EDITORIAL: Just fix it: ACA can be improved, but repeal isn’t needed

The HealthCare.gov website is photographed in Washington, Wednesday, Oct. 31, 2018. Health insurance sign-ups for the Affordable Care Act are down with just a few days left to enroll in most states, even though premiums are stable, consumers have more choice, and millions of uninsured people can still get financial help. The nation’s uninsured rate could edge up again. (Pablo Martinez Monsivais | The Associated Press)

Apparently emboldened by Attorney General William Barr’s summary report of Robert Mueller’s Russian collusion investigation that declined to seek new indictments, President Trump and congressional Republicans have resurrected their attack on the Affordable Care Act. Once again they are calling for a total repeal and replacement of the health care plan known as Obamacare.

They should just give it a rest. A complete replacement of the federal healthcare law isn’t necessary, and what would they replace it with? We don’t know, and apparently neither do they.

Universal health care has been debated for more than a decade.

Barack Obama pledged to provide it during his 2008 presidential campaign, and in 2010 he signed into law the Patient Protection and Affordable Care Act; it’s generally known as Obamacare.

Republicans opposed universal health care as a general concept, and fought the ACA, promising outright repeal if they became a congressional majority.

That was until the law proved to be popular, even among many low- and middle-income people who vote Republican. Only then did Republicans start promising to replace ACA with a better version, if only they could repeal it. They’ve offered no details about the new act, however, even after 10 years of debate on the subject.

The few proposals that some GOP lawmakers have suggested aren’t significantly different than the current bill — more tweaks than outright replacement.

Obamacare has especially benefited Texas and the Rio Grande Valley — the least insured state and region in America. As of 2016 more than 63,000 people were enrolled in the ACA in Cameron, Hidalgo, Starr and Willacy counties. Overall, Obamacare reduced the number of uninsured Texans by nearly 1.8 million by 2015, according to the U.S. Department of Health and Human Services.

Even more people would have found coverage if the state had accepted federal funding to expand Medicaid to those who didn’t qualify for the ACA.

The Congressional Budget Office reports that the act has reduced the federal deficit by $143 billion from 2010 to 2019, largely by shifting costs from tax-funded indigent care accounts to ACA insurers. And by encouraging the 33 million newly insured Americans to seek routine and preventative medical care, the CBO speculates that it has saved much more in emergency healthcare costs.

ACA isn’t perfect, but it doesn’t need to be scrapped entirely. For example, incentives could be upgraded to encourage more private insurers to participate, and plan managers could consider the oft-suggested idea of using the size of the ACA and Medicaid marketplace to negotiate lower drug costs.

If the opposition party had a better idea, we’d know it by now. If it’s merely looking to enact legislation that carries Republicans’ name, Americans surely would gladly recognize them as the party that fixed Obamacare, rather than one that replaced it with a Trumpcare that isn’t any better.