Tag: repeal and replace

A Long-Overdue Conversation about How to Replace ObamaCare

With the prospect of a Republican president who could conceivably repeal and replace ObamaCare, it is time for ObamaCare opponents to take a hard look at their “replace” plans. As I have argued elsewhere, expanding health savings accounts – a proposal I call Large HSAs – beats other alternatives like health-insurance tax credits. In short, if opponents succeed in repealing ObamaCare, Large HSAs would take another step in the direction of a market system. Health-insurance tax credits would constitute a step backward, because they would simply resurrect some of ObamaCare’s worst features–including an individual mandate and much of ObamaCare’s government spending and redistribution.

I set off a kerfuffle last week when I wrote that Sen. Marco Rubio’s (R-FL) ObamaCare replacement plan contains an individual mandate in the form of tax credits for health insurance. Rubio supporters and others were none too pleased. 

The Senate’s Historic ObamaCare Repeal Vote

Highlights from my op-ed today at Real Clear Policy on last week’s Senate vote repealing the majority of ObamaCare:

Health-care entitlements are supposed to be a political third rail — touch them, and you die. This Senate vote means majorities in both chambers of Congress will approve a bill repealing not one but two health-care entitlements…That alone makes yesterday’s vote historic.

Even more remarkable, it is doubtful Republicans will suffer at the polls for it. Republicans have done well by running against Obamacare. Most recently, Matt Bevin won the governor’s race in Kentucky by campaigning against ObamaCare’s Medicaid expansion, which his predecessor implemented.

The history-making doesn’t end there. A bill repealing the majority of ObamaCare is now almost certain to land on President Obama’s desk. It is not often that presidents have to veto a law repealing most of their signature legislative achievement.

Finally, the vote is historic for what it portends: It proves that America is just one presidential election away from repealing ObamaCare…

With that prospect on the horizon, states that have not implemented ObamaCare’s Medicaid expansion will now be even more reluctant to do so. This vote may even encourage Governor Bevin to make Kentucky the first state to withdraw from the expansion…

Republicans and Democrats should replace ObamaCare not with “ObamaCare-lite,” but with reforms like large health savings accounts (HSAs), which would drive down medical prices and deliver an effective tax cut of $9 trillion — greater than the Reagan and Bush tax cuts combined.

 

The New York Times and The Boston Globe Unload on ObamaCare

Aside from one necessary clarification (see far below), it would be difficult to improve on what the New York Times, the Boston Globe, and the enrollees they interview have to say about ObamaCare.

First, from yesterday’s New York Times article, “Many Say High Deductibles Make Their Health Law Insurance All but Useless”: 

But for many consumers, the sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: sky-high deductibles that are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage.

“The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.”…

“We could not afford the deductible,” said Kevin Fanning, 59, who lives in North Texas, near Wichita Falls. “Basically I was paying for insurance I could not afford to use.”

He dropped his policy…

“Our deductible is so high, we practically pay for all of our medical expenses out of pocket,” said Wendy Kaplan, 50, of Evanston, Ill. “So our policy is really there for emergencies only, and basic wellness appointments.”

Her family of four pays premiums of $1,200 a month for coverage with an annual deductible of $12,700…

Alexis C. Phillips, 29, of Houston, is the kind of consumer federal officials would like to enroll this fall. But after reviewing the available plans, she said, she concluded: “The deductibles are ridiculously high. I will never be able to go over the deductible unless something catastrophic happened to me. I’m better off not purchasing that insurance and saving the money in case something bad happens.”

“While my premiums are affordable, the out-of-pocket expenses required to meet the deductible are not,” said [Karin] Rosner, who makes about $30,000 a year…

“When they said affordable, I thought they really meant affordable,” [Anne Cornwell of Chattanooga, Tenn.,] said.

And from today’s Boston Globe article, “High-Deductible Health Plans Make Affordable Care Act ‘Unaffordable,’ Critics Say”:

“We can’t afford the Affordable Care Act, quite honestly,” said Cassaundra Anderson, whose family canvassed for Obama in their neighborhood, a Republican stronghold outside Cincinnati. “The intention is great, but there is so much wrong. . . . I’m mad.”…

The Andersons’ experience echoes that of hundreds of thousands of newly insured Americans facing sticker shock over out-of-pocket costs…

“This will be an issue at least one more time in the 2016 election. It could absolutely still hurt Democrats,” said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. “Polls about the Affordable Care Act have a considerable amount of middle-income people who say either the program has done nothing for them or actually hurt them.”…

“Unfortunately, what we are headed toward now is universal crappy health insurance,” said Dr. Budd Shenkin, a California pediatrician…“It’s just not a good deal for people,” he said.

“We’re in the process of looking at going without insurance,” [Cassaundra Anderson] said, calculating that the family will be better off financially just paying the $2,000 tax penalty for not abiding by the law’s mandate. “What am I even paying these insurance people for? Why should we reenroll?”…

“I cannot get anything with this insurance. Nothing,” said [Laura] Torres, who avoids seeking treatment for her thyroid condition and high blood pressure because of cost. “I just pay my monthly payments, try to take care of myself, go to work, and hope something serious doesn’t happen to me.”…

Amete Kahsay, 53, works as a temporary warehouse packer in Columbus. The Affordable Care marketplace is her only option for health insurance. She and her husband, an airport shuttle driver, pay $275 a month for a “bronze” plan with a $13,200 deductible.

Shortly after they signed up for insurance last year, her husband rushed her to the emergency room when she experienced dizziness. The visit, which included a CT scan of her brain, cost $1,700. She paid the charge from her savings, then returned to her native Ethiopia, where care is cheaper, to consult a neurologist and seek follow-up care.

“I support Obamacare. Without it, I wouldn’t have any type of insurance. But I’m not sure it’s worth the money,” said Kahsay, a US citizen who is registered as an independent voter. “Now, unless I get very, very sick, like only if it’s life-threatening, I won’t go to the doctor. I just lay down and take a rest.”

The necessary clarification is that these people are not complaining about high-deductibles in a market system. In a market system, consumers who choose high deductibles save money on their premiums and therefore have more resources to help them pay their out-of-pocket expenses. ObamaCare, on the other hand, manages to pair high deductibles with higher premiums, stripping many people of this benefit of high-deductible plans and leaving them unable to pay their medical bills. 

King v. Burwell Helps Repeal Obamacare

It’s baaaaaack.

In today’s issue of The Hill, the Heritage Foundation’s “dangerous” director of economic policy Paul Winfree and I explain that King v. Burwell makes repealing ObamaCare about nine Senate votes easier:

As early as this week, the House could consider a reconciliation bill that repeals only parts of ObamaCare, leaving many of its taxes in place. Not only do more Americans oppose that approach than oppose ObamaCare itself, but the Supreme Court’s recent King v. Burwell ruling shows why a full-repeal bill is more likely to reach the president’s desk. Indeed, unlike partial repeal, Senate leaders can all but guarantee that full repeal can pass the Senate with just 51 votes…

A full-repeal bill, by contrast, would recognize that ObamaCare creates a single, integrated program of taxes and subsidies that work in concert to expand coverage, and would eliminate that entire program as a whole. Its primary effect would be budgetary. According to the Congressional Budget Office (CBO), full repeal would eliminate $1.7 trillion of spending and “would reduce deficits during the first half of the decade.” Retaining ObamaCare’s spending cuts would ensure that repeal reduces deficits in perpetuity…

The Senate Budget Committee can further clarify that these provisions create one integrated program. First, it can ask CBO to score ObamaCare as it scored President Clinton’s essentially identical proposal in 1994, with “all payments related to health insurance policies…recorded as cash flows in the federal budget.” Second, it can adopt that score as the baseline against which the Senate considers reconciliation. Using that baseline would show ObamaCare’s regulations are merely components of a larger program, that all financial effects of repeal would be budgetary, and that Congress may repeal those regulations via reconciliation just as it can repeal rules regulating any other government spending Congress zeroes-out through that process.

Read the whole thing.

WSJ: ‘Roofer Union Calls for Repeal of Obama Health Law’

Take it, Janet Adamy:

A labor union representing roofers is reversing course and calling for repeal of the federal health law, citing concerns the law will raise its cost for insuring members.

Organized labor was instrumental in getting the Affordable Care Act passed in 2010, but more recently has voiced concerns that the law could lead members to lose their existing health plans. The United Union of Roofers, Waterproofers and Allied Workers is believed to be the first union to initially support the law and later call for its repeal.

“After the law was passed, I had great hope…that maybe the rough spots would be worked out and we’d have a great law,” said Kinsey Robinson, international president of the union, which represents 22,000 commercial and industrial roofers…

Mr. Robinson says the union’s concerns about the law began to pile up in recent months after speaking with employers.

The roofers’ union’s current insurance plan caps lifetime medical bill payouts at $2 million for active members and $50,000 for retirees. Next year, the plan has to remove those caps in order to comply with the health law. Other aspects of the retiree plan must become more generous in order to meet the law’s minimum essential coverage requirements next year. All that will increase the cost of insuring members, Mr. Robinson said, and has prompted the union to weigh eliminating the retiree plan.

Adding to those cost concerns is a new $63-per-enrollee fee on health plans that pays insurers to cover people with pre-existing conditions next year. Looking ahead to 2018, when the law levies an excise tax on high-value insurance plans, Mr. Robinson predicts that at least some of the union’s plans will get hit by it…

Over time, Mr. Robinson says, his optimism that regulators or lawmakers would address the union’s concerns diminished. “I don’t think they are going to get fixed,” he said. On Tuesday, the union called for a repeal of the health law or a complete reform of it.

Will the last ObamaCare supporter please turn off the lights?

Will the Last ObamaCare Supporter Please Turn off the Lights?

Senate Finance Committee chairman Max Baucus (D-MT) was the primary author of the Patient Protection and Affordable Care Act, known colloquially and affectionately as ObamaCare. Today, he predicted his own law would cause a “huge train wreck” when the federal government begins implementing it fully later this year. He’s not the only one who’s worried. Other Democratic senators have expressed concerns. An Obama administration official recently offered this vote of confidence:

We are under 200 days from open enrollment, and I’m pretty nervous…The time for debating about the size of text on the screen or the color or is it a world-class user experience, that’s what we used to talk about two years ago…Let’s just make sure it’s not a third-world experience.

How could Baucus come to fear his own bill? Maybe because he never read it, as he admitted to his Libby, Montana, constituents in 2010:

Naturally, a Baucus flack later clarified what he meant:

Senator Baucus wrote the bill that passed the Finance Committee and then worked with his colleagues to write the health care bill that is law today. He has spent years crafting this policy and hundreds of hours reading and perfecting it. There is simply no question that he understands the provisions in the health care law…

If so, perhaps Baucus could explain the law to his colleague, Sen. Jay Rockefeller (D-WV). Rockefeller may have spent more time studying health care than any other U.S. senator, Baucus included. For example, Rockefeller founded the Alliance for Health Reform and headed the organization for more than a decade. And yet Rockefeller finds ObamaCare to be “the most complex piece of legislation ever passed by the United States Congress” and “just beyond comprehension”:

But can we really blame Baucus if ObamaCare supporters – including himself – didn’t understand the bill they were passing? After all, he warned us that not all of them would understand it:
http://www.youtube.com/watch?v=q_P8aAXJD14&feature=youtu.be

So to recap: Baucus wrote an early draft of the law, helped to write subsequent drafts, didn’t read the final law, totally understands it, and now fears it.

Will the last ObamaCare supporter please turn off the lights?