Newark, New Jersey(CNN) Sylvia Mathews Burwell is issuing a grave warning to Republicans: Repealing Obamacare will result in "chaos."
Burwell, President Barack Obama's secretary of Health and Human Services, told CNN Wednesday that dismantling the Affordable Care Act will hit millions of Americans' healthcare coverage, result in a spike in premiums and unleash widespread uncertainty across the insurance market.
The secretary's sober remarks came five weeks after Donald Trump's Election Night victory — an unexpected outcome that has suddenly handed the Republican Party an opening to overhaul Obama's signature policy accomplishment. In anticipation of Trump's inauguration on January 20, GOP lawmakers are preparing to vote to repeal key portions of Obamacare early next month.
"If there is repeal, there would be chaos," Burwell said in an interview at a diner in Newark, New Jersey. "If your child is on your policy 'til 26, and it's repealed, that goes away. If you have a pre-existing condition -- asthma, cancer, diabetes, high blood pressure, any of those things -- you could be kept off of insurance if you had to make a move or a transition or were unemployed for a portion of time."
She added: "The 20 million folks who have gotten insurance -- that would go away too."
That 20 million figure is the estimated net increase of individuals insured through Obamacare. Many policy experts agree with Burwell that the law, now almost seven years old, is so massive and complicated that rolling it back would inevitably be a messy and disruptive process.
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Burwell cautioned that even a partial repeal would have a domino effect on the entire health care system, and that coming up with a replacement is a massive endeavor.
"It is a difficult task and our system is one where when you move one piece, it's related to another piece," she said. "It's like a Jenga puzzle. And if you pull a piece out, you can make the thing tumble."
To counter these concerns, Republican lawmakers have suggested putting off when the repeal would go into effect by as many as three years -- a plan that has been dubbed "repeal and delay" in Washington.
House Speaker Paul Ryan, a fierce critic of Obamacare, has pointed to that hypothetical transition period as a way to ensure that nobody is "worse off" after repeal.
Burwell replied: "'repeal and delay' is a repeal and recipe for collapse."
"Insurance companies have to make their decisions in the first half of the year -- whether or not they're going to be in the marketplace and what prices they're going to charge," she said. "With that level of uncertainty, we've seen studies and more and more analysis is coming out that what insurance companies will do -- many of them -- will make the choice to be out of the marketplace or else to raise their prices dramatically."
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Trump has nominated Georgia Rep. Tom Price to be Burwell's successor at the Department of Health and Human Services. An orthopedic surgeon, the Republican congressman has authored several versions of an Obamacare replacement plan and is Capitol Hill's most outspoken critics of the ACA.
Burwell told CNN that she has congratulated Price on his nomination and offered her assistance in executing a smooth transition.
But despite the cordial tone, Burwell nevertheless echoed many of her fellow Democrats by going after Price's Obamacare repeal blueprint.
"It actually goes even further than repealing," she said. "Right now, 11 million seniors have benefited $23 billion -- that's something the congressman's plan wants to take away. The other thing is, the congressman has proposals on Medicare and the employer-based market that would do things that would potentially increase costs for individuals in those markets."
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Working with Democratic lawmakers and other Obama administration officials, Burwell has been touring cities on the East Coast this week to encourage Americans to meet this week's December 15 enrollment deadline for coverage beginning on January 1.
Over cookies and muffins at Tops Diner in Newark on Wednesday, Burwell spoke with several individuals who said they would not be able to afford their current coverage if not for the Affordable Care Act.
David Moyer, a 34-year-old man from Westwood, New Jersey, says he is a big beneficiary of Obamacare. Prior to the law, he said, he and his wife paid around $500 a month for a plan that covered little and had a sky-high deductible of over $10,000. Now, he says, the couple pays less than $300 each month, doesn't have a co-pay for their doctor, pays nothing for generic medicine and has a deductible of $1,000 each.
Asked how he feels about GOP efforts to repeal Obamacare, Moyer said, "I won't lie to you and say that it's not something that I'm worried about. I would hope that our lawmakers who represent us would realize the good that the Affordable Care Act has done for people."