Getting to the heart of health care
The Senate must move now to repeal and replace Obamacare
It’s still there. Like chewing gum stuck to the bottom of a shoe, Obamacare refuses to let go. No other Republican promise made over the past eight years, repeated endlessly during 2016 presidential election campaign, was more popular than the assurance that Barack Obama’s namesake legislation would expire with his term of office. Six months into Donald Trump’s presidency, the promise remains unredeemed. That may soon change. With the hammer of repeal and replacement about to drop, two words of advice: Don’t miss.
It’s do or die for Senate Majority Leader Mitch McConnell, whose secretive team of Republican senators is racing to release its version of the House-passed American Health Care Act by Thursday, with a Senate vote promised before the Fourth of July recess. Anything short of 50 votes plus Vice President Mike Pence as a tiebreaker would be devastating for the Grumpy Old Party.
For President Trump, the end of Obamacare cannot come soon enough. In Milwaukee last week to highlight the health insurance dilemma, the president tweeted: “2 million more people just dropped out of ObamaCare. It is in a death spiral. Obstructionist Democrats gave up, have no answer = resist!” The White House added a sobering statistic to drive home the point: Individual premiums have doubled between 2013 and 2017.
The president’s alarms over the collapse of the Democrat-engineered plan have kept momentum rolling toward repeal following the House vote last month. It’s puzzling that Mr. Trump is said to have told several senators last week that the House bill is “mean,” and the Senate version must reflect more “heart.” With a spare two-seat majority, senators laboring without the help of a single Democrat are on a high wire without a net. Catcalls risk making a fatal slip likely.
The Congressional Budget Office estimates that the American Health Care Act, which passed the House by a comfortable margin, would leave 23 million Americans without insurance. Though some who want insurance but can’t afford it might agree the plan is “mean,” millions of others, particularly the young, don’t have insurance because they don’t want it. It’s a risky choice, but it’s a choice.
Mr. Trump’s remark, if indeed that’s what he said, casts a shadow over the House bill, with which the Senate version must be reconciled. Aware of the president’s criticism, some senators are said to be considering a more Democratfriendly plan that phases out Obamacare’s taxes more slowly than the House version, to preserve funding for Obamacare-driven Medicaid expansion, boost tax credits offered by the replacement plan, and to pay for opioid treatment.
Nudging the legislation closer to a system that is failing — the system critics call Obamacare Lite — will earn no points for compassion. Americans currently with Obamacare policies know what it means to have health insurance but not health care. They’re waiting for Congress to get on with repealing the insurance they can’t afford to use and enable them to buy a policy that they can afford to use. It’s called “choice.”
A Senate retreat toward government-mandated health care will consign any replacement plan to the death spiral that doomed Obamacare. If the Republicans fail, a future Democratic administration — and eventually there will be one — will enact a single-payer program, a permanent socialist welfare-state health care system. That really would be heartless.