Congressional Republicans have kicked off the process of repealing Obamacare, but it’s unclear what the future of healthcare looks like. There’s absolutely no question Obamacare failed, and Democrats’ only alternative is to have more government involvement in healthcare.
Frustrated by the immediacy of the repeal process, Democrats have blasted Republicans for failing to produce a replacement plan. Fortunately, this is far from the truth: No less than four replacement plans were introduced in the previous Congress, and President Trump has indicated that his administration will release its own plan shortly.
In 2017, the Republicans have a chance not only to repair the Democrats’ mistakes of the last eight years, but their own mistakes from more than two decades ago.
Obamacare is a disaster: Rates have skyrocketed and are projected to rise another 25 percent within the coming year. Enrollment is significantly lower than the Congressional Budget Office originally estimated. Millions struggle to pay for basic medical services.
Although the blame for this terrible plan lies mostly at the door of liberal naiveté, some belongs to Republicans. When the Health Security Act, or Hillarycare, was proposed in 1993, Republicans mustered massive resistance. Politicians, pundits and academics all united in a successful campaign against Hillarycare’s expansion of the federal bureaucracy and its interference in people’s right to choose their own healthcare.
Hillarycare was soundly defeated, but Republicans failed to deliver a comprehensive alternative. Instead of reforming healthcare based on patient-centered, free market principles, they passed two new entitlements: the State Children’s Health Insurance Program (SCHIP) in 1997 and Medicare Part D in 2002. They also allowed the larger, more pressing issues in the system to lie dormant. Those issues returned with resounding force: Obamacare passed in 2010, and Americans are today living with the consequences of Republican indecision from over 20 years ago.
The mistakes of the 1990s must not be repeated. Republicans must deliver an effective replacement for Obamacare, and soon.
This means successfully passing Obamacare repeal through reconciliation and abiding by its provision of a two-year window to replace the failed 2010 law. Any lengthening of that window risks losing critical votes in midterm elections, during which the party in the White House typically loses seats.
A comprehensive approach must adhere to the following principles:
Remove regulations and reduce costs. Obamacare mandated that companies pay a minimum 60 percent of actuarial benefits, which was a contributing factor to premium increases. It also selected 10 specific benefits that insurance companies are required to include in their plans to qualify, benefits that not every American needs.
Such top-down regulations, crafted by unelected bureaucrats, led to higher premiums and copays. Removing them will reduce the exorbitant costs that have made the Affordable Care Act so unaffordable.
Allow states a greater role in crafting policy. Gutting restrictive regulations at the national level will allow states to develop policies tailored to the needs of their residents. States can work with local insurance companies to determine what services companies must provide.
Block grants can also be given to states for Medicaid, a federal program that even Obama admits has become overwrought and impracticable. Allowing states to adopt Medicaid will streamline the program so it can directly help those who need it the most.
Similarly, the federal government can grant funding to states for high-risk pools, making quality care accessible for Americans with pre-existing conditions.
Restore control of healthcare to the patient.Congress must expand the healthcare options available to patients. Obamacare demolished Health Savings Accounts, or HSAs. Restoring them will free patients from crippling taxes on their medical expenses and give them greater control over what providers they choose.
Congress must also prioritize portability. As American workers become increasingly mobile, having insurance that transfers from job to job, much like a 401(k), is necessary for stability.
Currently, employers are offered tax incentives to provide insurance for their workers, but workers themselves are not given this option. Extending tax incentives to workers and allowing them to purchase insurance apart from an employer will increase portability and stability.
Republicans find themselves uniquely positioned at this moment. They must act, and act quickly. Failure to do so leaves the door open for a larger, more invasive version of Obamacare in the future, just as failure to replace Hillarycare in the 1990s led to Obamacare. By removing restrictions, reducing costs, and restoring power to states and patients, Republicans can decisively recover from past errors and reshape the future of healthcare for years to come.
Adam Brandon (@adam_brandon) is president and CEO of FreedomWorks. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.
