Kerby Anderson

Is it really possible to repeal and replace Obamacare? That is what Donald Trump and many Republican candidates have been saying for months. Dr. Merrill Matthews says they will face some significant challenges in trying to keep that campaign pledge.

Republicans may still have a slim majority in the Senate, but they do not have the necessary 60 votes to end a filibuster. Unless they can find a number of Democrats willing to join them, they won’t be able to pass a full repeal of Obamacare.

They might be able to repeal part of the Obamacare through the reconciliation process (that only requires 51 votes). Even if they are able to accomplish that, many of the regulations from the Affordable Care Act will remain.

Perhaps the greatest challenge exists within the ranks of the Republican Party. While most would favor repeal, it is the replace part where there is some division. Various factions favor different solutions to replace Obamacare.

There are a few things that the president-elect and the future Congress can and should do. First, establish tax fairness. People who get their health insurance through an employer get a tax benefit the rest of us who buy our health insurance as individuals do not. This would help the self-employed and others without employer-provided coverage.

Second, Congress can and should expand benefits like Health Savings Accounts. This puts more economic power in the hands of the patient and has been demonstrated to lower health care spending. Dr. Ben Carson has been a leading advocate of these Health Savings Accounts and should be given a prominent role to promote them.

Third, Congress could allow people to buy health insurance across state lines. This would introduce competition and provide greater consumer choice.

Repeal and replace may not happen next year, but that cannot be an excuse for Congress sit idle when many Americans are facing problems with their health insurance. There many things they can do.