Can simplest solution preserve best of Obamacare?

We begin with a newsbreak: A new group of refugees is now fleeing the tumult of their villages and cities back home, seeking security and protective comfort in their chosen American sanctuary city—Washington, D.C.

These are not your ordinary refugees—they are Republican senators and representatives in the U.S. Congress. They have just spent a harrowing week back home. They used their Presidents Week congressional recess to convene their first town hall meet-and-greets of the Donald Trump presidential era.

But things didn’t go so well. They were ambushed by overflow crowds of angry voters who don’t like the way things have been going ever since Republicans won control of both ends of Pennsylvania Avenue. A significant part of that anger was politically arranged by progressive activists who succeeded in doing to conservative Republicans what tea party activists did to Democrats and moderate Republicans back in 2010.

But the largest contributing factor to the voter anger directed at Republican senators and representatives didn’t require sly scheming—because it is very real, and even frightening to many voters. They are frightened about what they are NOT hearing from Trump and most Republicans in Congress about what will happen when they succeed in repealing President Obama’s Affordable Care Act. Republicans haven’t shown voters how they will replace it or sufficiently addressed what its elimination might mean to middle class folks who voted for Trump as an act of blind trust.

It turns out that the ACA, or Obamacare, has become increasingly popular the closer it gets toward its politically promised demise. ACA premiums are higher than anticipated, insurance options are increasingly limited. Yet Obamacare remains a godsend for persons with pre-existing conditions who previously would have been denied coverage. Polls show Americans now say they basically like Obamacare, or at least want parts preserved and the rest of it fixed but not totally replaced. And at their recess events back home, Republicans got an earful from voters who are now worried and even afraid. They didn’t need activists to drag them out—they needed to confront their senators and representatives with their real-life concerns.

Clear Lake, Iowa, pig farmer Chris Petersen, a Democrat, confronted Republican Sen. Chuck Grassley and summed up the concerns that Republican were hearing across the country: “With all due respect, sir, you’re the man that talked about the death panels. We’re going to create one great big death panel in this country.”

But the Republican senators and representatives could offer little reassurance. Except to say: Just trust us.

And that brings me to the alternative that has always made the most sense to me. I first heard it decades ago from my great friend Michael Bromberg, Washington’s premier (actually, legendary) health care industry lobbyist, who died last year. As Washington kept politically self-destructing by devising all sorts of massive health care plans, Mike, a common-sense Republican, kept insisting all major objectives of all sides could be achieved by instead starting with the simplest idea:

Just take the best health insurance that is available to Washington’s elites—the senators and representatives and everyone who works for the federal government—and make it available to everyone in America.

The Federal Employees Health Benefits, or FEHB, Program basically allows all of Washington’s elites to enroll in any plan they choose—at very favorable rates (which can be negotiated because of the vast size of the federal plan’s membership).

So, if that plan is now the plan for all Americans, what about those who cannot afford to pay for coverage at all? Mike always said provisions must be enacted to assure that the poor will have subsidized coverage. And the near-poor and lower middle classes would receive supplemental aid on a sliding need-based scale. But the beauty of this plan is that it can be done without massively restructuring the entire health sector economy. So that’s where it merits bipartisan backing— yes, even here in the political hate-city of Washington.

When the ACA was enacted, it required all legislative branch employees (including senators, representatives and their staffs) to purchase coverage through the ACA networks in their states or Washington, D.C. So your senators and reps can’t buy into FEHB anymore. But all executive and judicial branch employees still get their coverage through FEHB. And, as the U.S. Office of Personnel Management website proclaims:

“Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country.”

That still sounds like a great place to start.