Former health law adviser: Seniors will feel the pinch if ACA repealed

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MIAMI, FL - DECEMBER 15: An Obamacare sign is seen on the UniVista Insurance company office on December 15, 2015 in Miami, Florida. Today, is the deadline to sign up for a plan under the Affordable Care Act for people that want to be insured on January 1, 2016. (Photo by Joe Raedle/Getty Images)

Editor’s note: The Axe Files, featuring David Axelrod, is a podcast distributed by CNN and produced at the University of Chicago Institute of Politics. The author works for the podcast.

CHICAGO — Repeal of the Affordable Care Act without a suitable replacement would weaken the finances of Medicare and mean higher prescription costs for seniors, an architect of former President Barack Obama’s health care law warns.

“Seniors will lose their coverage for prescription drugs in their ‘donut hole,’ so they’ll have a lot of drugs that they have to pay for that they don’t have to pay for now … and Medicare’s solvency would be much worse,” Nancy-Ann DeParle told David Axelrod on “The Axe Files,” a podcast from the University of Chicago Institute of Politics and CNN.

DeParle, who oversaw the Medicare program during the Clinton administration and served as Obama’s top adviser on health reform, said the potential impact on seniors is one of the reasons the White House and Republican leaders in Congress are finding it challenging to fulfill their pledge to “repeal and replace” the Affordable Care Act.

DeParle also said that the stated goal of Republican leaders to provide universal access to affordable health care without mandating that people buy insurance is only possible through massive new spending.

“I’ll submit to being drawn and quartered if there’s a way to do all of this,” she joked before adding, “Could you make it work? Perhaps, with massive subsidies, much larger tax credits and subsidies than we currently have.”

While DeParle said she doesn’t think repeal is a foregone conclusion, she said that the threat of repeal alone is undermining the health insurance system, with “markets (that) are already feeling very rickety.”

And she suggested that a primary reason for the Republicans’ legislative predicament is because the law they want to eliminate is filled with conservative ideas.

Pointing out that Democrats on the Senate Health, Education, Labor and Pensions Committee accepted more than 160 Republican amendments to their health care bill, DeParle recalled: “I used to tease the President — I won’t name the names here — but certain senators had more of their ideas in the law than he did.”

“These were things that we thought made the law stronger. Ideas to go after fraud, waste and abuse; ideas to make prices more transparent,” DeParle added. “They were good ideas and we agreed with them.”

After giving a defense of the Affordable Care Act and its role in lowering uninsured rates and slowing health care spending, DeParle acknowledged that, like any big piece of legislation, there is room for some modest improvements. She believes Democrats would be eager to work with Republicans if they believed they had a genuine commitment to improving the law.

But, she said, “it’s sort of hard to repair the roof when they’re trying to burn the house down.”

To hear the whole conversation with DeParle, click on To get “The Axe Files” podcast every week, subscribe at

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