Panel discusses ACA repeal, future of health reform

As efforts to repeal the Affordable Care Act ramp up, health policy experts are weighing in on the possible impacts of replacement goals and what parts of the far-reaching healthcare law work and what parts don’t.

The Kaiser Family Foundation and the Committee for a Responsible Federal Budget hosted a public forum Tuesday morning where at two panels of industry insiders from both sides of the aisle sounded off on healthcare reform.

Elizabeth Fowler, Ph.D., vice president of global health policy for Johnson & Johnson and one of the architects of the ACA, stressed that GOP leaders—many of whom are pushing for a quick repeal while details of a replacement remain scant—should hesitate to completely start over, though she noted there were a number of areas for improvement within the law.

“Are we there yet? Not quite,” Fowler said. “But let’s not tear everything down and start from scratch.”

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Stephanie Carlton, a consultant with McKinsey & Company and a former health policy adviser in the Senate who worked on Jeb Bush’s presidential campaign, said that conservatives are still concerned about the rate of inflation in healthcare costs in the post-ACA healthcare landscape, though she did laud its efforts to reduce the uninsured rate.

Carlton pointed to several areas where healthcare reform still needs to work, notably in improving efficiency as the system transitions away from fee-for-service payment models and in looking more at population health initiatives and the social determinants of health. People with unmet social needs can become a burden on the healthcare system as they are frequent “superusers” that contribute to overcrowding, FierceHealthcare previously reported.

The panelists also discussed the role of President Donald Trump in the repeal effort and whether a bipartisan solution is possible. Avik Roy, president of the Foundation for Research on Equal Opportunity and author of “Transcending Obamacare,” said he thinks Trump’s call for “insurance for everybody,” which conflicts with the Republican party line, suggests he can shepherd an effective effort to replace the law.

“I think it’s been actually very helpful to the debate that Trump has been outspoken about universal coverage,” Roy said. “My hope is that the president can be a very important part in steering Republicans in the right direction.”

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Roy acknowledged that a contentious campaign and concerns about Trump’s moves in his first days in office may make that difficult.

Harold Pollack, Ph.D., a professor at the University of Chicago and a fellow at the progressive think tank The Century Foundation, said that the “knife fight” over the law could hinder progress, especially as elements of good policy may not make for good politics. Democrats are likely to turn to the “victory of no,” just as Republicans did under the Obama administration.