I know a lot of conservatives are getting nervous that the GOP is losing its nerve on ObamaCare repeal-and-replace. I think it’s just the nature of the 24-hour news cycle these days.
Hey, we haven’t heard anything about repealing ObamaCare this week. It’s doomed!
Relax. You didn’t hear much about it because everyone’s been hyperventilating about the immigration order, Judge Gorsuch and Betsy DeVos, but just this week the House Energy and Commerce Committee has been working on fine-tuning its approach to replacing the failed law:
The Energy and Commerce Health Subcommittee discussed drafts of four bills which each address piecemeal issues within the larger Affordable Care Act, including how to deal with people who have pre-existing health conditions, how much more to charge seniors compared to young people, and how to spur people to keep continuous coverage throughout their lives.
Many Republicans, including Committee Chair Rep. Greg Walden (R-Ore.), have said that they won’t put forward one major Obamacare replacement bill but will instead replace the law with a set of smaller measures.
The hearing comes as lawmakers on both sides of the aisle consider how to stabilize the insurance market while Republicans move forward on changes to the nation’s health insurance system. While some lawmakers have said they want to “repair” the ACA, House Speaker Paul Ryan said Thursday that fixing the country’s health care system means repealing and replacing Obamacare.
“The notion that this individual market is in a wonderful place is a fiction,” House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said. “All you have to do is listen to the experts that are out there. It can’t survive the way it is today.”
Three of the four bills discussed Thursday had been introduced in previous years. The popularity of Obamacare’s requirement to guarantee coverage for people with pre-existing conditions may have prompted Republicans to propose the fourth bill, which does the same thing in a different way.
To cover those with existing health conditions, the proposal would encourage everyone to maintain health coverage throughout their lives — though the GOP is still figuring out how to do so. The idea is meant to bring more younger people into the insurance pool, driving down premium costs.
Another bill aims to decrease premiums by increasing Obamacare’s age rating band, allowing insurers to charge older people up to five times more than younger people. (The current band is three to one.)
House Speaker Paul Ryan says the process of working out how to replace ObamaCare should be complete during the second quarter of the year. I know that timetable is a disappointment to those who thought we’d see a repeal within days of Trump taking office, but I think that was always an unrealistic expectation. ObamaCare has distorted insurance markets severely during the years it’s been in effect. It’s flooded the risk pool with older, sicker people while forbidding insurers from properly pricing the policies it sells to such people. Meanwhile, the rush of young healthy people joining the risk pool never materialized, despite the individual mandate, threats of fines and ad campaigns touting “brosurance.”
Insurers are bailing on the exchanges because they’re losing their shirts, and states are experiencing budget hits as federal support for increased Medicaid spending tapers off.
It takes time and thought to come up with solutions for all this. We can’t go back to the world of 2010, because ObamaCare destroyed it (and health care law wasn’t so good then anyway). We have to move forward from the reality of today, and that doesn’t mean making it like ObamaCare never happened. It means solving the problems ObamaCare has caused.
The Wall Street Journal this morning chastised the Nervous Nellies who are panicking because it seems a little quiet on the ObamaCare repeal front:
All of a sudden the press is filled with stories about Republicans supposedly retreating from their promise to repeal and replace ObamaCare. Liberals are claiming vindication and conservatives are getting nervous, but the stampede to declare failure is premature. The orderly transition to a more stable and affordable health-care system is merely beginning.
As with much else in the Donald Trump era, people should avoid rushing to conclusions. Too much significance is attributed to Republicans adding the word “repair” to their vocabulary, as if this represents a policy change. The insurance markets really do need repair, and doing nothing isn’t realistic amid ObamaCare’s downward spiral.
Likewise, the GOP retreat in Philadelphia last month was contentious, according to leaked audio, but debating the merits of different ideas is how political parties form a strategy. Republicans now recognize that they can’t blame President Obama for insurance disruptions, even if his Administration caused them. They also increasingly understand that they’ve been handed an armed bomb and need to be careful and serious when defusing it.
It’s a reflection of just how difficult it will be to diffuse this bomb that some of these proposals are head-shakers. One proposal calls for encouraging people to maintain health insurance over the course of their lives. What exactly does that mean and how would you do it? I’m skeptical about the idea that you can draw up any sort of legislation that achieves such a goal, and even more skeptical about the wisdom of trying.
But that’s why replacing ObamaCare is as complicated as it is, and can’t be done in a day, or a week.
Paul Ryan is predicting that the GOP will have all this worked out in the second quarter of the year. That would be fantastic, timing-wise anyway. Obviously the real test is the substance of the legislation itself, regardless of how many pieces it comes in. But just because you haven’t been hearing a lot about it over the course of three or four days doesn’t mean nothing is happening. Obama left us with a lot of problems, and to expect the GOP to have them all solved in the course of a few weeks is to set yourself up for inevitable disappointment. Kick back, relax and watch as events unfold. It’s going to take some time to get it right.
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