Repealing and replacing Obamacare is going to be harder than Republicans think, the former Affordable Care Act implementation director told CNBC on Tuesday. "Be careful what you wish for," Jay Angoff warned.
But President-elect Donald Trump has a chance to lower health-care costs by using his dealmaking skills to "drive hard bargains" with drug companies, hospitals, doctors, medical equipment makers and insurers, Angoff said in a "Squawk on the Street" interview.
"One ray of hope for the Trump administration [is] … Donald Trump has been very good at … negotiating," he said, but stressed it's tough to negotiate on behalf of the government like one would negotiate in business.
The major obstacles to getting rid of Obamacare are hospitals, doctors and even insurers, said Angoff, a former Missouri insurance commissioner, arguing they all like President Barack Obama's health-care law.
"Obamacare helps the hospitals get paid; helps the doctors get paid," he said. "Even the insurers, who'd like to make certain changes to Obamacare, they still have a law which requires people to buy their product and subsidizes people for buying their product."
Pressed on why insurers would want the ACA to continue when companies including Aetna, UnitedHealth and Humana are basically pulling out due to losses on the program, Angoff agreed that the law could be tweaked to make it more attractive for insurance companies.
"There's a way to make the system even better for insurers. Insurers can be permitted to sell skimpier coverage [and] to have more pricing freedom so that they can charge people more," he said.
Another area that may present trouble for Trump, as it did Obama, is whether people who like their Obamacare coverage will get to keep it, said Angoff, who's currently at the Washington-based law firm Mehri & Skalet.
Many people who wanted to keep their insurance prior to Obamacare were forced to make changes to comply with the coverage minimums of the new law.
"[Also] what happens to all those subsidies that Republicans have called bailouts, with some justification, under Obamacare? The insurers want to keep those subsidies," Angoff added.