It’s a big week in Washington, with the fate of Obamacare hanging in the balance. On Thursday, the House of Representatives is expected to vote on the American Health Care Act, which would repeal the bulk of the massive law, and replace it with a better, more market-oriented alternative. If the House bill passes, Obamacare would be on the ropes as the debate shifts to the Senate. If the AHCA fails, Obamacare would remain the law of the land – possibly even forever.
But Obamacare foes should be optimistic. While disagreements between Congressional Republicans have dominated news headlines, the AHCA has picked up a considerable amount of momentum as it nears the House floor.
To be sure, the House bill has some imperfections: some of Obamacare’s tax hikes and regulations will have to be dealt with in other legislation. Nevertheless, it’s a dramatic step in the right direction for our healthcare system and certainly warrants strong support from the conservative and libertarian community.
One of the reasons for optimism is the work of thoughtful legislators like the chairman of the conservative and influential Republican Study Committee, Rep. Mark Walker, R-N.C. He, along with about a dozen of his RSC colleagues, endorsed the bill late last week after constructive conversations with its authors.
To his great credit, Walker was able to negotiate some important improvements to the legislation that would provide states with additional flexibility and help establish work requirements for the Medicaid program. These changes aren’t mere window dressing. As Grace-Marie Turner of the Galen Institute noted in a recent Forbes column, the additional flexibility will allow states to pursue “new, better and more efficient ways not only to provide medical care to people in poverty but to help and encourage them to develop the work habits necessary to escape poverty.” These are the types of positive refinements that should help the bill make its way through Congress and to the president’s desk.
It should be noted that several of Walker’s predecessors at the RSC have also made a huge mark on the AHCA. Former RSC Chairman Tom Price is now the head of the Department of Health and Human Services. A bill he introduced in 2015, the Empowering Patients First Act, provided the basic legislative framework for the AHCA. Another former RSC chair, Vice President Mike Pence, has also been heavily involved with the development of the legislation and discussions on Capitol Hill.
In terms of policy, the bill’s conservative merits have been well-documented. It repeals many of Obamacare’s worst provisions like the individual mandate, the employer mandate, the exchanges, and $900 billion worth of tax hikes. It puts Medicaid on a budget and empowers states to innovate and improve the troubled program. Instead of the top-down control of health insurance markets imposed by Obamacare, it creates an advanceable, refundable tax credit that will allow low- and middle-income families to control their healthcare dollars, and make decisions that best suit their own needs. It expands health savings accounts – both in terms of contribution limits and the flexibility of funds. And it reduces the deficit by $300 billion over a 10-year period.
Still, the path forward will be difficult. Democrats are united in opposition to the bill. Some Republicans are still hesitant to support it. Passage is far from assured, but those who understand what’s at stake should be encouraged by the growing support behind the AHCA. It’s the best, and perhaps only, opportunity to repeal most of Obamacare and clear the way for further free-market healthcare reforms.
This is not a sparring session or an exhibition fight – it’s how Congress and the White House can go the distance and win for taxpayers and patients.
Brandon Arnold (@BrandonNTU) is the executive vice president at the National Taxpayers Union.
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