U.S. President-elect Donald Trump gestures during a news conference in New York, the United States, on Jan. 11, 2017. U.S. President-elect Donald Trump met the press Wednesday for the first news conference since the election. (Xinhua/Gary Hershorn)
by Matthew Rusling
WASHINGTON, Jan. 11 (Xinhua) -- U.S. President-elect Donald Trump wants to repeal and replace outgoing President Barack Obama's historic healthcare overhaul, also known as Obamacare. But some experts said that might not be so easy.
The landmark legislation was seen as part of Obama's legacy, as the controversial health care plan aims to get health insurance to millions of low income people. But critics have blasted the plan as imposing unfair and very expensive tax burdens on the middle class.
The Republican Party (GOP) has during the Obama administration called for the repeal and replacement of the legislation, and now Trump said he aims to make this a priority.
But some experts said pulling the legislation may be easier said than done.
"The GOP would like to repeal all of Obamacare and then start anew with a different approach. But it is not clear they have the majority support in the Senate to do this," Brookings Institution's senior fellow Darrell West told Xinhua.
Indeed, it remains unclear whether there is an adequate replacement for a system that now insures over 1 million Americans, and some lawmakers are reluctant to kill the program and leave Obamacare subscribers in limbo.
Some Republicans already have introduced an amendment to delay repeal until a replacement is provided. They want details on what comes next so they don't get blamed if millions of people lose their health insurance, West said.
The problem is each provision affects big parts of the health sector. Getting rid of Obamacare may lead people without insurance to go to hospital emergency rooms for medical care. This will create enormous financial problems for hospitals, he said.
Part of the healthcare law stipulates that all Americans must purchase healthcare coverage or pay a fine, a very controversial measure that critics have blasted as government inappropriately overstepping its boundaries.
Removing the individual mandate means many healthy young people will get rid of their coverage, which will leave insurance companies with sicker, older people as customers. That will drive their costs upward, West said.
At the same time, Republicans would like to repeal a law that requires insurance companies to have a physical office in states where they operate, something that free market advocates have blasted as limiting competition in the industry.
But it will take 60 votes in the Senate to do this, which Republicans are not likely to have since most Democrats will oppose this change, West said.
So the political situation is pretty uncertain at this point, he said.
Dan Mahaffee, an analyst with the Center for the Study of the presidency and Congress, told Xinhua that the GOP will have to keep some parts of Obamacare due to political pressure especially a provision preventing insurers from discriminating against preexisting conditions, as a well as a provision that allows young Americans to stay on their parents' insurance until they turn 26.
Furthermore, there are aspects of it that healthcare providers have built their operations around that will require careful consideration to avoid significant market disruption.
Because of these factors, there will be parts of the GOP proposal that keep or clearly echo aspects of Obamacare, he said.
Julian Zelizer, professor of history and public affairs at Princeton University, told Xinhua that the GOP will try to repeal all of Obamacare, or at least make a symbolic demonstration that they will follow through on their promise to do so.
But gradually, Republicans will have to use other methods to weaken the program, such as budget cutting, weak administration and incremental cuts to the program, he said.
There also remain concerns that the GOP may repeal a great deal of the healthcare law without providing a replacement.
It could be disastrous for Americans and for the health insurance industry. Many Republicans in Congress are aware of this risk and the feedback effects on the party can be very costly, he said.