As a matter of policy, I don't like it one bit.
The ObamaCare taxes are the most urgent reason the whole thing needs to be repealed, and the worst thing about the Medicaid expansion is that it brought even more people into dependence on government for health care. What we need to do with Medicaid is return it to its original purpose, which is to provide a safety net for the truly poor. The idea that you can tighten up Medicaid requirements, but then turn around and still spend taxpayer money on those no longer eligible, simply creates one more way to make Uncle Sam everyone's sugar daddy at the doctor.
As a matter of politics it doesn't seem much better. It sounds like you might get Rob Portman and Bill Cassidy, although it still not enough to bring Susan Collins on board. And why should Mike Lee or Ted Cruz go for it? But this seems to be the opening salvo in the White House's attempt to take what was dead and bring it back to life:
The Medicaid plan that is being advanced by some Republicans and Ms. Verma would use funds from the Affordable Care Act’s taxes to cut out-of-pocket costs for people who are forced to leave Medicaid due to cutbacks in the Republican bill.
It wasn’t clear Thursday whether Ms. Verma’s pitch would attract any of the GOP senators who said they were opposed to an earlier version of the bill, let alone enough to let the bill squeak through. But at least one senator who has voiced concerns about the bill’s Medicaid cuts said Ms. Verma has taken a careful approach by providing data without overselling her proposal.
“She’s not in the business of lobbying, but she’s in the business of getting us good information,” Sen. Rob Portman (R., Ohio) said.
Sen. Bill Cassidy (R., La.) said, “She’s obviously a knowledgeable person who’s implemented innovative programs...That gives a great deal of street credibility.”
Sen. Susan Collins of Maine, one of the Republicans who is opposed to the GOP bill, said she wasn’t convinced by the pitch because the amount going to consumers would fall far short of the bill’s $756 billion in cuts to federal Medicaid funding over a decade. Under the plan, up to $200 billion from the taxes would go to support affected low-income people.
“If you’re still going to take more than $700 billion out of the Medicaid program, you still have significant problems,” Ms. Collins said.
The underlying problem here is that you've got anywhere from fix to 10 Republican senators who have totally bought into the underlying presumption that guides ObamaCare - that everyone should have their medical bills paid by a third party, and that it's up to the government to make sure no one can ever be turned down by the third party they would like paying their bills.
That's what's wrong with the CBO scores you've been seeing for every possible repeal bill. They all assume that people need comprehensive health insurance that pretty much pays for everything, and that if government doesn't either provide it or guarantee access to it, they will all lose it with no conceivable way of attaining a workable alternative.
That is totally wrong, but it's the sort of thinking that permeates Washington D.C. Democrats and the media believe it unquestioningly. Far too many Republicans either believe it as settled wisdom or are too afraid to challenge it because it's such institutionalized thinking. Suggest that people will be just fine if the government doesn't provide them with health care and prepare to be blasted on the Sunday shows and in the New York Times and the Washington Post.
Who needs that? Especially when you're not especially sold on any particular philosophy apart from whatever keeps getting you re-elected.
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That's the problem with a proposal like this. The reason to repeal ObamaCare is that it established an entirely new government entitlement that's killing the very structure of health care finance. It's making the finance institutions unstable while making services themselves less effective and harder to access. It's forcing people to pay for things they don't need and will never use just so the biggest consumers of these services won't have to pay their own bills.
That is a recipe for disaster, and with every year ObamaCare has been in effect, we've seen that disaster manifest more and more.
The solution is to head 100 percent in the opposite direction, restoring most health care transactions to the status of individual purchases between consumer and service provider, with no other parties involved, and saving insurance for what insurance is supposed to be - protection against risk too big for you to handle. Instead, this White House proposal concedes in one form or another, government is responsible for making sure going to the doctor never costs you anything.
Until we reject that idea entirely, we're never really going to be rid of ObamaCare. They have to come up with a better approach than this.
