President Trump’s campaign promise to “repeal and replace” the Affordable Care Act (ACA) has proved to be easier said than done as Republicans who control Congress have been unable to devise a workable and acceptable replacement for the controversial health care law.
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In early February, President Trump told Fox News that his administration may not finalize its replacement plan until sometime in 2018. While many conservative Republicans continued to urge repeal, even without a replacement in place, at least six Senate Republicans said they would not vote for repeal without replacement legislation ready to roll, for fear of leaving 20 million Americans uninsured and concern about ending key ACA coverages, such as protection for consumers with pre-existing conditions.
“At this point, all we know is that something is going to happen to the ACA, but we don’t know exactly what that will be,” said Jeff Frankel, MD, health policy chair for the American Association of Clinical Urologists (AACU). “But we certainly hope there will be some regulatory reforms. The current situation will make it extremely difficult for small practices to continue unless there are modifications.” He was referring to meaningful use requirements for electronic health records and advance payment modifications under Medicare.
Complicating the ACA replace-and-repeal scenario, which has concerned and confused insurers and providers alike, have been other Trump edicts via executive order, such as his original immigration order prohibiting entry into the U.S. from seven predominantly Muslim countries. That order was ultimately overturned by a federal appeals court, but President Trump said he was considering issuing a revised travel ban. The AUA issued a statement expressing concern about the original order’s impact; read it online at bit.ly/AUAimmigrationstatement.