After GOP fails to repeal Obamacare, what’s next for U.S. health care?

obama-240x300As the late, sultry diva Peggy Lee used to croon: Is that all there is?

The Republicans in Washington, after seven years of trying and dozens of faux earlier votes, have failed to repeal and replace the Affordable Care Act. Obamacare, the signature legislation of the previous Democratic administration, persists as the law of the land.

Not hearing champagne corks flying after the end for now of the desperate legislative floundering of Republicans in the House, Senate, and White House?

That’s appropriate. Partisans may yet renew their attacks on the ACA.  And as even its advocates have conceded, Obamacare needs work. Although it has reshaped the American health care system—and now likely will do so for longer still—the program that tens of millions of patient-consumers rely on for health insurance coverage has flaws and these make it vulnerable to bureaucratic foes who would cripple or kill it with neglect or malice.

Will President Trump, as he has long suggested, work to cause critical protections for Americans’ health to “simply implode?” Will Tom Price, the head of the Health and Human Services Department, wage an official campaign to undermine the ACA? Will Republicans in Congress, having seen their last and best Obamacare replacements plunge in public popularity and go up in flames in votes on the Senate floor, now turn to make needed ACA repairs?

Here’s some of what we might wish to be vigilant about in health care policy terms in the next bit:

The GOP’s 2017 fiasco with the ACA got so much coverage that there isn’t much to add. It is worth asking whether the Senate has debased democracy in irreparable fashion, creating an autocratic policy path that Americans should fear will be followed any time in the future.

Republicans came within a few votes of passing Trumpcare in lamentable fashion. The so-called skinny option—for which no hearings ever were held, no experts ever were consulted and a handful of senators knew the details of—was written up as a legislative text during a partisans’ lunch. It didn’t get shared with all members of “the world’s greatest deliberative body” until 10 p.m. that same day. Its opponents, not its backers, had to get the independent Congressional Budget Office to try to score the measure in a dead heat for its costs and effects. Majority Leader Mitch McConnell put it up for a vote in the dead of night.

That’s an awful way to make laws affecting a sector of the economy that comprises 17.5 percent of the GDP and on which Americans spend $3 trillion a year.

In my practice, I see the major harms that patients suffer while seeking medical services and the wrenching economic struggles they put themselves through to try to afford medical care. Our leaders put the country through the wringer for half a year now to accomplish what with the ACA? Is our health care better, more affordable, accessible, or safer? Health care policy isn’t fun. It has been heartening to see that as complex and daunting as it can be, American voters understand its importance and they have exercised their democratic rights to stay all over their lawmakers. They need to keep doing so.

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