I hope you had a better summer than Obamacare did. The president’s signature achievement has suffered blow after blow. Let’s recount:
1. The administration was forced to delay implementation of the employer mandate. The individual mandate remains in place, but it will operate on the “honor” system regarding subsidies.
2. The administration had to lift the cap on out-of-pocket expenses for those using the exchanges.
3. The administration delayed signing off on insurer contracts for the exchanges.
4. We learned the exchanges are bedeviled by data security concerns.
5. Aetna, one of the largest insurers, is pulling out of one of the biggest markets, New York, and four other states.
7. Costs are skyrocketing, as the National Journal confirms today (“For the vast majority of Americans, premium prices will be higher in the individual exchange than what they’re currently paying for employer-sponsored benefits. . . .”)
8. When the House voted to delay the individual mandate nearly two dozen Democrats crossed over to vote with Republicans.
9. The right-wing effort to “defund” Obamacare was rejected by the speaker of the House and has failed to gather steam in the Senate, depriving the White House of a badly needed distraction.
10. Poll after poll shows Obamacare is more unpopular than ever, and the president is so lacking in credibility he has had to draft President Bill Clinton to drum up support for it.
Opponents of Obamacare should recognize how big a burden this will be for the Democrats in 2014 and 2016. But they must also take care to do nothing to muddy the waters. This is the president’s baby and the Democrats’ burden; let them defend it.
Given how badly Obamacare has been roughed up, the temptation is great to say Republicans don’t have to come up with their plan. That’s bad politics and a missed opportunity. Voters want a few things (e.g. protection from rate hikes for preexisting illnesses) and will be hesitant to dump the whole thing without assurance these will remain in place.
Moreover, given how costly Obamacare is and how many people will remain uninsured (20 million? 30 million?) this is the easiest time to introduce a GOP alternative. “It’s not universal!” the Dems will scream. Well, neither is Obamacare. “Costs will exceed whatever government subsidy or voucher Republicans propose!” Well, probably not as much as under Obamacare.
Ideally we should wean the public away from tax-exempt employer-provided health insurance. However, for now, it would be advisable to add to the existing health-care system with a comparable tax treatment for individually purchased plans and a credit for poorer Americans. Americans should be able to buy a plan, if desired, of the type they want (e.g. catastrophic for the young and healthy) with expanded health savings accounts (pre-tax dollars can be used to pay for premiums, deductibles, etc.). Throw in some transparency for insurance customers, interstate insurance sales and Medicare and Medicaid reform along the lines Rep. Paul Ryan (R-Wis.) has laid out. The result would be a perfectly presentable alternative that doesn’t raise taxes, isn’t compulsory, doesn’t create a huge new bureaucracy with the Internal Revenue Service as enforcer and will wind up costing a whole lot less. Oh, and it will allow you to keep your own plan, something that Obamacare plainly won’t permit in all cases.
When that alternative is available (You want Obamacare or a credit for whatever plan you want? You want to keep your coverage and your spouse’s plan under your employer plan, or have your spouse dumped under Obamacare?) Americans will demand Obamacare be jettisoned.