Editor’s Memo

Repeal and Replace Is the Story


The timing is uncertain. And the gory details will emerge only after many turns of the legislative meat grinder. But the appointment of Tom Price as HHS secretary has removed any doubt that repealing and replacing the ACA will dominate health care this year—and many to come.

There are other issues. We’re diving into biosimilars this month and whether they can take some of the gallop out of runaway pharmaceutical costs. The short answer: well, maybe. For the long one, see our coverage.

But repeal and replace is the story.

Many health care policy experts believed—some quoted by us—that the ACA was here to stay. Not all, though. Princeton’s Paul Starr said in an interview published in our September 2016 issue that he had doubts about the ACA being “a permanent part of the American policy landscape”—and he saw it that way even if Clinton had won.

It may seem like we are driving off a cliff, but Republicans and conservatives have some fairly well-developed ideas about what to swap in for the ACA. In her interview with Contributing Editor Richard Mark Kirkner in this issue, Diana Furchtgott-Roth of the Manhattan Institute limns the broad outlines of some of them: eliminating the federal benefit mandates, turning regulation back to the states, high-risk pools.

Before Price was confirmed by the Senate, Sarah Kliff at Vox wrote an excellent summary of the repeal-and-replace legislation he introduced as a Republican congressman from Georgia. (Kliff, like Starr, is worth reading and paying attention to.) Continuous coverage figures prominently. Read up on it if you want to understand the GOP plans.

In Kliff’s critique, the Republican vision of a deregulated individual insurance market will advantage the young and the healthy over the old and the sick. We’ll hear more about that from the Democrats, and the Republicans will push back.

With apologies to the late, great Maurice Sendak, let the wild repeal-and-replace rumpus start.

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