Opinion: What Republicans need from their Obamacare bill

Senate Majority Leader Mitch McConnell (R-Ky.) speaks to reporters in the U.S. Capitol on Tuesday. (Ron Sachs/CNP/Sipa USA/TNS)

WASHINGTON — How this week was supposed to end: “Republicans know what they’re doing for health reform!”

How it really ended: “Republicans know what they’re doing for health reform?”

Like the House before it, the Senate had to pause its efforts to scrap Obamacare. Most everything remains on the table. There was the Senate bill, panned by one observer not as Obamacare 2.0 but as Obamacare 1.1 — just a service patch. There was President Donald Trump’s sudden support Friday for a vote now on a clean repeal (to take effect in no less than two years) followed by a longer debate over a replacement. And there was the possibility of no agreement.

Underlying all these options is an open secret: However this shakes out, at least a couple of elements of Obamacare are here to stay. One is the ban on insurers denying coverage to consumers because of pre-existing conditions. Another is the provision allowing people to keep their adult children on their plans until age 26.

These items don’t necessarily make for a healthier insurance market. Doesn’t matter. Constituents have expressed clearly a desire to keep them, even as Congress jettisons other parts of the law.

Rep. Barry Loudermilk of Georgia puts it this way: When you pour concrete, it quickly begins to set. You can prevent or slow its setting by agitating it, but only those parts you keep moving. Anything else will harden and require a jackhammer to break up.

In this way Obamacare, despite its long record of unpopularity, has altered Americans’ views about health care, and the government’s role in it. So the most interesting question in this debate right now is: What could Republicans do that would have an equally lasting effect?

Having spoken with several Republicans in Georgia’s delegation this week, I’ll offer a couple of suggestions.

First is reintroducing market forces into the individual insurance market. Obamacare sought to establish markets (i.e., the exchanges) while strangling market forces through over-regulation. The result has been a series of predictable failures that threaten to send the exchanges into a death spiral.

Insurers need the latitude to create varied products for consumers and then compete for their business. Obamacare didn’t allow that. The GOP bill needs to re-establish in Americans’ minds the benefits of a freer and more competitive insurance marketplace.

Second is revamping Medicaid, giving states more flexibility to run their programs and restoring it as a safety-net program for the aged, blind and disabled, plus poor pregnant women and children, and not a way to insure the working poor.

The latter point is key: Obamacare’s Medicaid expansion had the perverse effect of devoting more federal dollars to the able-bodied than the people the program was meant for. That’s not to say the working poor shouldn’t get help, just that Medicaid isn’t the right way to provide it. The GOP bill needs to help Americans view Medicaid as a true safety net, not a vehicle for moving ever more people into government dependence.

No bill will be the end-all, be-all of health reform. But Republicans can and must ensure their effort, whatever shape it eventually takes, has an even more durable effect than Obamacare did.

Reader Comments 0

445 comments
AndyManUSA#45
AndyManUSA#45

“So, this is a developing story,” he continued. “I don’t know much about it other than it seems to be, on the end of the Trump individuals, a big nothing burger but may spin out of control for the (Democratic National Committee) and the Democrats.”

And won't we all laugh like he-ll when it does?

AndyManUSA#45
AndyManUSA#45

Clue for clueless and deranged; we here at the IReport camp don't need highly politicized and corrupt "intelligence" agencies to tell us how to think. We are not mind numbed robots or sheep being led to the slaughter

AndyManUSA#45
AndyManUSA#45

Clue for clueless and deranged; we here at the IReport camp don't need highly politicized and corrupt "intelligence" agencies to tell us how to think. We are not mind numbed robots or sheep being led to the slaughter, we can think for ourselves. And it doesn't take much to sort through this one. Why would Putin want Trump to be the president?

Is he stupid like the liberals are?

breckenridge
breckenridge

Ivanka Trump will be in the White House........as a maid?

Bwwaaaaaaaaaaaaahhhhhhhhhaaaa

Mary
Mary

You blabber like a lib. Yes you do.

Mary
Mary

Haley will be the first female prez.

AndyManUSA#45
AndyManUSA#45

Not only will Donald be the president until 2024, Ivanka will be in the White House for the 8 years after that.

Fact!

Why do you think the rat fascists are so freaked out? Their turn in power is ovah with.

breckenridge
breckenridge

GETTYSBURG, Pa. July 2 ― A few hundred armed militia group members, Sons of Confederate Veterans, Ku Klux Klaners, and other self-described patriots descended upon the Gettysburg battlefield Saturday to defend the site’s Confederate symbols from phantom activists with the violent far-left group Antifa.

Although many came expecting violence ― even after Antifa made it clear its adherents never planned to show up ― the only bloodshed came when a lone militia group member accidentally shot himself in the leg.

SGTGrit
SGTGrit

Trump, like him or hate him is the first non-traditional president to come along in non-traditional times as we've known politics. It may be a first leading to a non-traditional electoral choice and a complete change in our system. Can you handle change?

breckenridge
breckenridge

@SGTGrit 

I can handle change, sure.  But that doesn't alter the fact that Trump sucks.

SGTGrit
SGTGrit

@breckenridge @SGTGrit 

What you're seeing is a new paradigm in politics. Republicans being replaced by conservative American traditionalists and Democrats being replaced by hard left activists. The latter well underway and the former only beginning.

breckenridge
breckenridge

Trump is a one-and-done president.  It's not too early for the GOP to start figuring out who they would like to be on the presidential ticket in 2020.

SGTGrit
SGTGrit

Time for all truly good Americans to come to the aid of their country. All others are uninvited.

AndyManUSA#45
AndyManUSA#45

North Korea is a byproduct of obozo's naivety.

Be thankful that we have President Trump to see us through these unfortunate times, instead of the fat drunken greedy slob he defeated.

Perfect!

JohnnyReb
JohnnyReb

@AndyManUSA#45

I've come to disagree more and more with Krauthammer as his Washington establishment roots have shown with Trump.

However, he said tonight that we only have two choices other than war.

Let Japan go nuclear armed, and reinstall nuclear weapons in South Korea.

Both will get China's attention unlike the rhetoric of old and they then would likely bring NK under control.

NK cannot survive without China's backing.

AndyManUSA#45
AndyManUSA#45

I know, I saw him talking about "tactical nukes," apparently forgetting that we could waste all of NK from our silos in South Dakota. Matter of fact, we should launch one MIRV full of leaflets that say, in Korean, next time this missile arrives, you will be smoke. Let them deal with that.

breckenridge
breckenridge

This North Korea thing is the biggest damn international crisis that we've seen in a long, long time.  I'm not convinced Trump has the knowledge, the patience, the diplomatic skills nor the attention span to deal with it. 

JohnnyReb
JohnnyReb

@breckenridge

Put those fears to rest, punk.

Trump has surrounded himself with the best administration team certainly since Reagan.

Unlike Obama who surrounded himself with academics.

SGTGrit
SGTGrit

@JohnnyReb @breckenridge 

Yes, he has and that was what solidified my support. You don;t have to love Trump but if you're an American conservative traditionalist you have to love his policies.

breckenridge
breckenridge

@JohnnyReb @breckenridge 

Trump has surrounded himself with boot lickers and yes-men.

He also needs to stop paying attention to things that are of absolutely no importance - his treatment by the media, whether he won the popular vote, etc.

AndyManUSA#45
AndyManUSA#45

RUSH: But they’ve told him that if he does it again, they are gonna dox him. Now, who are they? Is CNN law enforcement? Is CNN in charge of this guy’s constitutional rights? Is CNN this poor guy’s gateway to freedom and the First Amendment? Does CNN have the right to tell this guy what he can and cannot do? Does CNN have the right to bully and demand this guy apologize, and then further hold over his head the threat to publicly humiliate him if he does it again?"

Sick!

AndyManUSA#45
AndyManUSA#45

"These same reporters also reached the consensus that Donald Trump being murdered every night on a stage in Central Park was not an incitement of violence. That was art. Donald Trump as Julius Caesar, Shakespeare in the Park getting murdered every night? “That’s just art. Trump needs to develop a thick skin!” Trump didn’t complain about it. Trump supporters did. CNN and their statement said: “It is a sad day,” a very, very, very sad day, “when the president of the United States encourages violence against reporters. - El Rushbo""

Insane!

SGTGrit
SGTGrit

Trump begins his foreign trip in Poland fast becoming an economic powerhouse as part of the rapidly growing New Europe where President Trump enjoys much support. This in contrast with the old Europe of Germany and the unpopular Anglea Merkel along with France, Austria, Belgium and Spain. Trump will meet with two of our adversaries Russia and China. Build up our military both conventional force but now even more importantly our nuclear and anti-nuclear force President Trump, nothing is more important than that now.

breckenridge
breckenridge

@SGTGrit 

Yes, Poland has a rather large populist movement.  That's what some Trump supporters here were attracted by, but I really don't see any populist legislation forthcoming.  But here's an idea.........tax cuts for the middle class, to hell with the wealthy. 

SGTGrit
SGTGrit

@breckenridge @SGTGrit 

The tax agenda provides for a tax cut for the middle class. As for the wealthy since many small business owners (BTW the largest employers in the country), pay taxes through there personal tax liability, This would be a huge job creation incentive.

SGTGrit
SGTGrit

More Americans trust the Trump administration than they do the media. 37% trust the White House to 30% the media. No surprise and courtesy of NPR/PBS NewsHour/Marist.

AndyManUSA#45
AndyManUSA#45

"Why Michele Bachmann’s $2-a-Gallon Gas Promise Is a Fantasy - time magazine

By Bryan Walsh @bryanrwalshAug. 18, 2011

Gas was selling Monday as low as $1.67 at several Cleveland stations, including the Hi-Tech station on Ocoee Street that briefly dipped its price to $1.64 earlier this week."

Anyone besides me wonder why liberals keep making predictions?

Stupid!

AndyManUSA#45
AndyManUSA#45

"“It’s going to be huge—absolutely huge,” Mr. Tarczynski said of the coming welcome for Mr. Trump. “They just love him, the people in Poland—they just really love him.”

Poland is working to put on a hero’s welcome for Mr. Trump as he prepares to give a major speech to thousands of Poles in a Warsaw square. Behind that effort is a recognition across the continent that Mr. Trump has the potential to change the balance of power in Europe."

The Poles loved Reagan too. They know good when they see it.

Fact!

poland-prepares-absolutely-huge-welcome-for-trump-1499247006

Visual_Cortex
Visual_Cortex

Golly, I wonder why Tom Price isn't talking about the report his own agency published about the viability of the PPACA?


http://www.latimes.com/business/hiltzik/la-fi-hiltzik-cms-risk-report-20170703-story.html


New data have been released contradicting Republican propaganda about the “failing” Affordable Care Act. What may be more embarrassing to the hardliners pushing repeal is that it comes from the government, specifically the Department of Health and Human Services.

Under Secretary Tom Price, the department has been a fount of anti-ACA rhetoric. But in an annual report about the ACA’s risk-management provisions issued Friday, Health and Human Services established that the key programs are “working as intended,” protecting insurers from unexpectedly large risks and moderating premiums for consumers.

Not only that, the data “would seem to refute the commonly held belief that the marketplace population is becoming sicker,” observes health economist Timothy Jost, writing in Health Affairs. In fact, according to the figures from 2016 in the latest report, the customer base is getting healthier and the risk pools have been stabilizing.


Oh well, Doctor Tom has a story and he's sticking to it.

Doomy
Doomy

@Visual_Cortex


Premiums up 105% in 4 years with $6,000 deductibles and one third of all counties in the U.S. having 1 or no carrier left and some gubment bureaucrats are saying its working as intended? 


HAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!

SGTGrit
SGTGrit

@Doomy @Visual_Cortex 

Indeed amusing if it weren't for the fact that people are being hurt by the collapse of the ACA. The left ignores facts that clearly provide indisputable facts that the exchanges are failing and insurers have been pulling out leaving subscribers with worthless health insurance.

breckenridge
breckenridge

Gee I clicked on the headlines late this  morning and ..........well NPR tweeted the Declaration of Independence yesterday. Some thought it was spam, others thought it was an attack on Trump. They really need to get a clue.


And this congressman bozo from Louisiana made a video at Auschwitz, said this could happen in America if we don't keep those terrorists out.  The JDL is all pissed off, as well they should be.


And Nikki Haley, the US ambassador to the U.N, whined about having to spend the 4th of July in meetings due to the North Korean missile test.


I think the world has gone crazy.

FIGMO2
FIGMO2

@breckenridge

Again with the Nikki Haley whines parade?

It was SHE who called the special session.

It was SHE who exhibited sarcasm directed at North Korea in a tweet.

breckenridge
breckenridge

You can find many quotes from James Madison describing his Christian beliefs. Most of the founders were Christian believers.

And you can find many quotes from many a Founding Father about their Christian beliefs. But, as you know, that is not the issue. The issue is separation of civil and ecclesiastical matters.

Caius
Caius

Reading the comments below I would agree with those saying the 1st Amendment is under attack. It is under attack as follows:

Religion from the Left, speech from the Left and Right, the press from the Right and peaceful assembly from the Left and Right. Note that there are no innocents.

Not a single section of the 1st Amendment gets a pass. It would appear that we place temporary political points way above the rights guaranteed in the 1st Amendment.


RoadScholar
RoadScholar

@Caius Do ya think that religion is under attack due to people saying they are Christians and then demonstrating they are anything but?

How can the left attack it since many cons feel that lefties are not religious (nor do they own guns)!

Visual_Cortex
Visual_Cortex

@Eye wonder

To be fair, we don't know what's off camera--he might have seen either some group of people he thought he needed to greet, or (possibly) a different ride.

I say this only because an awful lot of folks have jumped on this as if it were evidence of dementia, and without knowing more, that's irresponsible.

Eye wonder
Eye wonder

@Visual_Cortex @Eye wonder

I'm not suggesting he is demented. And sure we don't know if there is other context to be considered. But, on its face, the twit (i) walks slowly down the stairs, (ii) to a vehicle that is right in front of him and that could not reasonably be for anyone else, (iii) seemingly oblivious to what's going on around him and without making any obvious gestures of having recognized something or someone else, and (iv) has "oh that's where I'm supposed to be headed" look on his face when directed to his vehicle. So I'm not exactly inclined to give the lying scumbag the benefit of the doubt here.

And for folks like WhiningFascistAndy, in the military we have a concept of "situational awareness."  President Lyingscumbag doesn't seem to have any.

refevatuk
refevatuk

my friend's sister makes 94 per hour at home. she has been unemployed for 9 months, last month her paycheck was 15604 just working on the internet for a couple of hours a day. check this

>>>>>>https://tinyurl.com/z5m5hl3

refevatuk
refevatuk

our buddy's half sister gets 66 every hour at home. she's been unemployed for five months... last month her paycheck was 16237 working on the internet five hours every day... see

>>>>>>https://tinyurl.com/z5m5hl3

Visual_Cortex
Visual_Cortex

"Our MSM is 24/7 disparaging Trump, what do you expect the rest of the globe to believe?"

Their own journalists, one presumes.

Oh, are THEY also in on this mass, UNFAIR (sniff!) persecution of our blameless, innocent, just-wants-what's-best-all-of-us President?