The prog­no­sis for re­peal of Oba­macare

Con­ser­va­tives con­tinue to sound the alarm about the ‘Af­ford­able Care Act’

The Washington Times Daily - - OPINION - J.T. Young served in the Trea­sury Depart­ment and the Of­fice of Man­age­ment and Bud­get and as a con­gres­sional staff mem­ber. By Ed Feul­ner Ed Feul­ner is founder of The Her­itage Foun­da­tion (her­

No­tably, Democrats sup­port the Demo­cratic Party less than Repub­li­cans do the Repub­li­can Party. Ad­di­tion­ally, Democrats’ greater party de­ser­tion is not just to vote for third party can­di­dates. They also vote for Repub­li­cans in greater per­cent­ages (8.4 percent) than Repub­li­cans vote for Democrats (7.4 percent). Democrats have done both in four of the last five elec­tions. Both con­tra­dict the pop­u­lar per­cep­tion of greater Repub­li­can dis­unity — at least among mem­ber ranks.

The five elec­tions are equally re­veal­ing re­gard­ing ide­o­log­i­cal sup­port. Con­ser­va­tives and lib­er­als were only slightly less loyal to par­ties than par­ties’ self-pro­fessed mem­bers. Con­ser­va­tives voted for Repub­li­cans on av­er­age 81.2 percent of the time, while lib­er­als voted for Democrats on av­er­age 84.6 percent of the time.

The ev­i­dence con­tra­dicts the per­cep­tion Repub­li­cans are the more ide­o­log­i­cally-at­tached party. Judged by lib­eral and con­ser­va­tive at­tach­ments, the con­clu­sion is not true. Tak­ing con­ser­va­tive and lib­eral vot­ing habits as in­dica­tive of how each group feels served by the re­spec­tive par­ties, lib­er­als feel Democrats do so markedly bet­ter (in each of the last four elec­tions) than con­ser­va­tives feel Repub­li­cans do.

Over­turn­ing these pop­u­lar as­sump­tions about Amer­i­can pol­i­tics raises a big­ger ques­tion. Why does the Demo­cratic Party, with a larger per­cent­age of the elec­torate and greater loy­alty from their ide­o­log­i­cal base, cur­rently trail Repub­li­cans elec­torally in Wash­ing­ton and even more so in the states?

A sim­plis­tic an­swer would be that it is be­cause Democrats desert their party in greater per­cent­ages. But that still only begs the ques­tion — why — es­pe­cially with the Demo­cratic Party ben­e­fit­ting from greater loy­alty in their ide­o­log­i­cal base.

Again, the num­bers pro­vide the an­swer. Al­though the Demo­cratic Party en­joys a much greater de­gree of ide­o­log­i­cal loy­alty from lib­er­als, that base is a dra­mat­i­cally smaller per­cent­age of the elec­torate than Repub­li­cans’ con­ser­va­tive one. Over the last five elec­tions, con­ser­va­tives have av­er­aged 33.8 percent of the elec­torate, just over a third; lib­er­als have av­er­aged just 22.8 percent, well un­der a quar­ter.

In Amer­i­can pol­i­tics, where small sin­gle dig­its mat­ter greatly, the 10.6 percent av­er­age dif­fer­ence be­tween lib­er­als and con­ser­va­tives mat­ters enor­mously. Even lib­er­als’ greater at­tach­ment to the Demo­cratic Party can­not off­set such a large quan­ti­ta­tive dif­fer­ence.

And there may be more than a sim­ple quan­ti­ta­tive dif­fer­ence at play too. Turn­ing back to pre­vail­ing con­ven­tional wis­dom, stripped of iden­ti­fiers, it premises that ide­ol­ogy was re­spon­si­ble for po­lit­i­cal dis­unity. Of course, by that it means Repub­li­can Party at­tach­ment to con­ser­va­tives frac­tures it.

Could not the same premise in­stead be po­lit­i­cally re­versed?

The points are there to make a case that the Demo­cratic Party’s stronger at­tach­ment to lib­er­als (as ev­i­denced by lib­er­als’ stronger at­tach­ment to it) has cre­ated a quan­ti­ta­tive and qual­i­ta­tive weak­ness. Quan­ti­ta­tively, the Demo­cratic Party’s ide­o­log­i­cal ally is sim­ply far less nu­mer­ous than Repub­li­cans’ — thus un­der­cut­ting their mem­ber num­bers ad­van­tage. Qual­i­ta­tively, that at­tach­ment may also ex­plain Democrats’ higher av­er­age party de­ser­tion — par­tic­u­larly to the Repub­li­can Party — than Repub­li­cans.’

It makes sense a party’s mem­bers would strongly sup­port it. It equally makes sense each end of the po­lit­i­cal spec­trum would sup­port the party they per­ceive most closely rep­re­sents their pri­or­i­ties — all vot­ers do that. The quandary ex­ist­ing in pre­vail­ing po­lit­i­cal anal­y­sis comes from the non­sen­si­cal con­clu­sions of con­ven­tional wis­dom: That the cur­rently ma­jor­ity party (Repub­li­can), de­spite its con­sis­tent mi­nor­ity of vot­ers, is harmed and frac­tured be­cause of ex­ces­sive at­tach­ment to one end of the ide­o­log­i­cal spec­trum (con­ser­va­tive). The re­ver­sal of con­ven­tional wis­dom ac­tu­ally bet­ter ex­plains cur­rent con­di­tions.

For more than seven years, Repub­li­can law­mak­ers, in­clud­ing Pres­i­dent Trump, cam­paigned on a prom­ise to re­peal Oba­macare. They rightly noted that Oba­macare se­verely dis­rupted the health in­surance mar­kets, mak­ing health plans pro­hib­i­tively ex­pen­sive for many Amer­i­cans. They re­minded ev­ery­one of Pres­i­dent Obama’s hol­low prom­ise that those who wanted to keep their health care plan or their doc­tor could do so if they wished.

The drum­beat was such that in 2015, when Mr. Obama was still in of­fice, Congress man­aged to pass a par­tial re­peal of Oba­macare.

The ef­fort was ve­toed, of course. But con­ser­va­tives didn’t give up.

We kept sound­ing the alarm about the dam­age that Congress had un­leashed by foist­ing the iron­i­cally named “Af­ford­able Care Act” on the pub­lic, while the Obama ad­min­is­tra­tion in­su­lated them from the full costs of the pro­gram with tax­payer sub­si­dies that were never even ap­pro­pri­ated. We ran the num­bers. We chron­i­cled the plight of real Amer­i­cans suf­fer­ing un­der the law.

Fast for­ward to 2017. The party that ran on a re­peal plat­form now holds the White House and a ma­jor­ity in both houses of Congress. Surely the plug would fi­nally be pulled on Oba­macare.

But no. In a vote that ig­nored the clear will of the Amer­i­can peo­ple, the Se­nate re­cently voted against tak­ing the next step in un­do­ing this dam­age.

In 2015, it was a cake­walk. Now, when there is an ad­min­is­tra­tion and a Congress in place that could get the job done, law­mak­ers have balked at the hard work of gov­ern­ing and un­do­ing the hard­ships of this dis­as­trous law.

And make no mis­take, un­do­ing is ex­actly what is re­quired here. No half-mea­sures will do. Re­peal is a must.

Oba­macare can­not be fixed or bailed out. The law’s man­dates, in­surance reg­u­la­tions, taxes, and ex­pan­sion of gov­ern­ment sim­ply go too deep. No par­tial ef­fort to ad­dress these prob­lems can truly free Amer­i­cans from the high in­surance costs and lim­ited choice they now face.

“For mil­lions of mid­dle-class Amer­i­cans, pay­ing their health in­surance bills is now equiv­a­lent to tak­ing out a sec­ond mort­gage,” writes health care pol­icy ex­pert Robert Mof­fit. “Com­pe­ti­tion among in­sur­ers is de­clin­ing pre­cip­i­tously in the in­di­vid­ual mar­kets (Aetna just re­cently pulled out of the Oba­macare ex­changes), and more and more Amer­i­cans are left with fewer choices and nar­rower net­works of doc­tors and other med­i­cal pro­fes­sion­als.”

That’s why it’s time for Congress to get back to work. Law­mak­ers need to revisit Oba­macare’s cen­tral prob­lems, pronto.

Step one, ac­cord­ing to Mr. Mof­fit, is to cut Oba­macare’s slew of taxes. Step two is to give the peo­ple and their state law­mak­ers the free­dom to de­cide for them­selves (us­ing an amended ver­sion of Oba­macare’s own Sec­tion 1332 waiver process) whether they want to keep Oba­macare’s costly in­surance reg­u­la­tions and man­dates.

Step three: phase down higher Med­i­caid pay­ments to able-bod­ied adults with­out chil­dren who can work. This would re­ori­ent fed­eral spend­ing to­ward the poor­est and most vul­ner­a­ble re­cip­i­ents.

Congress also could use a taste of its own medicine, so to speak, which is why Mr. Trump should can­cel the il­le­gal tax­payer in­surance sub­si­dies for con­gres­sional health cov­er­age — monies drawn from the Trea­sury by the Obama ad­min­is­tra­tion with­out statu­tory au­tho­riza­tion.

“That way, House and Se­nate mem­bers and staff can fully ex­pe­ri­ence Oba­macare the way that mil­lions of mid­dle-class Amer­i­cans do — hav­ing to pay in­flated pre­mi­ums with­out the ben­e­fit of special tax­payer sub­si­dies that are avail­able to no other class of Amer­i­can cit­i­zens,” Mr. Mof­fit writes. “If mem­bers of Congress want Oba­macare, they should get it — good and hard.”

In Wash­ing­ton, there are no per­ma­nent vic­to­ries or per­ma­nent de­feats. We must con­tinue to press to com­pletely roll back the dam­age caused by Oba­macare and re­place it with a pa­tient-cen­tered health sys­tem that works bet­ter for all Amer­i­cans.

Make no mis­take, un­do­ing is ex­actly what is re­quired here. No half-mea­sures will do. Re­peal is a must.



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