The One Republican Who Wants to Keep Obamacare
Policy + Politics

The One Republican Who Wants to Keep Obamacare

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While Republicans continue waging war on Obamacare, one of their own remains adamantly supportive of the president’s healthcare law and is encouraging lawmakers to set aside politics and let health reform work.

Dr. Louis Sullivan, former Health and Human Services Secretary under President George H. W. Bush says he sees promise in the law, which has extended insurance to more than 9.5 million people since it took effect, the Los Angeles Times reported Monday.

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Sullivan said that though the law has some issues that need to be worked out, it is “not fatally flawed.”

“I'm for the Affordable Care Act – it has some issues, but rather than working to try to dismantle it, we should really try and work together to make this work," Sullivan said. He noted that the more than 6 million who have signed up for coverage on the exchanges signals that the law is beginning to really take hold. 

Bush’s former HHS secretary’s views are out of step with congressional Republicans, who have relentlessly targeted Obamacare since it took effect. They argue that the law, which will cost over $1.5 trillion according to the Congressional Budget Office, is both a debt increaser and a job killer.

So far, they have voted more than 51 times in the House of Representatives to repeal or dismantle the law. And as the midterm elections loom, the GOP is gearing up for another round of votes to carve away at Obamacare.

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Sullivan says he strongly disagrees with using the health care law as a political strategy. “There should be less politics in addressing health care issues.”

He argued that several major provisions within the Affordable Care Act were part of a plan he helped craft under Republican President George H. W. Bush in 1991. That framework included the individual mandate—the provision most staunchly opposed by today’s Republicans, which requires Americans to have health coverage. Sullivan noted that the conservative Heritage Foundation lobbied in support of the individual mandate, which the organization now opposes. The Republican plan also included a concept similar to the health insurance exchanges, as well as subsidies to help make coverage more affordable.

“If they supported it then, why is it so hard to get it through now?” Sullivan asked at a health conference in Denver on Thursday. “Now the Republican Party is attacking that same concept… I’m not for that kind of political one-upmanship.”

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Still, the GOP leadership is forging ahead with plans to repeal the law and replace it with their own alternative ahead of the midterm elections. Though no formal plans have been proposed, the Washington Examiner reports that the Republican framework will likely include provisions to reduce fraudulent malpractice lawsuits, allow consumers to purchase insurance across state lines and encourage small businesses to pool resources and lower the cost of insurance they offer to their employees.

“Repealing Obamacare is a prerequisite, but we will also share our alternative approach with working middle class families being harmed by that law,” said House Majority Leader Eric Cantor, who is spearheading the effort.

However, administration officials and health policy experts, including Sullivan, agree that repealing and replacing the law in the near future is likely unrealistic.

“If this were to be repealed my concern is that it would take a decade or more to replace,” Sullivan said. Adding that he hadn’t heard any real alternatives to the law.

Related: Will States Opt Out of Medicaid Expansion

Recent polls have shown that the majority of Americans would prefer to see the law fixed, instead of repealed.

Sullivan, who now serves as CEO and chairman of the Sullivan Alliance, a nonprofit that works to improve health care for low-income Americans, railed against the 21 Republican governors who did not expand their Medicaid programs under the law. 

“I do not agree with these governors,’’ Sullivan said, adding that those states that did not expand coverage were leaving money on the table.

Under the law, the federal government fully funds states’ Medicaid expansion programs for three years, then at 90 percent thereafter. Most governors who did not expand the program say they feared their states would not be able to afford it down the road.

In Sullivan’s home state of Georgia, Gov. Nathan Deal rejected Medicaid expansion—which would have provided about 650,000 low-income people with health coverage- because of the long-term costs.

“I think that is something our state cannot afford,” Deal said to the Atlanta Journal Constitution. He added that it “is probably unrealistic to expect that promise (of federally funding) to be fulfilled in the long term, simply because of the financial status that the federal government is in.”

Related: The Growing Puzzle Over Obamacare Enrollment

Sullivan, who chairs Georgia’s Grady Health System, said he was particularly disappointed with Deal and said his state couldn’t afford not to expand Medicaid.

The Congressional Budget Office previously estimated that states would spend just about 2.8 percent more on Medicaid with health reform than without it.

Sullivan said if Georgia decided to expand its Medicaid program, the federal money could go toward helping pay the salaries of health care providers at places like Grady hospital, which he said is always on a tight budget.

When asked if he thinks Georgia will expand Medicaid in the future, Sullivan seemed doubtful. “It is certainly my hope that it does happen …without expanding the program, we’re still left with this problem of uninsured people.”

Sullivan, who was recently named a “Republican trailblazer” by the National Republican Committee, is one of the only conservatives who has publicly embraced Obamacare. When asked whether he would advocate the law to his fellow Republicans, he said he did not wish to be a part of the political debate, and only views health reform through the eyes of a physician.

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