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This month marks the ninth anniversary of the Affordable Care Act, or Obamacare, being signed into law. Nine years is a long time for the millions of Americans who have been adversely affected by this failed law through higher premiums, fewer options and loss of health care all together. South Dakotans continue to contact me to share their stories about how Obamacare is just too expensive. For some of them, their health insurance premiums cost more than their mortgage payments. The American people deserve better.

In 2017, the Senate voted on legislation that would repeal and replace Obamacare. I supported the measure, but unfortunately it failed by a close vote of 49-51. Since that time, we have worked to dismantle Obamacare piece by piece by focusing on the law’s unpopular provisions. The Tax Cuts and Jobs Act that was signed into law last year repealed Obamacare’s individual mandate that imposed an unfair tax primarily on the backs of families making less than $50,000 per year. We were also able to get rid of the Independent Payment Advisory Board, which was often referred to as a “death panel.”

I recently joined my colleague Sen. Martin Heinrich (D-N.M.) to introduce legislation that would repeal the “Cadillac Tax” provision in the Affordable Care Act. If implemented, the Cadillac Tax would impose a 40 percent tax on certain employer-sponsored health care plans. This would dramatically increase the costs of healthcare for South Dakota families. The Cadillac Tax is currently scheduled to go into effect in 2022, and unless we’re able to repeal it, millions of middle-class families across the country will be impacted. Our legislation currently has more than 20 cosponsors — both Republicans and Democrats — and we’re working hard to advance it in the Senate.

Obamacare has been a disaster for the millions of people who were forced off the health care plans they liked and who are now paying higher and higher premiums every year, while having fewer plans to choose from as providers leave the marketplace. I have always said that we need patient-centered, market-based health care reform that will reduce costs for patients by giving them more options for health care coverage. Competition within the marketplace will result in more choices for consumers, so they can find a plan that best fits their needs and their budget.

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“Medicare-for-all” is an idea that has been discussed recently by some as a solution to the failed Obamacare law. Medicare is a government-run health insurance program for Americans aged 65 and older. Right now, the biggest driver of our debt is the rapid, unchecked growth of mandatory payments including Medicare. If we were to open up Medicare for Americans of all ages, our debt would skyrocket (even more than it already has) and future generations would be on the hook to pay for it.

We have seen firsthand how government-run healthcare fails those who it has a responsibility to care for, with examples at the Indian Health Service (IHS) and the Department of Veterans’ Affairs. South Dakotans have heard the stories of babies being born on bathroom floors at IHS facilities, dirty or broken medical equipment, long wait times, excessive red tape and worst of all, patients being sent home from the doctor and dying because they failed to receive proper care. These are prime examples of what happens when the government is in charge of providing health care.

Every American deserves access to quality, affordable health care coverage, but Obamacare and Medicare-for-all are not the answers. I’ll continue working in the Senate to support patient-centered, market-based reforms that are truly affordable.

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Mike Rounds represents South Dakota in the U.S. Senate.

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