SAN FRANCISCO — Acting CMS Administrator Andy Slavitt in his last major speech before leaving the government said Monday that repeal of the Affordable Care Act without simultaneous replacement would paralyze providers and insurers as they await clarity.
He also warned President elect Donald Trump, who has said he will battle drug makers to drop their products' prices, that he'll need a "fair amount of stamina" to fight that fight.
Speaking at the J.P. Morgan Healthcare Conference, Slavitt said repeal would create “needless chaos” that would cost 2.6 million healthcare jobs and decimate a sector that was led the nation's job growth in 2016.
Replacing ACA later, he said, “would be irresponsible.”
The test for the incoming administration should be the same as the last administration and that is to offer better healthcare coverage than when either tenure began.
Slavitt argued that President Barack Obama had passed that test. He cited the more than 20 million newly insured and healthcare costs rising at 2% annually instead of 6% under Obama's predecessor, George W. Bush.
Drug prices, on the other hand, have skyrocketed over the past decade. Mylan, for example, raised the price of its EpiPen epinephrine auto-injector 550% over the past eight years.
A Kaiser Family Foundation survey last fall found 77% of Americans say prescription drug costs are unreasonable, with 82% backing giving Medicare the power to negotiate drug prices, something Trump said during the campaign he would be interested in pursuing should be become President.
"God help him," Slavitt said, "If [Trump] has the stamina he will see two things... the American public is being taken advantage of. And secondly, we are funding the (research & development) for free riders across the world.”
Controlling the costs would be seen as antithetical to a free market economy, something that the billionaire real estate mogul might not support.
Slavitt suggested proposals being floated to eventually replace the ACA and Medicaid expansions with state block grants would also affect the greater economy. It would leave states with less money and not increase flexibility that they already enjoy in determining how residents participate in the federal program. He specifically pointed to the state of Indiana, which expanded the use of health savings plans for consumers when it expanded Medicaid under Vice President-elect Mike Pence, then the Governor of Indiana.
Kaiser Permanente CEO Bernard Tyson at a session that started the conference Monday said consumer benefits and provider standards developed under the ACA should be the “starting point” for any reforms that the new administration promotes.
The newly insured, Tyson said, gained “front door” access to the healthcare system rather than having to use the emergency room as a last resort to seek care.
Kaiser, the nation's largest integrated health system with annual revenue of $65 billion, has been able to keep its expense growth rate below 2%, by promoting prevention and early diagnosis among its 10.6 million health plan members and millions of other patients who get care at Kaiser hospitals and clinics, Tyson said.
The trump Administration should not risk the progress made under the ACA by waiting to replace the program, Tyson said. “It must be replaced,” he said.