Column: Don’t settle for partial Obamacare repeal
If president-elect Donald Trump and the Republican Congress have a mandate to do anything, it is to repeal Obamacare. The law isn’t working, they campaigned on abolishing it, and repeal would be a huge step toward providing more secure access to care for the sick.
Obamacare has been a misadventure from the start.
Its architects promised not to tax your health benefits or force you to purchase insurance. Guess what. They taxed your health benefits and forced you to purchase insurance.
They promised everyone could keep their doctors and health plans. They lied. Obamacare will throw another two million people out of their health plans this year.
They promised choice and competition. Insurers are fleeing the insurance exchanges, leaving millions with only one insurer.
They promised it would save lives. A year after the health care law took full effect, average life expectancy is falling.
They said Obamacare would end discrimination against the sick. Yet somehow the health plans and coverage sick people want keep disappearing.
They promised to make health insurance affordable. Obamacare premiums are skyrocketing, in Oklahoma by an average 76 percent.
When Obamacare didn’t work, President Obama rewrote it himself. So did the Supreme Court. It still isn’t working.
Supporters promised Americans would learn to love it. Obamacare has enjoyed seven solid years of solid public opposition.
The law’s architects bragged about how they deceived voters. They even called voters stupid.
The voters were not amused. They elected a president and congressional majorities who promised to end Obamacare. The more voters supposedly had to gain from Obamacare, the more they swung to Mr. Trump.
Former President Bill Clinton called Obamacare the “the craziest thing in the world.” Healthy people “wind up with their premiums doubled,” he guffawed, while sick people get “their coverage cut in half.” Architect Jonathan Gruber admitted that if the law’s authors had been honest, it never would have passed because even Democrats would have turned against it.
Repealing Obamacare would free Americans to purchase more secure health insurance than either Obamacare or employers offer. Every day Congress waits, the problem of pre-existing conditions gets worse.
Congress should replace Obamacare as Mr. Trump pledged during the campaign.
Expanding tax-free health savings accounts would free more than 100 million Americans to buy coverage that’s more affordable and secure than what they have now. It would also be a larger effective tax cut than the Reagan and Bush tax cuts combined.
Letting consumers and employers purchase insurance licensed by other states would make coverage more affordable by letting consumers avoid unwanted regulatory costs.
These reforms would leave fewer Americans with uninsurable medical conditions. The subsidies required to get such patients the medical care they need would then be smaller, and therefore more economically and politically sustainable than Obamacare.
Incredibly, some congressional Republicans are mulling a partial repeal—keeping the parts of Obamacare that supposedly protect sick patients, but instead make coverage worse and that are causing insurance markets to fall apart. There is even talk about keeping Obamacare’s billions of dollars in bailouts to insurance companies—including billions that a federal judge ruled unconstitutional—and using the money to replace Obamacare with Obamacare-lite.
We shall see whether Republicans treat their promises the same way Obamacare supporters treated theirs.
Michael F. Cannon is director of health policy studies at the libertarian Cato Institute.