Obamacare put Republicans back in the majority in 2010. Failing to repeal it will take them out. You cannot run for election promising to repeal the law, vote to repeal it 50 times knowing that President Obama would veto it, and then fail to repeal it when you had the votes to do so. Americans do not know all of the moves in the Congressional dance, but they know when they’re being played.
Shortly after Obamacare was signed into law Rep. Steve King (R-Ia.) filed a discharge petition to repeal it. If 218 members of the House sign a discharge petition it must be brought immediately to the floor for an up or down vote.
The Republican leadership urged its members to not sign the petition. They warned that certain provisions of Obamacare, such as allowing children to remain on their parent’s insurance up to the age of 26 and the mandated coverage for those with pre-existing conditions, were popular and Republicans shouldn’t want to be accused of taking those benefits away.
Republicans are now debating over how to keep their campaign promise to repeal Obamacare without taking away the popular Obamacare benefits.
They will maintain the fiction that 26 year-old “children” should remain on the coverage of Mommy and Daddy. They will maintain coverage for pre-existing conditions. They will find a way to help pay the premiums for lower-income Americans.
The vast majority of Americans still get their coverage from their employer. Of those who gained coverage because of Obamacare, two-thirds went to Medicaid. The repeal of Obamacare will leave approximately four percent of America to be dealt with. Surely a solution can be found for them.
There are four issues that should be addressed to solve the majority of the problems.
First, a 1986 law makes it illegal to refuse emergency room care regardless of ability to pay. That has become health care coverage for a significant part of the so-called uninsured.
I once visited a chicken processing plant in my district. The general manager told me that only 40 percent of her employees availed themselves of their health coverage because they didn’t want to pay their $90 per month share of the premium. In the previous year two of her employees, who were covered, had babies and told the hospital they didn’t have insurance. They didn’t want to pay the co-pay. No one on any side of this debate has suggested dealing with the 1986 law. They need to revisit it.
Second, before Obamacare was passed policies were sold state by state and costs varied widely due to legislatures mandating benefits. It began with the women’s movement demanding that laws be passed to mandate that all insurance policies include coverage for pap smears and mammograms. Then men demanded coverage for prostate screens. Today some states require coverage for sex reassignment surgery while others mandate coverage for hair transplants. Guess what? When you mandate that all be covered for something that few will use the cost goes up.
That is precisely what happened with Obamacare. A 60 year-old couple wanting to slip away into retirement has to be covered for obstetrics and pediatric dentistry. People should be allowed to choose what they want to insure.
Third, much of America works for small business. A business employing 5 to 10 people has a pool too small to adequately spread risk and it will pay a huge premium. Allowing the pooling of many companies or associations into one plan would increase the size of the pool and lower costs.
Fourth, doctors provide tests that are marginally helpful to be able to defend their care in the event of a lawsuit. True story: A lady without insurance went into the emergency room with a ferocious headache. The doctor concluded that she had a migraine and then proceeded to run more than $2,000 worth of tests. He then prescribed medicine for migraines. When asked about all the tests he said sadly that there was a small chance that he would be sued and he had to make sure he covered all the bases. We have no idea how much additional costs are added for this reason, but it’s conceivable that it doubles the cost of healthcare.
Doctors who fight the charges in court generally win, but insurers usually choose to settle. Passing a law forcing the loser to pay for the costs of the suit would go far in limiting lawsuits.
Will all of this be dealt with? Probably not. There is no appetite for eliminating the mandatory coverage in emergency rooms. Tort reform was passed in the House in 1995 and defeated in the Senate. It may be addressed this year but it will have trouble in the Senate again. None of the bills stop state legislatures from mandating benefits.
Congress should repeal Obamacare tomorrow and then debate how to replace it by open enrollment season next fall. Concerning which, a modest suggestion: If Congress fails to come to a conclusion they can just offer America the same program that Congress has.
During the debate on HillaryCare Rep. Cliff Stearnes (R-Fla,) introduced a bill that would open the Federal Employees Health Benefit Plan to all. The FEHBP crosses state lines. It is delivered by private insurers competing for business. It allows all to choose what they want to insure against.
Businesses could buy in to cover their employees and states would be allowed to put their Medicaid population into the program to save large sums in management costs. Such a pool of tens of millions would be large enough to cover pre-existing conditions with some premium support from the state risk pools.
The legislation to accomplish this would take approximately one page. It should include tort reform in the form of loser pays.
The American people could get health insurance, not only as good as Congress, but the same as Congress. End of discussion!
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