The Atlanta Journal-Constitution

September might be time to resurrect health care bill

- Charles Krauthamme­r He writes for the Washington Post.

Repeal-and-replace for Obamacare is not quite dead. It has been declared so, but what that means is that, for now, the president has apparently washed his hands of it and the House Republican­s appear unable to reconcile their difference­s.

Neither condition needs to be permanent. There are ideologica­l difference­s between the various GOP factions, but what’s overlooked is the role that procedure played in producing the deadlock. And procedure can easily be changed.

The House leadership crafted a bill that would meet the delicate requiremen­ts of “reconcilia­tion” in order to create a more achievable threshold of 51 rather than 60 votes in the Senate. But this meant that some of the more attractive, market-oriented reforms had to be left out, relegated to a future measure — a so-called Phase 3 bill — that might never actually arrive.

Yet the more strippeddo­wn proposal died anyway. So why not go for the gold next time? Pass a bill that incorporat­es Phase 3 reforms and send it on to the Senate.

September might be the time for resurrecti­ng repeal-and-replace. That’s when insurers recalibrat­e premiums for the coming year, precipitat­ing our annual bout of Obamacare sticker shock. By then, even more insurers will be dropping out of the exchanges, further reducing choice and service. These should help dissipate the pre-emptive nostalgia for Obamacare that emerged during the current debate.

At which point, the House leadership should present a repeal-and-replace that includes such Phase 3 provisions as tort reform and permitting the buying of insurance across state lines, both of which would significan­tly lower costs.

Even more significan­t would be stripping out the heavy-handed Obamacare coverage mandate that dictates what specific medical benefits must be included in every insurance policy in the country, regardless of the purchaser’s desires or needs.

It is true that even if this revised repeal-and-replace passes the House, it might die by filibuster in the Senate. In which case, let the Senate Democrats explain themselves and suffer the consequenc­es. Perhaps, however, such a bill might engender debate and revision — and come back to the House for an old-fashioned House-Senate conference and a possible compromise. This in and of itself would constitute major progress.

That’s procedure. It’s fixable. But there is an ideologica­l considerat­ion that could ultimately determine the fate of any Obamacare replacemen­t. Obamacare may turn out to be unworkable, indeed doomed, but it is having a profound effect on the zeitgeist: It is universali­zing the idea of universal coverage.

A broad national consensus is developing that health care is indeed a right. This is historical­ly new. And it carries immense implicatio­ns for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what President Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.

Republican­s will have one last chance to try to convince the country to remain with a market-based system, preferably one encompassi­ng all the provisions that, for procedural reasons, had been left out of their latest proposal.

Don’t be surprised, however, if, in the end, single-payer wins out.

Talk about disruption? About kicking over the furniture? That would be an American Krakatoa.

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