Posted on 01/06/2017 8:23:21 AM PST by SeekAndFind
On health care, congressional Republicans should listen to Donald Trump. The president-elect may not be chock-full of ideas about health-care policy, but he has the right political instincts. He has said that Obamacare should be replaced, that its beneficiaries should not simply be stripped of coverage, and that people with pre-existing conditions should be protected.
It is possible and desirable to devise legislation that meets these objectives. Trump has also warned congressional Republicans to be careful — and he is right about that, too, because their current course does not look likely to accomplish the repeal of Obamacare or its replacement by something better.
Senate Republicans want to pass a bill that repeals the taxes and spending in Obamacare, but not its regulations. That’s because they think that they can use a legislative process to avoid Democratic filibusters only if they leave the regulations alone. They think that this partial repeal of Obamacare will set the stage for later legislation that repeals the rest of the law and creates a replacement.
This seems highly unlikely. Leaving Obamacare’s regulations in place while getting rid of its individual mandate — a tax measure, which Republicans would eliminate in their first bill — would further destabilize health-insurance markets. No one would cheer the Republicans for producing that outcome: not conservatives, who would know that Republican boasts of having repealed the law were false; not the many voters of all kinds who would see their insurance disappear or grow still more expensive; not the Democrats, who would be happy to blame Republicans for this mistake and everything else that goes wrong with health care afterward.
A better course would begin with the recognition that Obamacare’s regulations are the heart of what is wrong with it. The federal government had been subsidizing the purchase of health insurance for scores of millions of people for decades before Obamacare came along, in ways that created some serious problems. But it was not until Obamacare that the federal government became the chief regulator of health insurance.
President Obama and his allies believed that the solution to the problems with health insurance — the large number of people who lacked it, its rising price — was to impose rationality on it from Washington, D.C. It is these regulations that are responsible for most of the complaints about Obamacare: the plans that have had to be discontinued, the rising premiums, the difficulty insurers have had in making a viable business on the exchanges.
Obamacare also creates tax credits that people who don’t have health insurance from their employers can use to buy coverage. There is nothing wrong in principle with allowing people who get coverage themselves to have tax breaks equivalent to the ones that benefit people who have employer coverage: Conservatives have argued for that approach for years. But Obamacare’s credits are complicated, are structured in a way that discourages work, and can be used only for the purchase of insurance policies that comply with Obamacare’s regulations.
The core of a conservative replacement of Obamacare — a replacement that is simultaneously a repeal — would be the end of the federal government’s role as chief regulator of health insurance and the restoration of the states to that position. Simplify the tax credits, pare them back if possible, and allow them to be used for any insurance policy that meets these two conditions: The policy meets the approval of state regulators, and people who maintain coverage can continue to buy such coverage at the same price if they get sick. People would have much more freedom to buy the coverage that meets their specifications rather than those of Washington regulators; they would have the means to buy basic coverage; and they would have the incentive to do it as well (since maintaining coverage would protect them in the event they got sick).
The mandate to buy insurance — a mandate that came into existence in order to counter the side effects of Obamacare’s onerous regulations — should simultaneously be abolished. And most people on Medicaid should be given the option to cash out their benefits and buy insurance on the regular, private market.
Too many congressional Republicans think that conservatives will take a quick but phony win on health care. We disagree. A real win is worth the time and effort.
Get rid of the mandate. Restore the 40 hr work week. Get rid of the real estate sale tax. The medical device tax too.
Let the free market rule.
First pass a law that puts all the lawmakers and everybody else under the same programs and laws that are imposed on the rest of us, without exceptions. This should point them in the right direction and make them focus on any details, or just make them leave us alone!
A thousand times - amen.
I think we need to be cautious, and responsible about a replacement.
We need to make sure, that the millions of Americans who were helped by Obamacare because we had done nothing previously to our messed up healthcare system, are covered by something.
That is big, and it is very important.
Let’s not let this election skew our focus. We had the right idea on a number of issues.
Exactly revenge on people who benefitted from Obamacare is not one of those things.
Our healthcare system had gotten very, very screwed up.
It needs to be fixed.
Maybe it needs to be fixed, by government involvement.
We will see.
The poor should go on each states Medicaid. The federal govt needs to get out of this business, the student loan business, flood insurance business, mortgage business, etc.
Just be prepared for some states to go Single Payer.
“We need to make sure, that the millions of Americans who were helped by Obamacare because we had done nothing previously to our messed up healthcare system, are covered by something.”
Absolutely, and I’m sure that’s a key piece of the immediate plan.
An unfunded federal mandate forced on the states? Who could have a problem with that?
How?
Why do we need a replacement at all? Just kill Obamacare and drive a stake through its heart.
Get the government out of the medical insurance business.
If you want healthcare OK and if you don’t want it OK, but don’t fine someone for not having it.
Private insurance companies are the best equipped for minimizing costs. It’s called competition.
Mandates only drive up costs.
I don’t know the answer to that, but I know we have supposedly such a “great” healthcare system that it costs gobs more than anywhere else on the entire planet.
Far far more.
Yet we cannot provide even basic coverage to millions of Americans?
I think we are seriously, screwed up on our healthcare system.
Big time. I frankly thing we have a system which is HUGELY removed from any sort of private control, but that is just me.
But it is expensive. Very expensive.
That it is. We have expensive down pat.
In the end it was all about signing up more folks up for Medicaid.
That was the outcome, it certainly was not getting healthy 26-35 year olds to enroll and pay.
Yes.
Except these were the same people who were paid for via the government.....one way or another. The sign hung in every ER in the country....no one turned away...
Bing, bing, bing! We have a winner!
Add to this, health insurance sold across state lines and limits to damages in malpractice litigation.
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