Republican Repeal: Failure Is Not an Option
By Scott Jennings
If the 2016 election was a rejection of incrementalism as asserted in this space last year, then Republicans should fear what will happen to their governing trifecta should they fail repeal and replace Obamacare.
Failure is not an option in dealing with the Kobayashi Maru brought on by Obamacare. Republicans must get this right not just because of their campaign promises, but because of the underlying fiscal problems Obamacare has wrought on the budgets of working families and state governments.
Year after year since Obamacare’s implementation, consumers have seen massive increases in their monthly premiums (as high as 47 percent in Kentucky this year) and deductibles. For individuals buying insurance through exchanges, average deductibles (what people pay out of pocket before insurance kicks in) are more than $6,000, while family plans carry deductibles of $12,393 under Obamacare’s bronze plans.
I know a young woman who recently had a baby. She and her employer share the cost of her health insurance. The baby is in good health but spent a precautionary couple of days in the neo-natal intensive care unit. Amazingly, her total bill for giving birth and the hospital stay wound up, nearly to the dollar, what her family’s deductible is for the year. What a coincidence!
When you add what she and her employer pay for “insurance” to what she paid out-of-pocket, she might have as well have had no insurance at all. She counts as someone with “coverage,” although that word for her meant nothing.
There are stories like this all over the country. These people vote, and they helped deliver full control of government to a political party that promised to do something about it. Failing them would be a political catastrophe.
Many state governments are desperate for relief, too. Obamacare dramatically expanded the number of people eligible for free health insurance under the Medicaid program, and, unsurprisingly, people signed up for it. It is amazing to watch liberals celebrate the success of signing up so many people for something that is free and results in a government fine if you don’t. By that logic, why aren’t we celebrating the massively popular federal income tax filing program?
Kentucky’s chief executive, Matt Bevin, has estimated the Commonwealth will need $1.2 billion it does not have to pay for its Medicaid expansion over the next five years. Bevin, who is wrestling with other budgetary pressures such as the Kentucky’s failing public pension system, has said the Medicaid expansion is “unaffordable and harmful, threatening to eat up the state’s budget and undermine Kentucky’s ability to provide care for the poorest residents.”
Fortunately, the process to replace Obamacare with something that works is clear of the U.S. House of Representatives, where the GOP’s first attempt died in the clutches of the House Freedom Caucus. President Donald Trump’s leadership in Health Care 2.0 helped save the deal as he plucked off members one by one, gaining support from both moderates and conservatives.
Now there is work to be done in the Senate where the next deal will be brokered by Kentucky’s Mitch McConnell, the “indispensable dealmaker” who frequently solves Washington’s seemingly intractable conundrums. The Washington Post recently presented a picture of the budding relationship between Trump and McConnell, the Majority Leader, and Politico reports that Trump is prepared to “let McConnell do his thing on health care,” a more patient approach than the president took with House Republicans. This is wise strategy from President Trump, who is learning to operate in Washington faster than the political press gives him credit.
McConnell, who has promised to rip out Obamacare “root and branch,” has committed to giving this issue all the time required to get it right. The Senate will need to build a plan that allows states flexibility with Medicaid, something Governor Bevin has already requested in the form of a waiver from the federal government.
And it must respond to situations like the Iowa patient whose care is costing one million dollars per month, personally accounting for 10 percent of what figures to be a 40 percent rate increase for all Iowa policyholders this year. This situation brings to life a staggering statistic: five percent of Americans spend 50 percent of all health care dollars, while about 50 percent of Americans spend virtually nothing.
Many Americans are paying more for insurance, rarely use it, and when they do the deductibles are so high it is meaningless. This is not politically sustainable, nor is it fair. The Republican plan to put the sickest Americans into high-risk pools will protect healthier insurance customers from these kinds of situations, as long as the pools are properly funded.
Republicans should ignore the mainstream media narrative that repealing Obamacare is going to cost them the House of Representatives in 2018, as recent polling reveals “that Republicans could be in better shape than conventional wisdom” suggests in the 25 most endangered GOP-held congressional districts, according to the Washington Examiner.
As one GOP spokesman said, “Only in Washington could doing what you repeatedly promised be considered a bad idea.”