Former Wisconsin governor and U.S. Health and Human Services Secretary Tommy Thompson said Republicans will repeal the Affordable Care Act, but they haven’t decided on a replacement.
President Donald Trump has promised insurance for everybody. House Speaker Paul Ryan and U.S. HHS nominee Tom Price have said they want to ensure access to health care. Thompson, who served under President George W. Bush, spoke at a WisPolitics luncheon Tuesday in Madison. He said it will be difficult and expensive to cover everyone.
“Everything is possible in Congress but its going be very difficult,” Thompson said. “It’s going to be very expensive.”
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Support is building for what Thompson calls a “repeal and repair” bill. But he said members of the House Freedom Caucus want to repeal Obamacare taxes right away, then come up with a replacement later.
“So there’s no really comprehensive plan yet in which everybody knows what they’re going to do,” Thompson said. “It’s still up in the air.”
Thompson said he’s been in contact with HHS nominee Price and is “plugged in” to Republican plans. Thompson expects piecemeal legislation that he said will improve Obamacare. For instance, selling insurance across state lines. Also, coverage would be less regulated than the plans under Obamacare; those plans had required benefits and different pricing depending on the level.
“They want an unlimited insurance exchange which doesn’t sell just a platinum, gold, silver and bronze,” Thompson said. “They want to be able to sell anything on there unfettered free enterprise. So anything that insurance companies wants to sell on the exchanges will be able to sold.”
Thompson said one of the biggest problem Republicans have in unraveling the ACA is deciding at what level to fund Medicaid. He said several Republican states expanded Medicaid under Obamacare – 13 states, including Wisconsin, did not take federal funding.
“Are you going to be able to cut back on those states that took federal dollars to (expand Medicaid) so that states like Wisconsin do not get hurt? Or are you going to move all the states up to the expanded match so that everybody’s treated equitably? And that right now is turning out to be a huge fight.”
Thompson predicts Congress will approve Medicaid block grants in some form. The question, he said, is whether it will be a lump sum or per capita. Gov. Scott Walker favors block grants, part of Speaker Ryan’s health plan known as A Better Way.
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