By Rep. Darrell Issa

[Editor’s note: This op-ed first ran in the San Diego Union-Tribune on May 11]

If your roof sprung a leak, you wouldn’t wait for it to collapse before making repairs. Such is the dilemma we encounter in our health care system. The Affordable Care Act is on the brink of total failure, crumpling under the pressure of its canceled plans, skyrocketing premiums, burdensome regulations, and sea of broken promises.

We have limited time left to act and save millions from the consequences of its wreckage.

This [month], the House of Representatives approved legislation that begins the process repairing the damage “Obamacare” has done to our health care system. I supported the bill because it is was a first-step, and our best shot, to make good on the commitment I’ve made to deliver real relief from Obamacare’s tax hikes, rising premiums, and ever-dwindling options for care.

Just take a look at the numbers.

This year in California, monthly health insurance premiums will increase by an average of 13 percent on the state’s exchanges created by Obamacare. Nationwide? Premiums have risen an average of $5,000 a year. These increases force families to pay more and get less, in part, from the litany of Washington mandates and regulations, but also because the law never addressed the underlying causes of the rising costs of health care in the first place.

These problems have only compounded as competition continues to be pushed out.

This year, three of the nation’s largest health insurers announced they would no longer participate in Covered California. Aetna, Humana, and UnitedHealth all announced they will be pulling out of California’s health care exchanges, deciding that even with billions in government subsidies and a backstop bailout for losses, providing coverage under Obamacare’s mandates still didn’t make much financial sense.

The side effects are a doozy: less choices for patients, and less competition to drive down prices.

Outside of California, the numbers are even worse. In more than one-third of the country, Americans no longer have any choice at all in their insurance provider, since only one insurer is now left to offer coverage on their state’s exchanges.

What protection do you have, really, when there’s no insurance left to buy? Yet, that’s exactly where Obamacare is headed, unless we act soon.

Across California, and the country, families are rightly concerned about the future of their health care. These families are exactly why we’re working so hard on reform.

For years, constituents have approached me, sent me letters, spoken to me at town halls, and told me story after story about how Obamacare has negatively impacted their lives, and why it needs to be repealed. Standing by and doing nothing simply isn’t acceptable. Yet, even as we’ve moved forward with repeal, we’ve constantly worked to protect the most vulnerable among us.

Despite what some have said, the plan we’ve passed explicitly prohibits insurance companies from denying access to health coverage for those with pre-existing conditions and, furthermore, empowers states to find new and innovative ways to bring down costs for these populations.

Take, Maine for example. In 2011, the state’s individual insurance market was being pushed into a death spiral as insurers continued to drop out and premiums continued soaring, so the state’s leaders decided to try something new. Maine created an “invisible” high-risk pool to provide support for individuals with pre-existing conditions (they called it “invisible” because, unlike other states, it didn’t remove individuals with pre-existing conditions from the traditional insurance market or even charge higher premiums) and relaxed its premium rating rules.

The result of this innovation? Patients of all ages saw premiums come down as much $7,000 a year. As premiums decreased, more people enrolled in the market — bringing down prices even further — and ultimately saved the state’s insurance market from near collapse.

Maine’s unique approach worked because states — not DC bureaucrats 3,000 miles away — know best how to meet the needs of their people. Supporting more of this local, fresh thinking is a key part of our plan and what we need to invest more in if we’re going to bring down costs for everyone.

Washington’s top-down approach has failed. As the bill heads to the Senate, it will undergo many improvements and I’ll continue my fight to strengthen it even further. But the choice we have now is simple. We can stand by idly and watch health care get more expensive and less accessible, or we can take action now. For years, we’ve promised to repeal Obamacare and put patients back in the driver’s seat of their health care.

Now’s our chance to deliver.

—Rep. Darrel Issa is the US Representative for California’s 49th Congressional District and a Senior Member of the House Judiciary Committee.