University of Texas-Austin's Robert Town and Katherine Hempstead of the Robert Wood Johnson Foundation discuss what's ahead for American health care.

Prospects of a new U.S. health care policy to replace the 2010 Affordable Care Act have dimmed further with Wednesday’s senate vote against a so-called “clean repeal” without an alternative plan in place.

The atmosphere leading up to the voting — where seven Republican senators crossed over to support the Democrats — was one of “high drama,” said Katherine Hempstead, senior advisor at the Robert Wood Johnson Foundation. It was also marked by “high insanity,” said Robert Town, economics professor at the University of Texas-Austin, who added that in voting for a bill that impacts one-sixth of the U.S. economy, the senators had access to “no expert testimony, no hearings and very little analysis.” Town and Hempstead discussed the likely path ahead for U.S. health care policy on Knowledge at Wharton’s SiriusXM show a day before the Senate vote.

A repeal of the ACA without a replacement would take effect in two years, so the Republicans have two years to craft a new plan, said Town. But any further uncertainty injected into the system would likely throw the insurance markets into chaos, he added. Hempstead called for an informed debate similar to the “intellectual investment” the Obama administration made in selling the ACA to Congress and the American people. “This Republican effort is so not about policy and about the merit; it’s about … finding the right combination that will spring the lock open and let this sail through,” she said.

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