Obamacare's Death Could Be Faster Than Republicans Intend : Shots - Health News Congressional leaders say they want a smooth transition from Obamacare. But insurance consultants say repealing the law before another plan is in place could jeopardize the insurance of millions.

Obamacare's Demise Could Be Quicker Than Republicans Intend

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Republican leaders in Congress say they'll vote to repeal much of the Affordable Care Act early next year. They envision a slow, drawn-out end to President Obama's health care law so that millions of people wouldn't lose their health insurance right away. That would also give them time to come up with a replacement.

The transition period could last months or even years. NPR's Alison Kodjak reports on the risks of that repeal and delay strategy.

ALISON KODJAK, BYLINE: Republican leaders have spent the last few weeks arguing that Obamacare is, as President-elect Donald Trump says, a disaster. And they're promising to repeal it early in 2017. Here's House Speaker Paul Ryan last week on CNBC.


PAUL RYAN: Obamacare is hurting people. We are seeing consistent double-digit premium increases, huge deductible increases, and the insurers are pulling out.

KODJAK: But Ryan and his colleagues also say they don't want to suddenly leave millions of people who have insurance through Obamacare with no coverage at all. So the latest plan - vote to get rid of the law, but delay its demise while they come up with something new. That means Republicans have to keep Obamacare going for months or even years.


RYAN: There needs to be a reasonable transition period so that people don't have the rug pulled out from under them.

KODJAK: But not everyone thinks that's a good idea.

ROBERT LASZEWSKI: I don't think the Republicans have come to grips yet that it's going to be their responsibility to keep the wheels on Obamacare.

KODJAK: That's Robert Laszewski, a health policy consultant. He says Republicans keep saying the Obamacare exchanges are collapsing, but by voting to kill the law, they may just speed up that process.

LASZEWSKI: While they're arguing that the thing is in death throes, that insurance companies are losing tons of money and it's not sustainable - well, so it's going to be losing tons of money. It's not going to be sustainable for this two-year transition period. Why do they think the insurance companies are going to provide the insurance policies in that scenario?

KODJAK: Laszewski isn't the only one who's skeptical of the repeal-and-delay strategy. Last week, America's Health Insurance Plans, the trade group that represents health insurance companies, circulated a memo on Capitol Hill warning that a sudden repeal of Obamacare could jeopardize the individual insurance market. They asked lawmakers to keep in place many of the financial incentives that are central to the law, including subsidies for people to buy insurance and cover co-payments.

And the American Academy of Actuaries warned in its own letter that a repeal with no replacement would be dangerous to the long-term health of the market. Cori Uccello is one of the Academy's senior fellows.

CORI UCCELLO: So insurers are in a situation right now where they're trying to determine whether or not they're going to participate in 2018. And part of that depends on whether in the long run it makes sense for them to participate in the market and in the long run depends on what's going to happen not just in 2018 but in the years after 2018.

KODJAK: The big problem is that through Obamacare, the government plays a huge role in helping people pay for insurance. So if companies think the government won't keep doing that, at some point, they could just stop selling individual policies.

Shubham Singhal leads the health care practice at the consulting firm McKinsey. He says insurance companies have to decide by spring whether to offer individual policies in the following year.

SHUBHAM SINGHAL: They will have to see more than the repeal element. They'll have to see whether delayed or otherwise. And if it's delayed, then what's the transition plan? That's going to be quite important for them to understand whether it creates a stable marketplace or not.

KODJAK: Which means Republicans may not have as much time as they now hope to come up with a new health care plan. Alison Kodjak, NPR News, Washington.

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