Republicans divided on Obamacare strategy
Republican efforts to quickly repeal Obamacare hit a stumbling block this week after a Congressional Budget Office study concluded that gutting the Affordable Care Act without enacting a replacement would strip 18 million Americans of their health insurance within a year and cause premiums to skyrocket. The report by the nonpartisan agency found that a total of 32 million Americans could lose their insurance within 10 years of a repeal, while premiums would spike 25 percent initially and then double by 2026. House Speaker Paul Ryan (R-Wis.) rejected the study, saying it was “meaningless” because it “takes into account no measures to replace the law.” But Sen. Susan Collins (R-Maine) joined a growing number of Republicans urging lawmakers to delay repeal until they have unveiled their own alternative health-care plans. Collins said she would propose a bill next week that would allow states to choose to keep Obamacare rather than adopt any Republican replacement.
President Trump added to the confusion when he told The Washington Post he was close to completing his own plan, and that it would provide “insurance for everybody” that is “much less expensive.” The pledge contradicts Republican proposals, which prioritize consumer choice over universal insurance. GOP lawmakers said the president had meant to promise “access” to insurance for everybody. “I assume that’s what he means,” said Sen. John Thune (R-S.D.).
What the columnists said
The GOP jitters are spreading, said Steve Benen in MSNBC.com. Republicans have realized that their current Obamacare strategy— scrap the law’s individual mandate, subsidies, and Medicaid funding now and deal with the consequences later—would cause a health-care catastrophe, stripping some 6 percent of Americans of their health insurance. As for Ryan’s complaint that the CBO failed to factor in Republican alternatives to the Affordable Care Act, he’s “half right”—but that’s because “there is no Republican alternative to the Affordable Care Act.”
Actually, Republicans have plenty of replacement ideas, said Yuval Levin in NationalReview.com. It’s just that replacing Obamacare will be enormously complex. There are several options under consideration: Lawmakers could let states auto-enroll uninsured people in inexpensive, catastrophiccoverage policies that would be paid for by tax credits, “nearly zeroing out the uninsured.” Or Congress could offer a federal tax credit that encourages people to buy more substantial coverage but will require them to absorb some of the premium cost. “The differences among these proposals involve serious trade-offs.”
Whatever happens, Republicans have already been boxed in by their own president, said Paul Waldman in The Washington Post. When Trump pledged “insurance for everybody,” with “lower deductibles,” he made an “absolutely gigantic promise” that Republicans never intended to keep. Their plan involves higher deductibles, under the free-market theory that higher costs will compel people to shop aggressively for policies and spend less on health care. Yet Republicans are now stuck with Trump’s pledge. “Democrats will be saying, ‘President Trump promised that everyone would be covered!’ every day for as long as this debate goes on.”