Ezekiel Emanuel, MD, PhD, is credited as the architect of the ACA, but during a recent interview with Meet the Press host Chuck Todd, he noted a few aspects of the law he would have changed had he known it would be received with hostility by the next presidential administration.
One of the most important changes would be added protections to cost-sharing subsidies, which alleviate out-of-pocket costs for ACA enrollees. However, these subsidies are open to annual appropriations by members of congress. Dr. Emanuel said that, had he known they would be in danger of defunding, he would have advocated for them to be protected as entitlements to ensure that the cost of premiums could be kept down.
Though it appears the ACA will soon be repealed, Dr. Emanuel still believes problems with the bill could be sorted if legislators really wanted to repair versus replace. He stated that renewing risk corridors and more strongly enforcing an insurance mandate would fix many of the ACA’s perceived shortcomings, though House passage of the AHCA makes these measures very unlikely.
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