs. For example, previously uninsurable patients now have access to a high-risk pool through which they may obtain insurance coverage until National Health Insurance Exchange (NHIE) opens in 2014. As a physician, I encounter many patients who simply are unable to obtain proper care for their chronic disease because they are unable to purchase insurance due to pre-existing conditions such as asthma. Once these benefits are experienced, support for them will continue to grow.


Dismantling key provisions is the next step. Kent Conrad (D-N.D.) has said that the new federal program to fund long-term care—the Community Living Assistance Services and Supports Act, or CLASS Act—is "a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of." Let’s clarify that the CLASS Act is a voluntary, long term care insurance that will provide in-home care, adult day care or assisted care living to elderly and disabled. Enrollees will pay into the program on a sliding scale type of system and not begin to enjoy benefits until they have paid for at least 5 years. As we begin to grapple with an aging population (Seventy million Americans will have turned 65 by 2030), the administration was correct to focus on preventive care, coordination of care and long term care. These interventions all serve to keep our elderly citizens and neighbors healthier and functional for longer periods of time. I see no hidden agenda or Ponzi scheme, just good policies to keep our elderly healthier.


Delaying implementation of key provisions is the next step. It has been suggested that opponents of the Affordable Care Act (ACA) could vote against scheduled cuts to Medicare Advantage (MA) programs. It has been clearly shown that MA programs offer no advantage to their enrollees – they do not enjoy better health, longer life spans, less hospital admissions, etc. What they do is cost the US taxpayers up to 14% more than a traditional Medicare enrollee would. Making MA programs more efficient is a key provision in the ACA that will help fund an extension in the life of Medicare for all seniors. Delaying its implementation would be speeding up the demise of the Medicare system. Maybe that’s the goal??


I remain amazed during this election season at how much energy and money is being poured into ways to repeal health reform. If those who are campaigning on a repeal of the health reform would collectively use their intelligence, power and money, we could surely refine and modify the existing ACA into a very powerful tool to improve the health of all Americans. Ms. Turner and those at the Galen Institute should work towards real solutions to improving the health care of Americans. They should strive to be a constructive, rather than destructive, force in this process.

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