Seize the moment to fix floundering Obamacare
The U.S. House Energy and Commerce Committee pulled an all-nighter, voting to approve a Republican replacement for Obamacare after a 27-hour session. The House Ways and Means Committee session lasted 18 hours and finished with a vote around 4 a.m.
Yes, the majority of House Republicans are in a huge rush to repeal and replace Obamacare. That is, they’re in a rush to keep a campaign promise. They’re also in a rush because of mounting opposition — not just from Democrats and associations representing doctors, nurses, hospitals and seniors but from conservative Republicans in the House and Senate.
Those conservatives are pumping the brakes hard on this proposed American Health Care Act. Some deride the bill as “Obamacare Lite” — replacing one overly generous entitlement with another.
These lawmakers seek a full repeal — Obamacare completely wiped away — including popular features that allow children to remain on parents’ policies until age 26 and forbid insurers from denying coverage for pre-existing conditions. One of them, Sen. Tom Cotton of Arkansas, urged his colleagues to “pause, start over. Get it right, don’t get it fast.”
That’s always a useful exhortation. But we agree with House Speaker Paul Ryan about the stakes here: “This is the closest we will ever get to repealing and replacing Obamacare,” he says. “The time is here. The time is now. This is the moment.”
Lawmakers who don’t seize it, especially Republicans, should expect the wrath of voters in 2018 and 2020.
Sure, everyone wants to see the Congressional Budget Office scoring of the bill, which will show its impact not only on the budget but also on Americans who now have insurance under Obamacare. That’s crucial. The CBO report should estimate how many people would gain or lose coverage under this legislation, and how different age groups and regions of the country might be affected. The CBO also may weigh in on how the proposal’s dramatic changes to Medicaid would affect enrollment and state budgets.
If the CBO says the GOP plan bounces too many Americans from coverage without giving them an affordable alternative, Republicans will have to retool, fast.
But remember why we’re in this situation. Obamacare isn’t some health care panacea, gaining new insurers and covering exponentially larger numbers of Americans every year. It’s floundering.
Fed-up insurers continue to abandon its markets because they can’t make money.
Among the latest to leave is Humana, one of the nation’s largest health insurers, which announced in February that it will stop selling Obamacare health plans next year for the same reason that others have pulled out of the marketplaces: With so many relatively healthy people avoiding Obamacare plans because of their fast-rising premiums and enormous deductibles, Humana reports that it is losing money on a sicker-than-expected customer mix.
Millions of Americans are happy with their coverage. They gained insurance, and that is extraordinarily valuable. But others can’t find affordable coverage that includes their doctors and hospitals.
If the Republican plan — with its less generous subsidies for some and its revised market-based rules — diminishes the number of Americans able to buy insurance, then an amended bill and subsequent bills can expand the law’s reach and affordability.
Right now, though, the choice is stark: Stick with Obamacare, its imploding markets and its millions of still-uncovered Americans.
Or drive toward a more flexible approach. These moments come rarely, most often when a new Congress isn’t yet obsessing on the next election.
Critics are focusing on what they don’t like about this bill. But this doesn’t have to be the last bill. It does, though, have to be the first bill — or Obamacare will finish its collapse, and Americans will have nothing in its place.