07 Mar Sauce for the Goose is Health Care Chaos for the Gander
The basic structure of the proposed House legislation on ObamaCare began to be leaked out over the weekend, and the full report came Monday. For 48 straight hours the expected cast of characters were relentless.
“Paul Ryan is a sellout.”
“This is ObamaCare lite.”
“These Republicans should rot in hell.”
And so forth and so on. The imperfections of the bill were put on full display, and the characters blamed were that logical cast of do-nothing losers in the “establishment” world of GOP politics. Rand Paul piled on. My friends at the Club for Growth went ballistic (and they actually are my friends). Heritage Action PAC (becoming the most credibility-strained group on capital hill) said the bill “expanded on the progressive promises of ObamaCare.” It’s been a bloodbath, some of which has been filled with genuine policy disagreement, and some of which has been utterly ignorant and politically oblivious. But in the course of the bloodbath, the Trump-loving, Paul Ryan-hating class forgot to ask: “What if this whole thing is straight from the desk of Donald Trump?” Those who couldn’t bring themselves to criticize Trump if he tweeted something utterly lacking in evidence about Barack Obama, or if he shot someone on Fifth Avenue, have been left in a quandary. They are supposed to hate Paul Ryan and his merry band of sellout liberal posers, and they are supposed to love Donald Trump and his swamp-draining, a$s-kicking, art of the deal ways. What is one supposed to do when it turns out Trump and Ryan are in this together?
Can I make a suggestion to those on the right who claim they want to reform the broken parts of the Obama administration, and who want to maintain some credibility for the length of time Trump is in office?
Do some homework, understand the policy, understand the politics, and just speak for the truth. Don’t bounce around like a devil in the high wind trying to figure out who it is okay to love one day and who it is okay to oppose another. Stand for something, please.
Here are the facts of the House legislation:
It is not perfect, but it does a lot of great things. The positives:
(1) It is a massive, and I mean, massive, tax cut. Over $600 billion of a tax cut! There are so many taxes embedded in ObamaCare the American people do not know about that there are the same amount of taxes repealed in the House bill the American people do not know about.
(2) It does a lot to reform the individual market. Do I believe the individual mandate should go, and not just the penalty attached? Yes, I do. But what this plan does is create high-risk pools separate from the individual market, and it certainly offers less stringent plans geared at bringing costs down.
(3) It massively expands the use of Health Savings Accounts. This is a pro-market solution and one that should continue expanding with even less restrictions into the future.
(4) It takes away federal (and unconstitutional) support of Planned Parenthood. No further comment necessary.
Now, there are plenty of negatives, some that bother me even given the politics and some that are probably forced upon us by the political reality:
(1) The pre-existing condition coverage requirement is, of course, ridiculous. It is also non-movable politically right now, and everyone knows it.
(2) It does not repeal enough regulations, even where it could do so politically and pragmatically.
(3) It’s dealing with Medicaid seems haphazard and inadequate. It expands federal subsidy for three years, and assumes the political environment will allow them to peel back at that point. Good luck.
(4) As best I can tell, it doesn’t touch tort reform, which is insane.
At the end of the day, the problems we face in repealing and replacing ObamaCare come from the reality of its passage: The ACA was a subsidy, unpaid for, and it has further created dependency on government, this time with people’s most private and crucial of issues – their own health care. It should never have been passed. The reality is that the people of the United States have politically declared – we want our own doctors, the best care, the lowest premiums, pre-existing coverage, and Johnny and Julie to be under mommy and daddy’s policy until they are eight years older than legal adulthood. The American population’s Santa Claus wish list is untenable, and now ObamaCare has allowed enough people to touch it that peeling back is tricky. I support any who want to commend the good things and fight the bad things, but I believe those tying their view into a lambasting of the GOP establishment, ignoring the reality that this is President Trump’s proposed bill, are guilty of an incredibly disingenuous approach.
So here we are. I am praying for some improvements to the final bill before it goes forward for a vote. I am reasonably optimistic that will happen. But I hope that those who share my desire for more real and authentic market reforms will align their view with consistency, regardless of what company they think their views have.