Kerby Anderson

During the first week of January, Senator Rand Paul urged Republicans not to repeal Obamacare without having a replacement plan ready. Friday night his phone rang. It was Donald Trump. He agreed with the senator that repeal and replace needs to take place simultaneously. This means that the replace part of the equation will be getting much more attention.

Everyone will have to explain their positions. Those who support the Affordable Care Act and do not want it repealed will have to explain why lower income and middle-income people have to pay so much more for a policy. Many have called my radio program. They will also have to explain whether they support the various HHS mandates that required businesses (like Hobby Lobby) and religious groups (like the Little Sisters of the Poor) to make abortifacients available to their employees.

Those who want to repeal Obamacare, will have to explain what the replacement will look like. And they will have to make clear what mandates and regulations they would keep that address issues like preexisting conditions.

Any replacement must address what I call the four Ps. These are: price, preexisting conditions, portability, and people (that is uninsured people). Every one of these issues is important. Consider the problem of portability. The average millennial will have 12-15 different employers in his/her lifetime. That means he/she will have 12-15 different health care plans. Some of the proposals would disconnect health care from employment.

Dismantling the Affordable Care Act will not be easy. There are now 20,000 pages of regulations. We posted a Facebook picture of what a stack of 20,000 pages of Obamacare regulations looks like. It is overwhelming. The bill created 159 new agencies.

Repeal and replace has been a slogan for most Republican candidates for many years. Now these members of Congress have an opportunity to change the current system. They face a significant task.