Fix Obamacare, finally
After falling one senator shy on an irresponsible, thrown-together plan cynically branded “skinny repeal” of the Affordable Care Act — thanks, John McCain — Senate Republicans have a fateful choice. They can finally meet the outstretched hand of Minority Leader Chuck Schumer, and get to work on real-world, bipartisan fixes to the law, which, though strained, is reparable.
Or they can go the vindictive way of the GOP leader, President Trump, who, movie villain-like, pledges to “let Obamacare implode,” then force the Dems to the table to humiliate and subjugate.
Obamacare is not some beast raging through the countryside, preying on women and children. It is a series of changes to federal law, many of them humane and long overdue, designed to increase access to health insurance.
Millions of families depend on the protections it provides and the insurance it makes available through intentionally interconnected policy.
Among other things, the law bars insurers from discriminating against customers on the basis of preexisting conditions. Sets limits on how much insurers can charge older Americans.
Allows kids to stay on their parents’ insurance to age 26. Establishes state-by-state insurance marketplaces for those who don’t get insurance through their employer or from the government.
Provides subsidies based on income — funded by built-in taxes — to Americans to help them afford policies on the individual market. Expands Medicaid in cooperation with states, so more low-income Americans are covered.
And requires all Americans to carry insurance or pay a penalty, to ensure that younger and healthier people make markets functional.
Trump, as chief executive of the federal government, has a duty to faithfully execute those laws, not to undermine them at every turn.
Instead, he cares only about “winning” — which to him means not serving the American people, but narrowly prevailing in the political fight as he’s framed it.
So intent was Trump on scoring this “win,” he was ignorant of the details of wildly different House and Senate plans to gut it. Didn’t matter to the President what happened to America’s health care, as long as he could put the notch in his belt.
Nor is Trump honest when he uses the verb “let,” as though the law is set to collapse of its own dysfunctional weight without intervention. What the President portrays as allowing nature to take its course is actually sabotage of a law that is, in many respects, functioning as intended.
The feds have an obligation to continue monthly payments to insurers, called cost-sharing-reduction subsidies, designed to drive down copayments and deductibles for lower-income households. Trump has threatened to stop them.
The feds have an obligation to let people sign up during Obamacare’s open enrollment period.
They have an obligation to impose a legal penalty on those without insurance.
While Trump must stand down from his dream of dismantling the law by fiat, Congressional Republicans must accept Schumer’s invite and address weak points. Fix the law, don’t shred it.
That means creating reinsurance programs that cover the highest medical costs on the Obamacare exchanges. Attacking the rising cost of prescriptions by allowing the government to negotiate lower drug prices for Medicare and Medicaid.
And adjusting subsidies to make them more responsive to health consumers’ needs.
Come to the table. Work together. For once.