In Farewell Remarks, Burwell Warns of Dangers Ahead

Health and Human Services Secretary Sylvia Burwell warned in a speech Monday that an Obamacare replacement could be “a step backwards.”

If a replacement plan does not cover as many people, maintain the quality of coverage and “keep bending the health care cost curve in the right direction,” it would leave the health care system worse off than it was before the Affordable Care Act, Burwell said in what was billed as her farewell address at the National Press Club.

Her speech comes as the Obama administration has sought to defend the 2010 health care law, which is considered President Barack Obama’s signature policy achievement. As Obama did last week, Burwell warned against repealing the law without having a replacement plan, warning that such a move could create an unstable marketplace.

The effects of that could be seen as soon as this spring, she said, suggesting that health insurers would either raise their rates or drop out of the individual marketplace created by the law.

“Our only chance of not going over that cliff depends on opponents of the law doing in the next two years what they haven’t done in the past six: Develop a comprehensive replacement plan,” Burwell said.

She warned that it would be tough for Republicans to draft a replacement plan that maintains some of the law’s more popular provisions, such as barring insurers from denying coverage to patients with pre-existing conditions. An individual mandate, which Republicans have railed against for years, is necessary to keep costs down and provide coverage for sicker patients, she said.

Similarly, if plans aren’t required to cover as many essential benefits, people who require inpatient mental health services, for example, would have to pay much more to receive those services, she warned.

“As for silver bullets, they don’t exist,” Burwell said. “If something sounds too good to be true, it usually is.”