Tough Choices Loom on Long Road to Replacing Obamacare

  • NBC News | by: BENJY SARLIN |
  • 01/08/2017 12:00 AM
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Republicans watched President Obama crash against the shores of health care reform over and over again over the last seven years. Now the wheel is in GOP hands, and the politics are only more treacherous.

Republican leaders are excited at the prospect of fulfilling their longtime promise to replace the Affordable Care Act, Obama's signature legislative accomplishment, and injecting more free market principles into health care. But the path is long, complicated and carries enormous risks, potentially taking the entire insurance system with it in the process.

The main problem is that there is no perfect replacement: Any changes they make to the system will inevitably create new winners and losers, just as Obamacare did. There is a long list of agonizing choices ahead for Republican lawmakers, many of whom are new to the nitty gritty of health care policy.

"There is no way to cover more people, have higher quality, and have it be cheaper," Aaron Carroll, a health care researcher at Indiana University, said. "If there was, everyone would do it.

Under Obama, Republicans successfully defined themselves in opposition to the new health care system. By keeping their fingerprints off the ACA, which passed in 2010 with no GOP votes at all, Democrats were forced to accept political responsibility for the entire health care industry — the good, the bad and the ugly. Now that dynamic will be reversed and it's up to Republicans to fix the system.
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