The failure of the American Health Care Act (AHCA) has put pressure on Republicans to come up with a compromise that unifies the party. There are signs this may be happening.
The Wall Street Journal reports that the House Freedom Caucus’s Mark Meadows and the centrist Tuesday Group’s Tom MacArthur have struck a tentative deal. Their compromise would allow states to seek waivers to opt out of most of ObamaCare’s insurance mandates.
In my last post (Three Solutions to the Healthcare Crisis – Part II) I discussed the option of Responsible Federalism as a means toward bipartisan support. This means allowing states to design and administer their own healthcare systems with federal support. The compromise in the Republican Party seems to be following this path toward resolution of their differences.
The issue of concern is the “essential health benefits” and “pre-existing conditions” language in ObamaCare that is driving up the cost of insurance coverage. Essential health benefits requires every compliant insurance policy to cover a long list of procedures for both men and women regardless of their need for this coverage. This artificially drives up the cost of insurance and the premiums that must be paid. Pre-existing conditions also greatly increases premium prices while protecting those with serious medical conditions who must change healthcare insurers.
By allowing states to make their own decisions on these key provisions, they can design insurance coverage to meet the specific needs of their residents. Those who value the essential health benefits can keep them – but pay the higher prices. Those who would rather design insurance for their specific needs can choose to eliminate the essential health benefits – and pocket the savings.
Democrats want single-payer healthcare – complete government control – which is socialized medicine. WSJ believes they will push for expanding Medicaid even more and lowering the age of eligibility for Medicare to age 55 or even 50. This conforms perfectly to Senator Bernie Sanders’ campaign promise of “Medicare for all.”
With Responsible Federalism they could try such a system in liberal states, like California and New York, without subjecting the rest of the nation to healthcare they don’t want. In a few years it should be obvious to all which system works best.
The advantage of this type of reform is that it allows states with more liberal governments to choose the government-controlled healthcare they favor – while giving more conservative states the option to remove government mandates and choose the freedom of a more market-driven system. This compromise seems to be uniting the factions of the Republican Party – perhaps it can achieve bipartisan support from Democrats as well.
The alternative is the continued implosion of ObamaCare. Insurance companies are deciding right now if they will offer insurance on the exchanges in 2018 and at what rates. If Congress doesn’t come up with a solution soon, the number of insurance plans offered on the exchanges is sure to decline and the prices are sure to increase. If Republicans don’t act soon to provide an alternative, the pressure will mount to let the government assume full control. We must not let that happen.