What's Up for Obamacare This Fall?

On August 22, the Washington Times ran "Senate health panel announces hearings on Obamacare markets" by Tom Howell, Jr., who quoted health committee chairman Sen. Lamar Alexander: "While there are a number of issues with the American health care system, if your house is on fire, you want to put out the fire, and the fire in this case is in the individual health insurance market."

Alexander is "pushing for legislation that props up Obamacare's markets, which failed to attract young and healthy people in the early rounds, in part by funding critical 'cost-sharing' reimbursements."  In this effort to prop up Obamacare's markets, Alexander is seeking a bipartisan solution, working with Democrat Patty Murray.  The article also reports a bipartisan plan being forged by two governors that "would focus on stabilizing the individual market."

It seems that some Republicans have given up on their pledge to repeal Obamacare.  On Aug. 21, The Weekly Standard ran "Diagnosis: Heartburn" by Jay Cost.  The blurb was "Is an Obamacare Bailout Coming?"  Jay Cost thinks so, and the reason for it won't please conservatives:

If history is any guide, conservatives should prepare themselves for some kind of bailout of the insurance industry – a backstop of some sort to keep insurers on the exchanges, offering policies that are not prohibitively expensive. Such a subsidy, while sure to generate bad headlines, would be perfectly in keeping with the corporatism that has defined our welfare state for more than half a century. ...

The unfortunate truth is that many Republican politicians are much more comfortable with Obamacare than they have let on these last seven years. Push comes to shove, they like its corporatist approach, and rather than doing the hard work to reform it will prefer simply to write a check to the insurers.

Mr. Cost repeatedly refers to "corporatism."  Republicans in Congress need to appreciate that one form of corporatism is the economic system of fascism.  Corporatism is when government gets in bed with business, and it hasn't worked very well in the health insurance industry.  On August 8 at The Hill, Mallory Shelbourne quoted Senate majority leader Mitch McConnell:

Now our new president has of course not been in this line of work before. And I think had excessive expectations about how quickly things happen in the democratic process. And so, part of the reason I think people feel like we're underperforming is because too many artificial deadlines unrelated to the reality and the complexity of legislature may not have been fully understood.

McConnell doesn't seem to appreciate that the problem with his legislation is its complexity.  But there's nothing complex about repeal.  Repeal can be entered on a single sheet of paper.  Republicans in Congress made the replace part complex by trying to retain Obamacare's "individual market" and its subsidy program.

If Senator McConnell can't get repeal done this year, then he needs to be replaced as majority leader with someone who can.  One August 10, The Daily Caller ran "Here's Who Could Replace McConnell As Senate Majority Leader" by Thomas Phippen.  It's an impressive list, but unless McConnell's replacement is prepared to jettison the filibuster, the GOP will just be playing games.

If Republicans like Senators Alexander and McCain are so anxious to get back to regular order and bipartisan legislation, then what they should have done back in January is a simple repeal of the individual and business mandates that would have taken effect immediately.  That would have told the Dems that the GOP was serious about keeping the promises they made to the voters, and it would have created the possibility for some real bipartisanship.  Instead, Republicans reach out to the opposition only after they've failed.

The above repeal of the individual mandate should also have outlawed commanding Americans to buy things, thus codifying certain dicta in NFIB v. Sebelius (see page 50 of the pdf): "The Federal Government does not have the power to order people to buy health insurance. Section 5000A would therefore be unconstitutional if read as a command."

Repealing the individual mandate would be disastrous for what's left of the Obamacare exchanges.  But Obamacare was disastrous for the pre-existing individual market.  The GOP's replacement legislation is complex precisely because it is trying to retain Obamacare's replacement for the individual market – i.e., the exchanges.  Government needs to get totally out of the individual market for health insurance.  It was government that ruined the individual market, which now requires constant infusions of government cash to private insurance companies just to keep limping along.  There's your corporatism, America.

Having wasted the first seven months of a historic opportunity to change the direction of government, the Republican Congress is turning out to be a huge disappointment.  There's still time enough to turn it around.  But if Republicans are not willing to do what's necessary to keep their promises to repeal and replace, then each and every one of them needs to be primaried and replaced.

Jon N. Hall of Ultracon Opinion is a programmer/analyst from Kansas City.

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