It was a popular election rally cry … and will be one of President Trump’s top priorities.
Trump: We’re going to repeal and replace Obamacare. We have no choice we have no choice. We have absolutely no choice”
Trump supporters want him to follow through.
Mike Sappe: I think it was a Nice try, but it did work. It needs to be tore down, dissected bad things get rid of and improve on, get rid of what don’t work.
Now the big question is: what comes next. Nathan Nascimento is a senior policy adviser at the conservative Freedom Partners Chamber of Commerce.
Sharyl Attkisson: There was bipartisan agreement that something has to be done, whether it's a fix or a complete overhaul or however you want to term it. How does that begin?
Nascimento: Just moving forward with a full-on repeal and replace measure is not going to solve the underlying problems. It's just going to make things worse.
Attkisson: What do you think needs to be done?
Nascimento: I think, as you start to target specific problems with the law, you allow for the multitude of free market solutions, market-centered, patient-centered solutions to arise to the surface. You allow for a number of ideas to see the light of day, not just jammed in a massive bill that's going to be stuck with a bunch of cronyism, a bunch of giveaways to uh big corporations, we want to bring this back to the people and let the market flourish.
Attkisson: So instead of a massive bill as you describe it, are you saying there should be a lot of smaller laws addressing targeted slices of issues?
Nascimento: Yes, absolutely. I think that, I think that's one way that you ensure that people are actually getting what they want.
What people want is insurance that actually covers their medical expenses without sky high deductibles and unaffordable premiums. Which was the promise of the Affordable Care Act in the first place.
Pres. Obama: It will provide more security and stability to those who have health insurance. It will provide insurance for those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government. (Applause.
Robert Laszewski: You know what, I told them not to call this the affordable care act.
Sharyl Attkisson: You told who?
Robert Laszewski: The Obama administration. The Democrats. Every Democrat I could find
Robert Laszewski is a policy adviser and analyst for the insurance industry. He's correctly predicted Obamacare's pitfalls since day one.
Robert Laszewski: The fundamental problem is not enough healthy people have signed up to pay for the sick, and not enough healthy people have signed up because the insurance plans that people are being offered just simply aren't of good value.
Sharyl Attkisson: What do customers see as wrong with the insurance product?
Robert Laszewski: The insurance products consumers see are still too expensive in terms of premium. And the deductibles and copays are too high.
Congress passed Obamacare in 2010 without a single Republican vote-- with the Democrats’ House leader Nancy Pelosi admitting even they didn’t know exactly what was in the bill’s 2,700 pages. Since then, some in Congress say it’s created a 20,000 page stack of rules and regulations.
Nancy Pelosi: We have to pass the bill so you can find out what’s in it away from the fog of the controversy.
Nascimento: We've looked at what happened with Nancy Pelosi, and we look back in time and we say, you have to pass the bill in order to know what's in the bill. We've learned our history from uh what happens when Congress passes the massive bills, that it's chocked full of a whole bunch of bad things and that, that don't really meet the needs of people.
Philadelphia investment adviser Rich Weinstein became a citizen journalist and in 2014 unearthed a series of online videos showing Obamacare architects admitting that they intentionally fooled the public about what was in store for them under the Affordable Care Act.
Weinstein: I started noticing more in the news that these people called architects were out there basically trying to influence public opinion and I figured these architect people were, they were mostly academics and I thought maybe they would leave a trail of breadcrumbs for me to figure out what was going on.
One star in these videos was Obamacare architect Jonathan Gruber, an economist at the Massachusetts Institute of Technology.
Jonathan Gruber: Look, I wish Mark was right. We could make it all transparent, but i'd rather have this law than not.
In a series of remarkable policy talks at conferences and in academic settings, Gruber seems to brag that Obamacare only passed through its lack of transparency and the stupidity of voters. For example, Gruber says he and other backers of Obamacare hid the fact that it would be costly to healthy Americans.
Gruber: If you had a law which said healthy people are gonna pay in, you made [it] explicit that healthy people pay in and sick people get money, It would not have passed okay. Lack of Transparency is a huge political advantage and basically, you know, call it the stupidity of the American voter or whatever, but basically that was really, really critical to getting the thing to pass.
Sharyl Attkisson: At its core, it was supposed to provide affordable insurance for everybody who needed it.
Robert Laszewski: Yes. The Affordable Care Act was supposed to ensure that whether you were employed or unemployed or self-employed, you would have access to affordable health insurance. For someone who's not getting a subsidy, who's paying the full cost of insurance, it's, it's likely that they're now paying about double what they paid before under the old market, where only healthy people could get in.//
Sharyl Attkisson: Can you explain in simple terms how the insurance companies are losing so much money if they're charging so much for premiums and if deductibles are so high?
Robert Laszewski: It's real simple. If you only provide a health insurance plan that the sickest people buy, you can't charge enough.
It's expensive, say experts, because nearly all of the government's plans to increase competition have backfired. Take the abysmal failure of the Obamacare co-ops: 23 nonprofits started up with your tax dollars. After sometimes paying exorbitant salaries to their executives, they've gone belly up one by one.
Robert Laszewski: There were 23 and 17 have gone broke so far.
Sharyl Attkisson: And that's our tax money that went down the tubes with it.
Robert Laszewski: About 3 billion dollars when it's all over, yeah.
For-profit insurance companies are jumping ship, too.
Robert Laszewski: Like Aetna, Humana, United Healthcare, some Blue Cross plans pulling back. A number of Blue Cross plans losing substantial amounts of money and having to go after major rate increases to stay in the business.
When it comes to replacing Obamacare, it will be complicated. And voters will likely demand more transparency this time.
Attissson: If you could wave a wand, what would the new system look like?
Nascimento: One that is free, for people to pick and choose whether it's health insurance plans or not even carry a health insurance plan. That they have a multitude of options to be able to see doctors whether they have that piece of plastic in their wallet or not. One that allows for expedited treatments to see them, to get to the marketplace so that people can have those new, innovative ideas that are being offered, one that is, is chock full of innovation and incorporates new technologies so that people can get real, timely healthcare in a fashion that makes sense for them.
One trick will be fixing what’s sorely broken—while keeping facets of Obamacare that work.
Sharyl Attkisson: Is it true that more people have health insurance today as a result of the Obamacare plans?
Robert Laszewski: It is true that more people have health insurance today because of Obamacare. Particularly because of the Medicaid expansion in the 31 states that have taken it.
Obamacare has also opened up affordable insurance to many with pre-existing medical conditions. Illnesses that once made it impossible for some to get affordable insurance.//
Virginia health insurance broker Ed O'Brien helps match up customers with the right policies.//
Ed O'Brien: A lot of people were able to get insurance that couldn't get it before because they had pre-existing conditions. So I suppose in some respects that was a good thing. Unfortunately, these preexisting conditions which aren't looked at any longer have caused insurance rates to go up at catastrophic rates.
Marvin Clark is unemployed but has insurance under Obamacare, subsidized, or partly paid for, with tax money. He worries about looming change under the Trump administration.
Clark: I’m very concerned. Because right now…me being 55, 56 years of age you know. I have so many health complications and you know the medications that I take is so expensive and so without Obamacare or the insurance that its provided though my health care and medstar , I Wouldn’t be able to afford it.”
Attkisson: What do you expect from President Trump?
Nascimento: I expect from President Trump to listen to the, what people have said, that they're tired of the one size fits all approach. They're tired of Washington telling them what to do. They want options for their families. They want affordable care, and they know that when government's involved, they don't get that. President Trump should be mindful of this. He should really listen to the people.