Tag: repeal and replace

Talk of Replacing ObamaCare Is a Bit Premature

Now that a bipartisan coalition in the House has voted to repeal ObamaCare, an even larger bipartisan coalition has approved a Republican resolution directing four House committees to “replace” that ill-fated law.  House Resolution 9 instructs the committees to “propos[e] changes to existing law” with the following goals:

  1. “Foster economic growth and private sector job creation by eliminating job-killing policies and regulations.”
  2. “Lower health care premiums through increased competition and choice.”
  3. “Preserve a patient’s ability to keep his or her health plan if he or she likes it.”
  4. “Provide people with pre-existing conditions access to affordable health coverage.”
  5. “Reform the medical liability system to reduce unnecessary and wasteful health care spending.”
  6. “Increase the number of insured Americans.”
  7. “Protect the doctor-patient relationship.”
  8. “Provide the States greater flexibility to administer Medicaid programs.”
  9. “Expand incentives to encourage personal responsibility for health care coverage and costs.”
  10. “Prohibit taxpayer funding of abortions and provide conscience protections for health care providers.”
  11. “Eliminate duplicative government programs and wasteful spending.”
  12. “Do not accelerate the insolvency of entitlement programs or increase the tax burden on Americans;” or
  13. “Enact a permanent fix to the flawed Medicare sustainable growth rate formula used to determine physician payments under title XVIII of the Social Security Act to preserve health care for the nation’s seniors and to provide a stable environment for physicians.”

Three things about the Republicans’ “replace” effort:

First, America’s health care sector has historically been handicapped by one political party committed to a policy of (mostly) benign neglect, and another party committed to degrading that sector’s performance through government subsidies, mandates, price controls, and other exchange controls.  Republicans now appear to be taking a different posture, and that’s encouraging — but not entirely.  When Republicans set their minds to reforming health care, they are often as bad as Democrats.  (See the Republican “alternatives” to ClintonCare.  Or Medicare Part D.  Or #4-#7 above.)  Exactly how House Republicans plan to deliver on the above goals remains to be seen.

Second, no matter how House Republicans plan to deliver on the above goals, their proposals will be preferable to ObamaCare.  Republicans quite literally could not do worse if they tried.

Third, no matter how good the Republicans’ proposals are, they will be utterly ineffective so long as ObamaCare remains on the books.  ObamaCare’s influence is so pervasive and harmful that it makes real health care reform all but impossible.

So it’s a bit premature to be talking about replacing ObamaCare.

House Vote to Repeal ObamaCare Is More than Mere Symbolism

The symbolism of today’s House vote is striking. Within a year of ObamaCare’s enactment, the House of Representatives has voted overwhelmingly to repeal it.

That didn’t happen with Social Security. It didn’t happen with Medicare. Social Security and Medicare did not face sustained public opposition from the moment they were introduced in Congress. They did not pass by one vote, in the dead of night. They were not challenged as unconstitutional by half the states in the union.  They were not struck down as unconstitutional by a federal court within a year of enactment.

The House vote to repeal ObamaCare is just the latest sign that ObamaCare goes too far, that it creates a more intrusive government than the American people are willing to accept.

But the House vote is not mere symbolism, as the Obama administration would have us believe.  This vote has moved the ball forward on repeal.  This and further similar votes in both the House and Senate will reveal where members stand on repealing ObamaCare.  Voters may use that information to replace pro-ObamaCare members with people who will vote to repeal ObamaCare in the next Congress.  That’s how the political system works.

At the same time, this repeal vote makes it more likely that the Supreme Court will strike down ObamaCare. Like it or not, the Supreme Court follows the election returns. This vote shows the Court that it will not pay a price in the public’s esteem if it overturns ObamaCare.

Today’s vote makes it more likely that someone with the power to scrap ObamaCare will do so – and the Obama administration knows it.  Why else would they come out with both guns blazing against a purely “symbolic” act?

When that happens, it will be a good day for America. Real health care reform is impossible while ObamaCare remains on the books.

HHS Wildly Overstates the Problem of Pre-Existing Conditions — and Ignores Its Cause

On the eve of a House vote to repeal ObamaCare, the Department of Health and Human Services has released a report claiming that if repeal succeeds, “1 in 2 non-elderly Americans could be denied coverage or charged more due to a pre-existing condition.”  A few problems with that claim:

  • An HHS survey found that in 2001, only 1 percent of Americans had ever been denied health insurance.
  • Economists Mark Pauly and Len Nichols write, “the fraction of nonelderly uninsured persons…who would be rated as actuarially uninsurable is generally estimated to be very small, less than 1 percent of the population.”
  • RAND health economist Susan Marquis and her colleagues find that in markets that do not impose ObamaCare-style government price controls on health insurance, such as California’s individual market, ‘‘a large number of people with health problems do obtain coverage…Our analysis confirms earlier studies’ findings that there is considerable risk pooling in the individual market and that high risks are not charged premiums that fully reflect their higher risk.’’
  • It is true that insurers charge higher premiums to many people with pre-existing conditions – and it is crucial that they have the freedom to do so.  Risk-based premiums create virtuous incentives for people to buy insurance while they are healthy and to be cost-conscious consumers.  They also encourage insurers to develop innovative products that protect against the risk of higher premiums.  The real problem here is that the government has created an employment-based health insurance system that denies consumers the protections that unregulated markets already provide, as well as additional protections that insurers would develop absent this government intervention.
  • ObamaCare’s health-insurance price controls will encourage insurers to deny care to the very sick people those price controls are intended to help.
  • The Obama administration projected that 375,000 people would sign up for ObamaCare’s “Pre-Existing Condition Insurance Plans” by the end of last year. But only 8,000 people enrolled in such plans by December 2010, suggesting the demand isn’t nearly as great as the administration claimed.

ObamaCare Takes a Shellacking

It wasn’t just the party of ObamaCare or its champion that took a “shellacking” at the polls yesterday.  The law took a shellacking as well.  One pollster reports:

This election was a clear signal that voters do not want President Obama’s health care plan.  Nearly half (45%) of voters say their vote was a message to oppose the President’s plan….

Arizona and Oklahoma passed constitutional amendments designed to block ObamaCare’s individual mandate.  Many new governors either plan to join the 22 states already challenging ObamaCare in court, or to block its implementation in other ways.  Congressional Republicans appear determined to use every tool in their arsenal to repeal it.

President Obama is striking a conciliatory note, saying he is open to “tweaks:”

If the Republicans have ideas for how to improve our healthcare system, if they want to suggest modifications that would deliver faster, more effective reform… I am happy to consider some of those ideas.

There is room to doubt his sincerity.  The Washington Post has reported that when President Obama begins a sentence with, Let me be clear, it is “a signal that what follows will be anything but.”  Obama has likewise claimed open-mindedness and flexibility when his behavior exhibited the opposite qualities.  (Remember how last year’s White House summit on health care was all about gathering “the best ideas.”)

Yet with a firm conviction that facts and science and argument still matter, I resubmit to President Obama this Cato Policy Analysis: Yes, Mr. President: A Free Market Can Fix Health Care.  In fact, a free market is the only thing that will.  But a reasonably free market is impossible with ObamaCare still on the books.

I doubt the president will read it.  But Republicans should.  They seem pretty solid on Repeal.  They’re weaker on Replace.