Should Republicans champion a bill to amend Obamacare and allow insurance companies to continue to offer plans people held when their cancellation notice arrived? Health-care expert James Capretta explains, “The House bill is not a fix. It would permit, not require, insurers to keep selling their 2013 plans into 2014. That would likely allow millions to stay out of the exchanges and get good health insurance.” And yes, this would seriously undermine the law: “It is unquestionably a major blow to Obamacare, not a fix.”
In short, if Republicans were willing to postpone the individual mandate, essentially letting people remain self-insured or covered under “nonconforming” plans without penalty then they should not have an objection to indefinitely (why would it have a time limit?) allowing the individual insurance market to survive?
To be clear, this would not be a new mandate on insurers telling them they must offer coverage. And many insurers for whatever reason might choose not to reactivate their lapsed policies. But some will do so and everyone who gets his insurance back should understand who swooped into save him and who wanted him to suffer the consequences of President Obama’s false assurance.
But, defenders of the bill will say, that will kill Obamacare! The response is two-fold.
First, Obamacare is killing Obamacare, as evidenced by the puny numbers (26,794 on the federal exchange and 106,000 overall) who enrolled — a larger group than people who actually purchased insurance. (The administration was supposed to have about 500,000 signed up by now.) The speaker of the House put out a statement that was compelling in its reasoning: “Millions of Americans are being told their health coverage is canceled at the same time that they are shut out of the government website. And even if they do manage to navigate the system, many are being rewarded with sticker shock, not the lower prices the president promised.” This is triage not for Obamacare but for its victims.
The better answer, however, is “Darn right.” Obamacare architect Jonathan Gruber said in a radio interview that the individually insured must be charged more in the exchanges for the law to work, in effect confessing to the wealth redistribution inherent in the plan. (In revealing the liberal totalitarian impulse behind the liberal welfare state, he said wanting to keep and pay for your own insurance amounts to a “free lunch.” It is, of course, the ones being subsidized who are getting a free ride.) Having been caught disrupting the lives and preparing to overcharge a certain group of Americans (the ones who bought individual insurance and are generally healthy), Democrats are treating this as a bug in the system; it is in actuality its central feature.
Accelerating the law’s demise is the Republicans’ goal. With much justification, they believe the bill is harmful to the economy, is creating more uninsured Americans than it is adding, will be much more expensive than advertised, will deprive people of insurance plans they already have and like and will do nothing to contain costs. They also decry the Independent Payment Advisory Board, which has the potential for rationing care by severely limiting payments to providers, and they have argued against the medical device tax as unfair, anti-competitive and anti-innovation. They aren’t being sneaky about their intentions. They have voted to repeal, defund and delay Obamacare. If they can kill it by draining Obamacare exchanges of the bodies needed to make the whole thing work, then more power to them.
Now, I don’t suggest that the GOP should merely vote to let people keep their individually-purchased insurance. I’d suggest they couple that with two other items.
First, HealthCare.gov should carry a warning that it has not been fully tested and is not completely secure from cyber-thieves. That is simply truth in advertising. When and if it is certified as secure, the warning label can come off. I mean what are Dems going to say? (“We have to conceal the risks from customers“?!)
Second, the House come up with a short list of items that fit onto a single page outlining their Obamacare alternative. Fortunately, there is the House Republican Study Committee (RSC), which includes items like protection for preexisting illnesses, high-risk pools for the hard-to-insure and leveling the tax treatment between employer-provided and individually purchased health-care insurance. Rep. Paul Ryan (R-Wis.) is also working on his own plan that may be the foundation for an Obamacare replacement. Conservative policy wonks Yuval Levin and Ramesh Ponnuru offer another variation utilizing a universal refundable credit instead of an exclusion from income for employer-provided insurance. To one degree or another each of these attempts to promote healthcare insurance markets and limit open-ended government-subsidies (e.g. the uncapped exclusion for employer-provided healthcare insurance, Medicare as a defined benefit plan, etc.).
The House leadership is moving forward with a “keep your insurance” measure by Rep. Fred Upton (R-Mich.). One sign as to how much trouble the White House is in will be the number of Democrats who vote for it.