Health and Science

Obamacare architect: We need to fix some of our mistakes that led to soaring costs

Key Points
  • Republicans and Democrats need to put politics aside to tweak urgent problems, Dr. Ezekiel Emanuel says.
  • "We have to get the costs ... down," argues Emanuel, while making a case to keep the structure of the law he helped create.
Health-care reform needs to focus on costs: Dr. Ezekiel Emanuel

While arguing against getting rid of the Affordable Care Act, Ezekiel Emanuel, an oncologist and former health policy advisor in the administration of Barack Obama, told CNBC on Tuesday that Republicans and Democrats need to put politics aside to tweak urgent problems with the 2010 health-care law.

"We need to have a timeline that's over the next few months that's going to stabilize the exchanges, but primarily try to bring the premiums down in the exchanges," said Emanuel, an architect of the ACA, better known as Obamacare. He's currently chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania.

Emanuel said on "Squawk Box" that the United States needs to change the way health care is administered, rather than going down the road the Republicans want to travel to repeal and replace Obamacare.

"We have to get the costs overall of the health-care system down. That needs to be the focus. That's actually a bipartisan issue. And that requires changing how we deliver care. That requires changing the financial incentives," he said.

Republicans have been trying to dismantle Obamacare for seven years. But now, even with control of the House, Senate and White House, party infighting has thus far thwarted those efforts.

Last week, the so-called skinny Obamacare repeal failed in the Senate, with three GOP defections — Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona — sinking the measure in a 49-51 vote.

In May, after fits and starts, the House narrowly passed its version of legislation to repeal and replace Obamacare in a 217 to 213 vote. That was an even slimmer margin considering the GOP holds a much larger 47-seat majority in the House.

Emanuel admits mistakes were made in setting up the ACA, which led to some problems that need to be fixed around the edges.

"All of us thought that the exchanges would be much more active," he said, also citing the troubled rollout of the federal marketplace "We could also talk about the situation of allowing — and I'm just as much at fault — the deductibles to go up."

But Emanuel said those knock-on effects are not reasons to abandon the health law, or as President Donald Trump has threatened to let it "implode" if Republican leaders on Capitol Hill can't deliver a repeal measure.

In a recent Slate interview, Emanuel said he met with Trump three times on health care and "a lot more" with his aides.

Emanuel told Slate he believes in the overall structure of Obamacare, including the requirement that all Americans have health insurance or face a tax penalty. He said he'd like to see the mandate "vigorously" enforced.

The mandate, however, is one of the top Obamacare pillars that Republicans on Captiol Hill and Trump object to the most. The GOP does not want to make people buy coverage, but rather provide everyone with the option to acquire insurance.