Five Do’s and Don’ts for GOP on Health Care Legislation

Twila Brase | June 22, 2017 | 10:04am EDT
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Senate Majority Leader Mitch McConnell (Flickr Photo/Gage Skidmore)

The jury is still out on when exactly the U.S. Senate will commit to passing any sort of health care reform, whether repeal or replace. Some have said that resolving the issue in 2017 is unrealistic, while others are pushing for action before the summer break.

I have long called for the full repeal of the Affordable Care Act.

Opening up the health care market again is key to health care reform—for patients and doctors.

If Republicans refuse to actually and directly repeal the law, there are several actions they can take to indirectly move in the right direction. First, repeal every Obamacare tax. Defunding the law disempowers it, leading to a “functional” repeal. Second, President Trump and the Senate must say “no” to funding the cost-sharing reduction subsidies. This bailout for insurers would keep the law they pledged to repeal from collapsing.

Third, President Trump could use an executive order to call on HHS Secretary Tom Price to specifically restore catastrophic coverage for all Americans, even though it’s currently prohibited by law, and authorize affordable insurance policies that meet the specific needs of those who purchase them rather than the rich set of benefits mandated by the federal government. These three actions would go a long way toward restoring affordability and health freedom in America.

Price, under his authority, can issue a regulation that authorizes states to open up their markets to customized major medical non-managed care policies. Trump, in turn, can call this his “Obamacare replacement.”

Democrats were passionate about pushing their agenda in the 2010 passage of Obamacare, but Republicans aren’t doing the same. Even though Republicans amended Obamacare in the American Health Care Act, it’s not clear how keeping the law mostly intact is a winning strategy.

I have also written a letter to Senate Majority Leader Mitch McConnell regarding the “repeal and replace” Obamacare bill, stating that Citizens’ Council for Health Freedom’s strong preference is for legislation that advances patient and doctor freedom, rather than a bill that maintains Obamacare’s federal control of health care. The following is a snippet from the letter:

“CCHF supports full repeal of the Affordable Care Act, and believes it is possible if the House and Senate would actually put it to a vote, regardless of what any ‘whip count’ may say. That said, if you do not plan to call the U.S. Senate to an up and down vote on Obamacare, we ask you to do the next best thing: help patients, doctors and real insurance companies break out of Obamacare constraints. To move all citizens, patients and doctors toward freedom and away from socialized medicine, please focus on CARE (the one and only reason for doctors/hospitals) not coverage. Thus, we request consideration of the following as you finalize your bill.”

 I offered “5 Do’s and 5 Don’ts” in the letter.


  1. DO jumpstart REAL insurance
  2. DO allow tax exemptions/charity
  3. DO fund high-risk pools to solve the pre-existing condition problem
  4. DO offer lifelong private insurance
  5. DO repeal, repeal, repeal


  1. DON’T fund state reinsurance grants
  2. DON’T require auto-enrollment
  3. DON’T continue or extend cost-sharing reduction subsidies
  4. DON’T jeopardize health sharing organizations
  5. DON’T expand managed care control

We understand that you are hoping to vote on a bill to repeal and replace Obamacare before the July 4th recess. As I noted above, our organization supports full repeal of the Affordable Care Act and a return to the 10th Amendment principles of federalism, which the ACA has violated for more than seven years.

Twila Brase is president and co-founder of Citizens’ Council for Health Freedom (CCHF,, a Minnesota-based national organization dedicated to preserving patient-centered health care and protecting patient and privacy rights. Celebrating its 20th year, CCHF exists to protect health care choices and patient privacy. Brase, a registered nurse, has been called one of the “100 Most Powerful People in Health Care” and one of “Minnesota’s 100 Most Influential Health Care Leaders.”


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