replace

‘They Have Promised This for the Last Four Election Cycles’

July 18, 2017 by GregC

Republican hopes of repealing or even drastically reforming Obamacare appear more bleak than ever after enough lawmakers emerged in the past day to scuttle an amended health care bill and sink a promised vote on a repeal bill.

Nonetheless, free market health advocates believe there is a way for this Congress to make headway while the GOP still controls the levers of power in Washington.

Moderates and conservatives are glum Tuesday. Senate Republican leaders were clinging to hopes of squeaking their amended bill through, even after Sens. Susan Collins, R-Maine, and Rand Paul, R-Ky., announced their plans to vote against the motion to proceed to the bill, albeit for completely different reasons.

However, on Monday evening, Sens. Mike Lee, R-Utah, and Jerry Moran, R-Kansas, publicly opposed the plan for not doing enough to eliminate taxes, reduce premiums, or kill regulations. With all 48 Democrats firmly opposed, four GOP defections spelled defeat for the legislation.

“I think there are just too many factions within this Republican caucus and with only two votes to spare, there just was not enough room for differences of opinion,” said Galen Institute President Grace-Marie Turner.

She says moderates were not willing to give up the federal Medicaid dollars.

“You’ve got the moderates who are very worried about losing the incredibly generous Medicaid match that their states are getting. Most of them are from states that expanded Medicaid. Remember, the federal government initially paid a hundred percent of the cost of the usually joint federal-state program if the states would put more people on their Medicaid rolls,” said Turner.

She says conservatives had their own reasons to balk at the larger GOP bill.

“Many conservatives are worried, rightly, about the regulations in Obamacare that are so difficult to reach through this narrow pathway that the Senate has to pass legislation with only a simple majority of votes,” said Turner.

“There’s some conservatives, like Rand Paul, who feel that any effort to try to do something else to provide subsidies to people going forward is really perpetuating Obamacare,” said Turner.

In response, Senate Majority Leader Mitch McConnell said he would bring forward a bill to repeal much of Obamacare and trigger a two-year sunset to give lawmakers time to craft a replacement. While hailed by conservatives, those hopes were also soon dashed as Collins and Sens. Shelley Moore Capito, R-West Virginia, and Lisa Murkowski, R-Alaska, revealed they would not vote on a repeal without seeing a replacement bill.

Both Capito and Murkowski voted for the same repeal bill in 2015 despite the absence of a replacement plan. President Obama vetoed the earlier repeal.

Turner says lawmakers act differently when a bill has no chance of becoming law than when it does.

“They knew President Obama was going to veto it, so there’s a difference between messaging and governing,” said Turner.

With Senate leaders unable to bridge the narrow divide between conservatives and moderates and the straight repeal apparently headed to defeat, many on the right believe it’s time to move on to other priorities.

Turner says that is not an option.

“They can’t not do something on repealing Obamacare. They have promised this for the last two election cycles. Every single member is going to have to go to his or her constituents and explain why, after all of this debate over Obamacare, they can’t get it done,” said Turner. “They known they have to do something.”

President Trump now suggests he may just let Obamacare collapse and blame Democrats since they did nothing to solve the problem. Turner says that strategy won’t work.

“They are going to be blamed for the millions of people that would lose coverage if nothing is done because these exchanges are failing, insurance companies are signing up to provide coverage next year because they are losing so much money providing so-called insurance under Obamacare rules that don’t work,” said Turner.

“Republicans own it. How can you have the White House and both houses of Congress and say that you don’t own this problem,” said Turner.

That being said, Turner is also slamming Democrats for asserting that Republican promises to repeal Obamacare are creating uncertainty among insurers and that is why premiums and deductibles are skyrocketing, rather than the Obamacare provisions themselves.

“That is just so completely beyond the realm of reality. The reason that costs are going up under Obamacare is because of the flawed structure of the bill that, for one thing, encourages people to wait until they’re sick to sign up for coverage and that provides all sorts of opportunities for people to drop coverage and game the system,” said Turner.

She still holds out hope that lawmakers will send power back to the states to address health care problems in the most effective way.

“Washington-centralized solutions are not the answer, whether Republicans are developing them or Democrats are developing them,” said Turner.

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‘All the Wrong Moves in the Obamacare Direction’

June 30, 2017 by GregC

A key member of the House Freedom Caucus says the Senate health care bill drifts too far towards the existing framework and that the smartest approach would be to repeal Obamacare and then get to work on a replacement, although he does not expect GOP leaders to choose that path.

Rep. Dave Brat, R-Virginia, taught economics for 20 years before pulling off a stunning defeat of then-House Majority Leader Eric Cantor in a 2014 Republican primary. He could not support the Senate bill unveiled by leaders last week.

“The original bill coming out of the Senate kind of made all the wrong moves in the Obamacare direction, which is shocking,” said Brat.

“It’s not just about adding more coverage or helping more people. That’s the way most people are thinking about this. What I think people lost track of is Economics 101. Obamacare is in the ditch because of its own economic logic,” said Brat.

He says lawmakers on both sides struggle to see the big picture.

“That Obamacare logic was just about 100 percent attention paid to coverage and no attention paid to the price of health care. As a result, people were covered with gold-plated health insurance policies, but no one could afford health coverage,” said Brat.

With Senate Republicans now unable to move their own bill, Brat enthusiastically endorses the suggestion of Sens. Rand Paul, R-Kent., and Ben Sasse, R-Neb., to repeal Obamacare now and then get to work on a replacement that can pass.

“The rational politics would have been, initially, to repeal Obamacare, which all of those senators voted for when it didn’t count. They all voted for the 2015 package to repeal Obamacare,” said Brat.

He says that’s exactly what Republican voters expected after the 2016 elections, but they aren’t getting it.

“When you vote 50 times to repeal and then you tell the American people you’re going to repeal and then you end up very close to Obamacare logic. That is not good for the Republican brand,” said Brat.

Brat is confident that if repeal came first, there would be plenty of interest across the spectrum in getting on board with the replacement bill.

“Then you have the leverage to work with the Democrats. There’s no shortage of people who want to add programs in D.C. in the swamp, right? So you first repeal and then the floodgates are open to add. You can get as many votes as you want from any politician to say yes. Politicians love to say yes. That would have been a brilliant move back in January,” he said.

So will House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell embrace that idea now that a comprehensive bill is flailing in the Senate? Brat is not holding his breath.

“I went to seminary so I’ll be praying for it, but I’m doubtful. That would be too good of news. I don’t think we’ve got a big enough spine to carry that off,” said Brat.

But why? Republicans scored decisive wins in three separate election cycles, due in large part to their promises to repeal Obamacare. So why aren’t they following through?

Brat sees three key reasons: keeping the special interests happy, the effort to protect vulnerable Senate incumbents from unpopular votes, and a relentlessly hostile media.

“Up in D.C., you’ve got to appease the swamp, so there’s all sorts of moneyed special interests you have to appease, ” said Brat, noting that the insurance companies love what the Senate GOP produced. “Then if you’re in tough seats, you’ve got to try to support those tough seats.”

Brat says the influence of the major insurance companies is a big problem, one that James Madison and Adam Smith warned against long ago.

“Both of them had the exact same logic. You want a large number of small competitors duking it out in this country. We’ve lost that. That’s the American way. Instead, we’ve got a few huge oligopolies running from D.C., which the elites can put their thumb down on and that’s why the American person is getting hammered right now,” said Brat.

As for the media, Brat says the avalanche of false, negative coverage is tough for many members to weather.

“After we passed the House bill, the mainstream media repeated misinformation and fake news for the next week. It was one simple line: House bill gets rid of pre-existing conditions. Everybody with pre-existing conditions is on their own and there’s going to be death in the streets,” said Brat.

“It is daunting to have confidence in the people back home, that they can see through that message when that’s all you see as a politician is that mainstream media. CNN, New York Times, Washington Post: House guts, destroys obliterates – all these crazy words. Then they say, ‘Politicians, you guys have to be more civil,’ as they lambaste us with falsehoods constantly,” said Brat.

One of the main reasons Brat opposes the Senate bill is because it fails to deal with what he sees as the fatally flawed framework of Obamacare.

“At least the House package had a little bit of room to negotiate some of the regulations and the regulations are Obamacare. If you don’t get rid of the Obamacare regulations, a young person cannot go out and buy a catastrophic package out of college, so they’re left with a gold-plated plan with a $2,000-$3,000 deductible. And I don’t know a lot of college grads with two or three grand in their pocket,” said Brat.

He is imploring his fellow Republicans to proceed on the principles they constantly espouse about the success of the free market.

“If you believe in free markets and the standard American package of free enterprise, etc., that will deliver the goods. Everybody knows these eye surgeries that started out at $6,000 per eye are down to $450 per eye to get your Tiger Woods eye surgery,” said Brat.

“That’s what the market can do if you let it alone. If you let the government intervene, you end up with Medicare, which is insolvent in 2034. You end up with Social Security, which is insolvent for the kids in 2034. $20 trillion in debt, $100 trillion in unfunded liabilities to those major programs, and we’re going to add more government,” said Brat.

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‘Let’s Do What We Said, Let’s Repeal Obamacare’

March 20, 2017 by GregC

Republican leaders are hoping to pass their health care replacement plan on Thursday, but the conservative sponsor of legislation to fully repeal the Affordable Care Act says the current GOP preserves far too much of the current system and must be rejected.

Rep. Jim Jordan, R-Ohio, is also a co-founder and former chairman of the House Freedom Caucus and has introduced legislation to fully repeal the Affordable Care Act, also known as the ACA or Obamacare. Jordan is vigorously opposed to the current version of American Health Care Act, arguing this is not what Republicans promised voters since 2010.

“We’re not repealing Obamacare. Even people who are for it, like Charles Krauthammer, has said it’s Obamacare-lite. It keeps the Obamacare structure and that’s not what we told the voters. If you don’t repeal Obamacare, you’re never going to bring down the cost of insurance for middle class and working class families,” said Jordan.

“So it is really that basic. Let’s do what we said. That’s what they sent us here to do. Let’s actually repeal Obamacare. A clean and complete repeal is what we’re after. This doesn’t do it,” said Jordan.

The American Health Care Act, or AHCA, is vigorously endorsed by President Trump and House Speaker Paul Ryan, R-Wisc. Ryan argues the plan does fulfill the promise to repeal and replace Obamacare.

Jordan laid out several areas he insists are key differences between a complete repeal and what the GOP plan does.

“We didn’t tell voters we were going to repeal Obamacare but we were going to keep some of the taxes in place, which the speaker’s plan does. We didn’t say we were going to repeal Obamacare but take the Medicaid expansion and extend it for several years, which the speaker’s plan does,” said Jordan.

“We certainly didn’t say we’re going to repeal Obamacare and start this new program of refundable tax credits and repeal Obamacare and get rid of the mandate but keep this 30 percent surcharge that we tell insurance companies you have to levy on people who don’t maintain continuous coverage,” said Jordan.

The most disturbing issue for Jordan is Republicans getting ready to own a massive health care reform that he believes will not lower the cost of health insurance.

“This is just Obamacare in a different format, and because of that it will not bring down the cost of insurance. It will not bring down premiums. Therefore, middle class families are still going to see the ridiculous high levels they’ve seen over the last several years,” said Jordan.

Jordan and several other members of the House Freedom Caucus are demanding a full repeal of Obamacare, just as the GOP-controlled Congress did in 2015 before the legislation was vetoed by President Obama.

“The one thing we know about our plan is it’s passed before,” said Jordan.

So why won’t leaders bring up that same bill?

“They’re saying some people may not vote for that, which is amazing to me. During election time you can do one thing, but once you get in office and it actually counts you can’t? That’s what drives voters crazy,” said Jordan.

Jordan also doesn’t buy the GOP leadership’s three-step approach to reform, which includes this bill, letting Health and Human Services Secretary Tom Price roll back many of the regulations in the current law and then passing market-based reforms in a separate bill that will likely require 60 votes to clear the Senate.

“That’s a joke,” said Jordan.

“We know phase two is going to get tied up in court. You saw what the courts have done on President Trump’s executive order on the travel ban. You’ve seen how he reworked it and came back with something we know is consistent with the law. And where is that right now? It’s tied up in court. So to think the left is not going to take Obamacare and tie it up in court is just ridiculous,” said Jordan.

As frustrating as it has been for full repeal proponents to plead their case with leadership, Jordan says the difference between conservatives and Democrats on the issue is like night and day.

“They view success as signing people up for government, Medicaid or Obamacare. We define success as let’s put in place the policies that make insurance affordable so that people can pick the plan that meets their needs. That’s what we’re trying to get accomplished,” said Jordan.

While Trump is vociferously supporting the GOP plan, Jordan is hopeful the president will be able to broker changes to the legislation that will rid the law of crippling insurance regulations dictating what has to be in all policies, allow for market based reforms that will drive competition and lower costs and repeal other burdensome regulations by statute.

Jordan, who met with Trump along with other Freedom Caucus members, says the White House has been far more accommodating than Republican leaders in Congress.

“We appreciate the outreach the White House did being willing to work with us. Our leadership initially talked about this binary choice, take-it-or-leave-it approach, which I don’t think is helpful. Since then I think they’ve been more open to talk with us, probably driven by the fact they don’t have the votes,” said Jordan.

With a vote planned for Thursday, Jordan suspects a scramble is underway to find more support for the AHCA.

“One thing I learned a long time ago is when leadership is out there saying they have the votes, that means they probably don’t have the votes. Based on what I know from our members of the Freedom Caucus and some other people, I believe they do not have the votes, so we’ll see how negotiations go this week,” said Jordan.

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‘We’re Repealing One Entitlement and Creating Another’

March 3, 2017 by GregC

Conservatives in Congress are increasingly frustrated by what has been leaked about the Obamacare repeal legislation and by what they see as a lack of transparency, even as House Speaker Paul Ryan insists Republicans are all on the same page and predicts unity on a final vote.

For most congressional Republicans, what they know of the repeal is what they read in a leaked report on the purported bill last week. Sen. Rand Paul, R-Ky., made headlines by unsuccessfully trying to get a hard copy of the legislation.

Most Republicans don’t know what’s currently being put together.

“I think it’s mostly members of committees with jurisdiction. You’re talking about members on Energy & Commerce and members on Ways & Means. That’s probably as far as it goes,” said Jason Pye, director of public policy and legislative affairs at FreedomWorks, which has endorsed the replacement bill authored by Sen. Paul.

“Maybe the broader conference knows the general discussion of what’s going on,” said Pye. “The actual legislative text is what matters. That’s where the nuances come into play.”

FreedomWorks shares the frustrations of Sen. Paul and other lawmakers clamoring for details.

“I think Sen. Paul has a point that this entire process is being done largely in secret. Americans deserve to know what’s going on. Are we going to see Obamacare-lite or are we actually going to see a real patient-centered alternative,” said Pye.

What would real transparency look like?

“We should be having hearings as the bill is going through. Why not have debates on C-SPAN while it’s being discussed and being drafted?” asked Pye.

On Friday, Politico reported that GOP leaders hoped to vote on repeal later this month and they were prepared to “steamroll” conservatives into backing the plan.

“They say they have no problem steamrolling conservatives by daring them to vote against an Obamacare repeal that their constituents have demanded for years,” reported Politico.

“‘Conservatives are going to be in a box,” said one senior Republican lawmaker. Trump, the source predicted, eventually will “go out front and … tell the conservatives … they’re either for this or for keeping Obamacare,'” the report continued.

That’s a far cry from the assurance of unity Ryan offered at his weekly press conference on Thursday.

“We’re all working off the same piece of paper, the same plan. So we’re in sync – the House, the Senate, and the Trump administration – because this law is collapsing. You can’t just repeal it. You have to repeal it and replace it with a system that actually works. That’s exactly what we’re doing,” said Ryan.

“I am perfectly confident that when it’s all said and done we’re going to unify because we all, every Republican, ran on repealing and replacing and we’re going to keep our promises,” added Ryan.

Pye says FreedomWorks is just as eager to scrap Obamacare, but he says how it’s done is vital.

“The speaker said that the repeal and replacement of Obamacare is entitlement reform. That certainly should be the case but the problem is we’re repealing one entitlement and creating a new one. You don’t do that as conservatives, especially one who claims to be a fiscal conservative,” said Pye.

He says if the leaked version of the bill is accurate, there is a lot to oppose in there.

“We were surprised to see the Republican version of the individual mandate included in this bill. We were surprised to see $100 billion in new mandatory spending over the next ten years in this bill. We didn’t anticipate that. We didn’t anticipate the new Republican version of the Cadillac Tax in this bill. We weren’t old those thing,” said Pye.

In the end, will leaders twist enough conservative arms to pass the plan? Pye doesn’t think so.

“Leadership is really who’s in a box right now. If the 70 conservatives in Congress stick together, if you keep 41 of those guys and maybe a couple more, [leaders] don’t 218 votes to repeal and replace,” said Pye.

“They’re going to have to listen to conservatives in the conference. I’m sorry. That’s just the way it is. And right now, this Lee, Cruz, and Paul trifecta sticks together, [Republicans] only have 52 seats in the Senate. You’re going to get Democratic votes on either side. You have to listen to conservatives,” said Pye.

Conservatives are already explaining what they want, namely in bills offered by Sen. Paul and Rep. Mark Sanford, R-S.C.

“It puts individuals on the same playing field as employers. It gives states the option for flexibility through Medicaid, allowing them to seek waivers from the Department of Health and Human Services. It expands [Health Savings Accounts] to the point at which you can pay your health insurance premiums out of that,” said Pye

“Those are patient-center alternatives and consumer-friendly alternatives that improve the health system and truly empower Americans to make their health care choices,” said Pye.

If conservative ideas are now adopted into the replacement bill, Pye suspects Republicans may abandon the effort to pass a repeal and replacement together. He says passing a repeal similar to the one President Obama vetoed last year might be where the GOP factions find common ground.

“I know everybody wants to get this over with now and I do as well, but there is no difference, fundamentally, between what we did in 2015 and what we should be doing now, other than the disagreements over replace. If we can’t figure out replace, let’s come back another day, but let’s go ahead and start the process on repeal,” said Pye.

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House Conservatives Push Quick Action on Obamacare

February 21, 2017 by GregC

The conservative House Freedom Caucus is pushing for quick congressional action to repeal and replace the Affordable Care Act and says the plans it supports will mean better coverage, lower costs and more control for patients.

And House Freedom Caucus Chairman says if Republicans don’t follow through on their promises to repeal and place the law, voters ought to send them packing next year.

“I am confident we can do that, and I am confident that if we don’t do that, everybody should send us home and they would have every right to send us home if we don’t deliver on a real promise to make it affordable,” said Rep. Mark Meadows, R-N.C., who leads the House Freedom Caucus in the current Congress. “We promised to do that. We’ve got to deliver.”

Reports vary widely as to how soon Congress may tackle the repeal, with some lawmakers wanting to get it done in President Trump’s first 100 days and others thinking repeal and replacement may not be completed until later this year or even early 2018.

Meadows says the GOP consensus is to get this done quickly, but a debate is brewing about whether to repeal now and replace later or pass the two bills at the same time.

“It’s that replacement plan that really is providing a great anxiety among some of the Republican members, what it should include and what it shouldn’t include. There’s still some disagreement there but I’m optimistic that we will go ahead in the next 30-45 days and vote on something in the House and the Senate and move this along,” said Meadows.

“If it waits until next year, it won’t get done, so [Americans] need to weigh in with their member of Congress to say, ‘We want them to act now,'” said Meadows.

Meadows also rejects the idea of allowing the current system to fester for another year as a means of building public demand for repealing and replacing current law.

“I can tell you from a principle standpoint, to suggest that we allow it to continue to spiral down so that more people are hurt is not something that would be prudent,” said Meadows.

But Meadows also dismisses the alarm from Democrats that repealing Obamacare will means tens of millions of Americans will lose their coverage.

“The Affordable Care Act, the way it is now, is not sustainable. A lot of those people who may have gotten coverage won’t be able to keep their coverage on the current trend,” said Meadows.

Many of those Americans who now have coverage got it through the expansion of Medicaid. Meadows admits that will be one of the thornier issues to navigate.

“It is a critical component that we have to address in some shape, form, or fashion. But whether they get this done with block grants on a per capita basis or some other mechanism, I believe that we can come up with a workable solution that doesn’t leave anybody behind and provides an adequate safety net,” said Meadows.

Last week, the House Freedom Caucus threw its support behind legislation from Sen. Rand Paul, R-Ky., that is designed to repeal the current law and simultaneously replace it with legislation that will patients much more freedom in choosing their coverage. Paul is fiercely urging GOP leaders not to blow a hole in the deficit by repealing the law and only then getting to work on a replacement.

Rep. Mark Sanford, R-S.C., is offering a companion bill in the House that Meadows says goes a step farther than Paul’s approach in the effort to break up monopolies in the insurance market.

Meadows says there are some must-haves for conservatives in any replacement legislation.

“It’s one of the few plans that is out there that won’t blow a hole in the deficit, actually will bring down costs, and hopefully will not only address the concerns about pre-existing conditions that many of my constituents and people across America have been concerned about, but do it in a way that actually drives the cost of health care down,” said Meadows.

Meadows says the final legislation needs to require insurers to cover people with pre-existing conditions and forbid carriers from cancelling policies when people get sick. He also wants more flexibility and freedom for people in their Health Savings Accounts, but is shying away from mandating that children be allowed to stay on their parent’s policies until they are 26 years old.

“We think the private sector can actually address that probably better than making it a mandate,” said Meadows, who also strongly endorses a plan from Sen. Paul to provide tax deductions for doctors who work a lot with low income patients.

“They don’t get to write that off now, so this will actually be an incentive to provide health care on a more philanthropic basis,” said Meadows.

Meadows says the cooperation between the White House and Congress has been excellent and that GOP leaders are showing respect for conservative ideas and strategies. At the same time, Meadows expects an intra-party clash over tax credits.

“Probably the biggest stumbling block right now is the leadership’s desire to use an advanceable, refundable tax credit, where a number of us probably don’t feel that’s the best approach to address it,” said Meadows.

Meadows urges his fellow Republicans to move intelligently but swiftly towards their top legislative priority. He says lawmakers need to stand on principle and let the political chips fall where they may.

“I think it’s more important that we act now to put forth not only a repeal but a replacement of all of it and make the tough decisions. As members of Congress, if we make the right decision and it sends us home, so be it,” he said.

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Brat: Tax Reform Must Come First

February 7, 2017 by GregC

Members of the conservative House Freedom Caucus are pushing party leaders to speed up work on major legislative priorities and stay committed to their campaign promises, but one key member says the effort should begin with tax reform and not Obamacare.

As the first 100 days of the Trump administration tick by, conservative lawmakers are urging leaders in the House and Senate to get going on their vows to repeal and replace the Obama health care law and jump start the economy with significant tax reform.

Rep. Dave Brat, R-Va., shot to conservative stardom when he topped then-House Majority Leader Eric Cantor in a 2014 congressional primary. A former college economics professor, Brat says getting tax reform done first and done right are at the top of his priority list.

He says news that top Republicans plan to address health care and infrastructure before the tax code is a mistake.

“That is hugely concerning. I taught economics for 20 years. That is piece number one, without which I can’t vote for anything else,” said Brat.

Specifically, Brat wants to see a major reduction in the corporate income tax rate and immediate expensing for business. He says that is the key to getting the economic engine humming. He says experts who helped to craft the 1981 Reagan tax cuts, such as Arthur Laffer, see those provisions as they keys to explosive growth, wage growth and job creation.

“He said that is consistent with eight percent wage growth, four percent GDP growth for the country and eight percent wage growth for a country that has not seen the average guy have their wages increase for 30 years,” said Brat.

He says getting that right will set the stage for everything else.

“If we don’t get that piece, we will not be able to afford any of the rest of it. That has to come first. It’s got to be in writing. It’s got to be in stone or I can’t go along with the rest of it,” said Brat.

As for Obamacare, conservatives have two growing concerns: moving more quickly to advance legislation and pushing hard against some GOP leaders who now seem willing to work within the framework of Obamacare than to repeal it in full.

Brat says part of the current delay on legislation is due to the Senate slow-playing the confirmation of Rep. Tom Price, R-Ga., to be the nest Secretary of Health and Human Services. The congressman says President Trump has made it clear that is the key to revving up the reform effort.

“A few weeks ago, he said, ‘Look, once Price is in that slot, then we’re going to move at lightning speed.’ So I think that’s what you can realistically hope for. Once Price [is confirmed], boom, the plan comes out and we run with it. I think it’s going to be surprisingly good,” said Brat.

“I don’t think it will be perfect. I’m not a big fan of tax credits because you can bid those up forever,” said Brat. “But it will not be Obama-lite from what I’m hearing.”

An aggressive approach in the House, however, may run into hesitation from Senate Republicans, who seem more willing to work within the existing framework of Obamacare.

“The Senate has made it clear they’re OK with tweaking Obamacare and repairing the existing broken system. I obviously think that’s the wrong way,” said Brat.

Brat says Gov. Scott Walker, R-Wis., is coming to rally the GOP members to stand strong on campaign promises to repeal and replace Obamacare.

“[Walker] says, ‘Once you start reform, you can’t backtrack. Once you take out one leg of the stool, which we already have done – Trump has already done some of the repeal by regulatory fiat. Once we start down that road, we’ve got to conclude it. I think (House Speaker) Paul Ryan is going to to come out and make that clear in the next few days,” said Brat.

Brat says the tinkering approach cannot work. He points out that the typical family on just a bronze plan is saddled with a $12,000 deductible just to get access to the health care system. As a result, he says it’s putting even greater financial pressure on Social Security, Medicare, Medicaid and veteran’s programs, which are now headed towards insolvency faster and faster.

The congressman says the current system bends the cost curve up by 20 percent for Americans. He says the only responsible approach is to bend the cost curve to zero in order to spare those programs and give younger Americans a fighting chance of actually seeing some of those benefits.

“We’re growing (the cost curve) at 20 percent now. Bending the cost curve down doesn’t mean you grow at 10 percent or five percent. It means you shrink the cost of health care to zero. That’s what you’ve got to do just to maintain balance. That doesn’t reduce costs. That just keeps them from growing more in the out years. So we’ve got some heavy lifting to do,” said Brat.

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Getting Specific on Repeal and Replace

November 16, 2016 by GregC

An effective overhaul of the nation’s health care laws will require scrapping the most damaging parts of Obamacare, keeping some of the provisions, and giving much more freedom to states and insurance companies to create vibrant competition that will increase consumer choice and bring down soaring costs.

That’s the assessment of Galen Institute President Grace-Marie Turner, a prominent voice against both Obamacare and the Clinton administration’s attempted overhaul of health care in the 1990s.

The Affordable Care Act, President Obama’s signature domestic legislation, survived a Supreme Court challenge in 2012. While the court states that mandating Americans buy health insurance is unconstitutional, the provisions were allowed to stand since people were given the choice to buy insurance or pay a fine.

Turner says the individual and employer mandates need to be the first things on the cutting room floor.

“They do have to go. The individual mandate, in particular, is the single-most unpopular part of this law,” said Turner, who says there are ways for the Trump administration to kill the mandates without a vote in Congress.

“There are ways through the regulatory process, not even through legislation, that Mr. Trump could basically eviscerate the individual mandate. But I also expect that to be very much on the chopping block when they do their repeal bill,” said Turner.

She says the employer mandate deserves the same fate.

“The employer mandate is the same. Even many of the president’s advisers have said that the employer mandate is really relatively useless, except for forcing people to buy – this is me saying this – that is extraordinarily expensive and is driving up everybody’s premiums and deductibles,” said Turner.

But while there has been much talk of full repeal, Trump recently said he would be open to keeping a limited number of provisions that have proven to be popular. Turner says keeping policies to forbid insurance companies from denying coverage due to pre-existing conditions or allowing adult children to stay on their parents’ policies should be retained.

“The president-elect should have have come out early on, saying, ‘Of course there are some goals in Obamacare that we share. We want to make sure that as many people as possible have coverage. We want to make sure that people are protected so that their insurance is real insurance. The fact that they’re in Obamacare does not mean that they’re bad,'” said Turner.

“They just have to go about a way of achieving those goals in a much different, more consumer-friendly, more market-friendly way,” said Turner.

She also expects Congress to provide a transition period from the current law to those new, market-oriented solutions.

Turner also says federal subsidies should still be available to those buying coverage on the individual exchanges, suggesting many people will still need a hand up even if efforts are successful to drive costs down through competition and choice.

She says subsidies are actually very fair.

“People with employer-based health insurance get huge subsidies worth $250-300 billion a year and forgiving that part of their income from taxes that goes to pay their health insurance premiums. So people who don’t have that option are being shut out. They’re paying their premiums with after-tax dollars. So yes, subsidies are going to have to be part of the equation,” said Turner.

Where Turner really hopes to see big change is the stripping away of the federal tentacles that currently dictate most details of the health care system. She says that will bring down costs and bring more people into the system.

“It would, as long as they don’t have so many rules that are forcing young people to pay so much more than their likely use of health insurance, which is one of the problems with Obamacare, and so long as you don’t have rules that allow people to simply purchase health insurance when they’re sick and drop it after they get treatment,” said Turner.

Turner says another vital step is to rip away the mandates of what has to be included in a given health care plan and allow the marketplace to decide what’s best.

“I can’t even think of the options that are out there that insurance companies might come up with – and smart actuaries – to give people the opportunity to make the decision for themselves what kind of coverage they need. Maybe it’s a health savings account. Maybe it’s a high-deductible plan, maybe it’s an HMO that has more restrictions on it,” said Turner.

“If people can make those decisions for themselves, then the market will be able to respond to them, rather than all these Washington bureaucrats and regulators,” she added.

Decenralizing power from Washington would also put more control in the hands of the states.

“The problem now is we’re all forced into this same strait-jacket of Obamacare. We all have to buy these hugely expensive products, which fewer and fewer people can afford. Give the market really an opportunity to provide products that people want to purchase within parameters and some guidelines that make sure it’s real insurance and that people are protected,” said Turner.

Turner says Obamacare is driving people away from a product they want because of the crushing mandates and high costs.

“People want health insurance. It’s not that you’re forcing them to buy something they don’t want. They want health insurance, but they don’t want to pay more for their health insurance than they’re paying for their mortgage, which is happening to many people right now,” said Turner.

Turner says new companies would spring to life when they see an explosion in demand from patients interested cheaper plans that better meet the needs of their families.

She says House Speaker Paul Ryan already has the relevant committee chairmen working on plans to overhaul Obamacare. However, she says it’s very unlikely that Republicans will try to achieve reform through one massive bill. Instead, Turner believes lawmakers will pursue a piecemeal approach targeting specific aspects of the current law that need to be changed.

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