The latest Democratic attack on Republicans is that they will repeal ObamaCare. While I agree ObamaCare should be repealed and replaced with something better, that isn’t going to happen.
The Wall Street Journal editors say, “The only election event more predictable than Democrats comparing Donald Trump to Hitler is their resort to scare-mongering about entitlements. They’ve now seized on a vague comment by Speaker Mike Johnson to claim that Republicans in Congress will repeal ObamaCare. Alas, no.”
Speaker Johnson was merely responding to someone in the crowd who was yelling “No ObamaCare!” But he told that person “ObamaCare is so deeply ingrained. We need massive reform to make this work.”
The Speaker later clarified that he doesn’t support repeal, which his comment suggested wouldn’t be possible given how politically entrenched ObamaCare now is. Republicans haven’t been able to cobble together a majority to do almost anything. How could they possibly repeal ObamaCare? Despite their 47-member majority in 2017, House Republicans barely passed a “repeal and replace” bill (217-213). A slimmed-down version of the bill failed in the Senate with Maine’s Susan Collins and Alaska’s Lisa Murkowski voting against it. But don’t let reality interfere with a campaign attack.
“They are determined to end the Affordable Care Act as we know it,” House Minority Leader Hakeem Jeffries declared. Kamala Harris said at a brief press conference Thursday that “health care for all Americans is on the line,” claiming that Republicans would strip coverage from people with “pre-existing conditions,” including breast cancer.
This is classic fear-mongering by the Democrats, much like their claims that Republicans want to eliminate Social Security. Just because you recognize there are problems that need to be addressed to ensure the future solvency of the program doesn’t mean you want to get rid of it. This is true for both ObamaCare and Social Security.
What’s wrong with ObamaCare?
The fundamental flaw in ObamaCare is it mandates a “one size fits all” insurance policy that needlessly raises the cost while failing to provide any additional benefits. Quite simply, men do not need coverage for mammograms and women do not need coverage for prostate exams! Yet ObamaCare bakes in the cost of this coverage for everyone.
There are many other flaws as well. All of these have driven up health premiums on the exchanges such that it’s unaffordable even with the subsidies. That’s why Democrats boosted subsidies in 2021. The Biden Administration then let more workers with families qualify for subsidies even if they’re offered employer coverage.
Now costs are ballooning. Federal spending on ACA subsidies has soared to $129 billion this year from $58 billion in 2020. The Congressional Budget Office forecasts the Medicaid expansion will cost $1.4 trillion over the next decade, and the ACA subsidies another $1.3 trillion—and that assumes the 2021 boost expires next year.
The law’s Medicaid expansion to healthy low-income adults is straining state budgets, which has prompted many to reduce payments for providers. As a result, sick people on Medicaid struggle to find doctors willing to see them. This has always been the flaw in Medicaid – reduced access to healthcare providers. ObamaCare is simply increasing the rolls of Medicaid making the problem much worse.
Who is benefiting from ObamaCare?
The real beneficiaries of ObamaCare are insurance companies because it subsidizes people to buy overpriced products they don’t need. That’s right – taxpayers are subsidizing insurance companies who are selling expensive healthcare insurance to people who don’t need the coverage. What can be done about this?
The WSJ editors say Republicans are discussing these reforms to lower costs and improve care:
- Repeal the law’s medical loss ratio, which requires insurers to spend 80% to 85% of premium dollars on medical claims. This de facto profit cap has reduced the incentive for insurers to control costs and spurred them to raise premiums and acquire pharmacies and provider groups to circumvent the cap, as no less than Elizabeth Warren has pointed out.
- Roll back the Administration’s rules that make it more vulnerable to fraud. A Paragon Health Institute report this summer found that millions of ACA exchange enrollees misreport their incomes and receive more subsidies than they should. Paragon estimated the cost of fraudulent enrollment at between $15 billion and $20 billion this year.
- Expand short-term health plans, which don’t have to provide benefits not all people need, such as pediatric services, maternity care and mental-health treatment. Such plans are much cheaper than the heavily regulated plans on the ACA exchanges.
- Expand access to association health plans to let employers in the same industry or area band together to provide coverage. This would reduce the cost for small employers—say, fast-food franchisees or contractors—of sponsoring plans.
- Shift healthy, lower-income adults from Medicaid to ACA exchanges so states can’t game ObamaCare’s rules to squeeze more money from Washington. This would also improve care for sick Medicaid patients.
The WSJ editors conclude: “These ideas aren’t radical, and they would be good for patients and taxpayers. Democrats are trying to scare voters about an ObamaCare repeal because their real goal is to put government slowly but surely in charge of all health insurance. Too bad Republicans are so inept at talking about healthcare.”
