Pre-ACA was not that great and was certainly not a free market. Trump and Republicans have a mandate to “repeal and replace”. Nothing ever said it had to be done simultaneously, and it shouldn’t.
Repeal it. No mandates, penalties, required coverages, no taxes, no paying insurers’ losses, no expansion of Medicaid. Just repeal it. With it gone, there will be pressure to do something that will actually decrease HEALTH CARE costs in a replacement bill, which CANNOT be simply subsidizing insurance costs.
Replace it. With a new law that JUST targets and eliminates every barrier to competition for lower HEALTH CARE costs not INSURANCE costs. And do nothing else in that bill, just create a free market (not “restore” since one hasn’t existed in decades). This would include stopping states from enacting their own requirements for coverage, malpractice tort reform with ‘loser pays’ and severe limits on non-economic damage awards, allowing re-importation of FDA approved drugs so Americans aren’t paying more than other countries’ citizens do, stripping the AMA of its monopoly on licensing physicians and accrediting medical schools, streamline FDA approval for drugs already approved in other countries, etc. If it is a barrier to entry in providing health care or insurance for health care, kill it in the Replace bill.
People seem eager to let the States take charge and be “50 laboratories” for experimentation, but as a resident of Californistan I am more frightened of what my state would do to me than even Obamacare did. If left to its own devices California would impose socialized medicine and taxes to pay for it in a heartbeat. The federal government should protect people from State-run monopolies and barriers to entry just as it does corporate monopolies.
Finally, get real about entitlement spending. For Medicare and Medicaid, that means a VOUCHER for LESS than was spent per beneficiary in 2016 that people can use to buy private insurance. Get the unaccountable (and expensive) government bureaucrats out of the loop of authorizing and paying for every single test and procedure some quack wants to perform — or just claims he performed to get payment. Insurance company employees striving to preserve every bit of profit won’t blindly pay — not when they know the voucher amounts available are fixed and they can’t pass along premium increases to Medicaid and Medicare voucher holders.
Let’s repeal it, then negotiate, till we reset the clock we can’t have that discussion
Depends on where you live.
It was much better in most states. And in some it was terrific. Northeastern states sucked due to RAT HillaryCare derivatives.