Millions sign up for Obamacare as Trump and GOP lawmakers scramble for a way to roll it back

While Republicans struggle to find a way to roll back the Affordable Care Act without jeopardizing healthcare for tens of millions of people, Americans continue to sign up for Obamacare health plans.

As of Dec. 24, more than 11.5 million people had enrolled in a health plan through one of the insurance marketplaces created by the law, including HealthCare.gov and Covered California, federal data released Tuesday show.

That is nearly 300,000 more sign-ups than at the same point a year earlier, signaling strength in the marketplaces despite GOP criticism and uncertainty about whether Republicans will scrap them.

“Nationwide demand for health coverage is higher than ever, as Americans prove again that marketplace coverage is vital to them and their families,” Health and Human Services Secretary Sylvia M. Burwell said.

The strong enrollment is complicating GOP efforts to rip apart the law, as a growing number Republican lawmakers urge President-elect Donald Trump and GOP congressional leaders to slow their rush to repeal it.

More than 10 GOP senators have publicly questioned the current push to repeal the law now and develop an alternative sometime in the next several years.

And Tuesday, Senate Health Committee Chairman Lamar Alexander (R-Tenn.), one of the chamber’s leading healthcare voices, said on the Senate floor that repeal and replacement must be done simultaneously.

“Obamacare should be repealed finally only when there are concrete, practical reforms in place that give every American access to truly affordable healthcare,” he said, adding that process would probably take some time.

The “repeal and delay” strategy has been nearly universally panned by leading patient, physician and other healthcare groups, which have warned it jeopardizes coverage for millions of Americans.

But Trump — who has said almost nothing about how to navigate the complex task of repealing Obamacare and replacing it with something that protects Americans’ coverage — seemed to suggest Tuesday that Republican lawmakers should charge ahead.

In an interview with the New York Times, the president-elect said a repeal vote should come “probably some time next week,” and “the replace will be very quickly or simultaneously, very shortly thereafter.”

Few healthcare experts or congressional officials believe that timeline is realistic, as there is no consensus among Republicans about how exactly to replace the law.

Talking to reporters at the Capitol, House Speaker Paul D. Ryan (R-Wis.) deflected questions about whether and when replacement legislation would be ready soon.

In the 6½ years since President Obama signed his signature domestic achievement, Republicans have never coalesced around an alternative or even submitted one to review by congressional committees or independent budget analysts.

In the meantime, Obama administration officials have been urging Americans to continue signing up for health plans even as the administration prepares to hand over control of the marketplaces after Trump’s Jan. 20 inauguration.

But many consumer are worried, and officials said Tuesday that federal call centers have fielded more than 35,000 inquiries from Americans who have asked whether they will have coverage next year under a Trump administration.

The coverage expansion has recorded historical gains in the last three years, as more than 20 million previously uninsured Americans obtained health insurance and the nation’s uninsured rate dropped to the lowest level ever recorded.

Many of these Americans have low incomes and rely on Medicaid, which has been expanded through the health law.

About 11 million got commercial health plans last year through HealthCare.gov and similar state-based insurance marketplaces created through the law.

More than 80% of these consumers receive government subsidies to offset the cost of their premiums.

There have been widespread concerns that the markets could collapse as insurers raised premiums sharply this year in the face of more costly than expected patients.

Some Americans saw their monthly insurance bills jump by hundreds of dollars.

Republicans have sought to capitalize on those problems, arguing repeatedly that the markets were unsustainable and needed to be scrapped.

“We are in the midst of a rescue mission to save the families who are getting caught up in the death spiral that has become Obamacare,” Ryan said.

But the steady enrollment numbers undercut Ryan’s claims, suggesting that the marketplaces probably would endure unless Congress and the Trump administration take further steps to destabilize them.

The current open enrollment period, the fourth since the law’s coverage expansion began, continues through Jan. 31, and consumers have until Sunday to sign up for coverage that starts Feb. 1.

noam.levey@latimes.com

Twitter: @noamlevey

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