Get­ting to the heart of health care

The Se­nate must move now to re­peal and re­place Oba­macare

The Washington Times Daily - - EDITORIAL -

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.

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