Republicans have long clamored for the opportunity to pass substantive, patient-centered health care reform. The health care system has become increasingly broken over time, the result of a steady shift away from anything resembling a market and towards a complex mix of mandates, subsidies, taxes, and regulations. In short, it became a powder keg, and Obamacare was the fuse. Unfortunately, that shifted Republicans’ remit – they no longer focus purely on implementing good policy, they had to worry about repealing bad policy.
As Dan McLaughlin writes for National Review, Democrats purposefully made that task as difficult as possible.
“[T]he healthcare marketplace is a complex business, and Obamacare’s distortions reach into nearly every aspect of it,” McLaughlin argues. “When Obamacare was launched in 2013, it was designed to be hard to repeal – Obama basically burned the ships of the existing insurance market behind him like Cortez, forcing a significant number of people out of their existing policies, and changing the mix of insurers and policies on the market in each state.”
Put simply, they created a system of handouts and subsidies that guaranteed that any reform created winners and losers. But what we can’t lose sight of is that Democrats have destabilized the health care market in ways that have resulted in ever-rising premiums and ever-fewer plan options. Despite the Obama administration’s extreme (read: illegal) efforts to save the law, insurers continue dropping out of the marketplace because they simply can’t make money, regardless of how high they push premiums.
The bottom line: Staying the course is simply not an option.
“Obamacare has failed the American people,” Speaker Ryan forcefully submits. “Over the past seven years, we’ve seen premiums skyrocket, choices dwindle and government take more control over our health care. Left unchecked, the damage wrought by Obamacare would continue to spin out of control.”
Even Democrats have acknowledged the damage done.
“You’ve got this crazy system where all the sudden 25 million more people have healthcare and then the people are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half,” former President Bill Clinton told a crowd in October. “It’s the craziest thing in the world.”
Actually, the craziest thing would be to stand by and do nothing about it. And yet that is exactly the tack that Congressional Democrats are taking.
“Not a single Democrat is negotiating,” Senate Majority Leader Chuck Schumer said recently on a call with MoveOn and the Progressive Change Campaign Committee. “We ain’t resting until the move to repeal the ACA has a dagger through its heart.”
That stands in stark contrast to Republicans, who are welcoming Democrat ideas and participation in the process.
“What the American people are looking for is results. And to get results in the Senate, as all of you know, it requires some Democratic participation and cooperation,” Senate Majority Leader Mitch McConnell said the day after the election.
Republicans began the process of delivering results yesterday by releasing their plan to replace Obamacare. The plan, which will be refined through the committee process, and supplemented with additional regulatory and legislative changes, isn’t perfect. No center-right reform bill could be.
What it is, is progress. What it is, is an offramp from assured destruction of the healthcare marketplace. And it does those things by repealing Obamacare taxes, maintaining vital protections for patients with pre-existing conditions and young adults, dramatically reforming Medicaid to allow states to innovate, strengthen market forces through the expansion of health savings accounts, and most importantly, implementing new tax credits so that Americans can buy the coverage they want, not the coverage the government wants.
As the Wall Street Journal editorial board writes, these changes represent tremendous improvements over the status quo.
The House proposal can be improved with amendments—and more work will be necessary in future years to make medicine more affordable, promote innovation, protect the most vulnerable and give patients more control of their health-care dollars. But the bill is a major down payment on a brighter health-care future. Republicans have a limited window for repeal and replace, and this is a once-in-a-generation opportunity. Democrats understand this, even if some conservatives don’t.
Let’s hope that situation flips. Democrats need to be made to understand the importance of working with Republicans to clean up the mess they created. And Republicans must come to see that when it comes to replacing Obamacare, the perfect must not be made the enemy of the good.