New GOP-led Congress targets health-care law
A new Republican-controlled Congress convened in Washington this week, poised to enact an ambitious agenda of tax cuts, business deregulation, and, first and foremost, the repeal of the Affordable Care Act. President Obama’s signature health-care law has brought health insurance to so me 20 million Americans since 2010. But Obamacare has struggled in many states as the number of insurers offering coverage on exchanges has shrunk and premiums have climbed; the government expects hikes to average 22 percent in 2017. Republicans have voted repeatedly to repeal the law, only to be thwarted by Obama vetoes. With Donald Trump entering the White House, Republican leaders now plan to use budget reconciliation—which requires only a simple majority of lawmakers in the House and Senate—to dismantle parts of the law affecting taxation and spending, such as insurance subsidies, Medicaid expansion, and the individual mandate to purchase insurance. “Today, we take the first steps to repair the nation’s broken health-care system, removing Washington from the equation,” said Senate Budget Committee Chairman Mike Enzi (R-Wyo.). Republicans have yet to agree on any replacement for Obamacare, and to postpone the political pain caused by any new plan, have said they may let most features of the law stand for three years.
President Obama this week huddled with congressional Democrats to plot a strategy for saving the law. In a letter to congressional leaders, the American Medical Association urged Republicans to craft a plan to replace Obamacare before taking any action “through reconciliation or other means that would potentially alter coverage.”
What the editorials said
A repeal now, replace later strategy for Obamacare “is fraught with political risk,” said The Wall Street Journal. The biggest danger is that a two-stage maneuver will embolden the extreme wings of both parties. The far right could “denounce any replacement as Obamacare Lite,” unless it’s a pure free-market solution. Liberals could oppose any negotiation on replacement provisions and “let the GOP twist in the wind.” Whatever happens, “Republicans will own health care, like it or not.”
“Here’s but just one problem facing conservatives,” said The Baltimore Sun. Many white, working-class voters who supported Trump could suffer “life-shortening consequences with Obamacare’s repeal,” particularly coal miners covered under a provision providing them with treatment for black lung disease. When the law finally dies, the health- insurance market may return to the old, inadequate, dysfunctional system that denied coverage to people with pre-existing conditions and made the unemployed and the poor get their health care in hospital emergency rooms, if at all.
What the columnists said
For Republicans, replacing Obamacare is a no-win situation, said Jonathan Chait in NYMag.com. Any alternative that tries to preserve its most popular features “will violate conservative dogma,” because it would require redistribution of resources from the wealthy and the well to the poor and the sick. But a free-market replacement would leave millions of Americans with bare-bones or no health insurance, guaranteeing a political backlash. Most likely, Republicans will extend the ACA “until Democrats have the presidency again, at which point they’ll no longer have an incentive to prevent mass suffering.”
“We can repeal Obamacare and still protect the sick” without making healthy insurance buyers shoulder the load, said Betsy McCaughey in the New York Post. Consider what happened in Alaska. “The burden of caring for 500 chronically ill patients was making Obamacare unaffordable for all 23,000 Alaskans in the individual market”—premium hikes for 2017 were estimated at a whopping 40 percent. So authorities created a tax-funded high-risk pool for the sickest people. “As a result, premium hikes were kept to single digits.”
High-risk pools always punish the people forced into them with high costs, said Paul Waldman in The Washington Post. Not that this bothers Republicans, who seem certain to overreach in their honeymoon period. Their entire agenda—“cut taxes on the wealthy, slash regulations on Wall Street, defund Planned Parenthood, maybe even privatize Medicare”—is hugely unpopular, even among Trump voters. Trump’s approval rating, meanwhile, is stuck in the low 40s—both Obama and George W. Bush were around 70 percent when they took office. The prevailing narrative is that this was a “change” election. But for most Americans, “the approaching bloom of change doesn’t seem to smell too sweet.”