Enough is enough.
The Senate needs to get back to work and deliver a health care reform bill.
Meanwhile, President Donald Trump needs to shut off the flow of illegal health insurance subsidies to members of the House and Senate and congressional staff, and force them to live under Obamacare’s damage just like other Americans.
With the collapse of the Senate effort to advance a health care reform bill, Americans witnessed a monumental failure of governance.
For seven years, members of the House and Senate repeatedly promised the voters that they would repeal and replace Obamacare. The voters repeatedly rewarded them with election to office, and Republicans secured majorities in the House and Senate.
Senators must now keep their promises.
It is amazing that even the “skinny repeal” measure could not garner 50 Senate votes. That measure was in itself light years away from anything even remotely resembling a coherent and consequential health policy.
It boggles the imagination: The Senate could not even muster support for the repeal of Obamacare’s profoundly unpopular individual and employer mandate penalties, a watered-down version of a state waiver program, and a medical device tax that previously secured strong bipartisan opposition.
Note also that in the course of the Senate debate, senators junked serious provisions to reduce or eliminate Obamacare’s massive taxation, reform the Medicaid federal payment system (a reform, incidentally, initially proposed by the Clinton administration), or restore to the people of the states the freedom to decide the kind and degree of health insurance market regulation that would best comport with their needs to reduce health care costs and expand coverage.
For millions of middle-class Americans, paying their health insurance bills is now equivalent to taking out a second mortgage. 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.
Liberal Democrats, of course, have proposed their own “fixes” to Obamacare, which boil down to bailouts of the broken program and more taxpayer subsidies.
Another favorite liberal “fix,” endorsed by leading Senate Democrats, is the creation of yet another government health plan—“a robust public option”—to compete against private health plans.
Yet the only way a “public option” can produce lower costs than private insurance is by using the power of government to fix payment rates to doctors and hospitals below the market and require, as liberals initially proposed in 2009, taxpayers to assume the financial risks.
In other words, Congress would need to give the “public option” special advantages.
Senate members need to go back to work immediately and revisit the central policy problems created by Obamacare. They need to cut Obamacare’s slew of taxes, 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 or not they want to keep Obamacare’s costly insurance regulations and mandates, and phase down higher Medicaid payments to able-bodied adults without children who can work, so as to reorient federal spending toward the poorest and most vulnerable recipients.
Meanwhile, Trump should light a fire under both Republicans and Democrats in Congress by simply canceling 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.
If members of Congress want Obamacare, they should get it—good and hard.
Reform of the huge, complex $3.2 trillion health care sector of the American economy is not going to be achieved in a single bill, or even a set of bills. It will be an ongoing process.
The ultimate goal of that process is to give Americans direct control over the flow of their health care dollars, as well as control over their health care decisions. Real health care reform would result in a dramatic increase in Americans’ personal freedom, and a restoration of the traditional doctor-patient relationship.
Members of Congress who share these goals must be relentless. They need to revive efforts to repair Obamacare’s damage.
They also need to take advantage of every legislative opportunity to make further progress—appropriations bills, budget measures, the federal debt ceiling, the reauthorization of the Children’s Health Insurance Program (CHIP), or whatever suitable vehicle comes along.
They need to recover the trust of the American people, and they need to start today.