Wednesday, March 08, 2017

Meet the new law; Same as the old law

Since the Affordable Care Act (aka Obamacare) was passed into law in 2010, the vast majority of Republican presidential and congressional candidates all indicated how repealing and replacing O-care was a priority.

I can't begin to recall how many O-care repeal votes House Republicans took after gaining control of that chamber in January 2011. But since Barack Obama was still president, said votes were merely symbolic. And since Obama was reelected in 2012, the GOP focused on regaining the Senate in 2014 (which they did) so they'd be in prime position to nuke Obamacare for real (No, really. They mean it this time. Pinky swear) if they could also win the White House in 2016. So with Republicans finally controlling the executive and legislative branches for the first time in a decade, they were like the proverbial dog chasing a car, ultimately approaching the back bumper.

Of all the opinion pieces written over these many years, Philip Klein is one guy who has continually had his finger on the pulse in this seemingly endless debate. He has maintained a healthy skepticism that the GOP would ever follow through on the repeal/replace pledge. As you might expect, his Tuesday piece had an air of "We waited 7 flippin' years for this?!?!"

In releasing their healthcare plan on Monday, House Republican leaders sent a signal loud and clear: liberalism has already won.

Barring radical changes, Republicans will not be passing a bill that ushers in a new era of market-based healthcare. In reality, the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place.

At this point, is it better to pass a bill merely to make the current law "suck less" or to just allow Obamacare to collapse under the weight of its continual failures? I say the latter, only because I too never really believed the GOP "establishment" had the political will to nuke the ACA. Why continue the ruse? By the way, President Trump, who was touted incessantly as the anti-establishment candidate during the 2016 campaign, is fully on board with this proposal, going so far as to implore Sen. Rand Paul (R-KY) to drop his objections.

Back to Klein.

Whatever the argument is as to whether voting for the Republican plan is better than doing nothing, objectively speaking, it is not a free market plan. It still rests on the premise that the federal government should play a significant role in subsidizing and regulating insurance markets in an attempt to ensure broad coverage. Thus, despite the political failures that resulted from Obamacare, the clunky legislation still moved the ball ideologically to the left. The argument isn't over whether the government should require all insurers to cover people with pre-existing conditions. The argument is about whether the government should pay for it by forcing healthy people to purchase insurance under the threat of a penalty, as Obamacare does, or by threatening anybody who doesn't maintain continuous coverage with a 30 percent late fee, as the GOP prefers. Liberals, in other words, have won the central philosophical argument, and Republicans are reduced to fighting over the mechanics.

If indeed the legislation is passed in its current form (though there's some who believe there aren't enough votes in the House), the likely failures of government- run healthcare will be hung around the GOP's collective neck. And for what? For a bill which isn't substantively different from the ACA? Seems like an awfully big price to pay for what appears to be yet another symbolic gesture.


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