As Members of Congress debate repealing and replacing Obamacare, they should learn from the failures of that law in crafting a better set of health care policies. One important step in that crafting is the establishment of a fairer and more reasonable set of rules for limiting health plans’ application of pre-existing condition exclusions. Policymakers should link the ban on exclusions for pre-existing conditions to a requirement of continuous coverage. Setting the right rules around the prohibition on plans applying pre-existing condition exclusions will not only stabilize insurance markets, but also provide a firmer foundation for future reforms of other aspects of health care policy.
. . .

Many people are going without insurance under ObamaCare because they cannot afford the law’s expensive plans or aren’t aware of their options. Congress can help these Americans and many others get insurance by enrolling them in no-premium, no-obligation plans from which they could withdraw if they wanted to. Opponents will argue that automatic enrollment infringes on personal liberty. But people placed into such coverage would be free to opt out or to select an option that better suits their needs. Few people opt out of employer pensions when they are placed into them automatically, and no-premium insurance would impose no cost on the enrollees.

. . .

It has become a tired, familiar act. Members of the House Freedom Caucus say they are the only true conservatives, while other congressional Republicans are RINOs, “Republicans in Name Only.” In the latest episode, the Freedom Caucus and its outside allies—including Heritage Action and FreedomWorks—denounced the GOP health-care bill as “ObamaCare Lite.”

These claims confused the grass roots but were simply untrue. Look at the legislation’s text, which canceled ObamaCare’s insurance exchanges, halted and reversed its Medicaid expansion, killed its taxes, and whacked its individual and employer mandates.

. . .

You cannot do health care reform if it frightens patients who believe they will lose access to the care they are already receiving. This is why the Congressional Budget Office estimates showing tens of millions of people losing insurance as a result of what Speaker Paul Ryan and company were trying to do was so devastating. It’s that kind of reality that killed Obamacare after it became law. Whatever Congress does must ensure stability and continuity of care, especially among the most vulnerable populations during the transition period between what we have now and what comes next. Congress’ first concern when it comes to health care reform should be about producing better health outcomes.

. . .

The Wall Street Journal makes an important point today about a subset of the Obamacare repeal fight: the lobbying to repeal the law’s taxes, like the ones on medical devices and investment income for the wealthy. It gets more complicated to get rid of them, the Journal points out, if President Trump and Congress don’t reach some kind of resolution on Trumpcare. That would shift all of the lobbying for repeal of those taxes to the tax reform fight, which is already likely to be complicated enough.

. . .

As Republicans take another crack at devising a plan to replace ObamaCare, here’s an idea they should consider: Give each Medicaid patient a health savings account—and put $7,000 in it every year. Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn’t mean much if the doctors in their communities don’t accept new patients through the program.

The GOP’s recently benched health care bill would have substantially reformed Medicaid by giving the states block grants, along with more flexibility on how to spend the money. But there’s a better model. Republicans should empower Medicaid patients by providing funds to them directly, which would allow them to build a personal safety net that could last a lifetime.

. . .

In an interview in the Oval Office, Mr. Trump said he was still considering what to do about the payments approved by his Democratic predecessor, President Obama, which some Republicans contend are unconstitutional. Their abrupt disappearance could trigger an insurance meltdown that causes the collapse of the 2010 health law, forcing lawmakers to return to a bruising debate over its future.

“Obamacare is dead next month if it doesn’t get that money,” Mr. Trump said. “I haven’t made my viewpoint clear yet. I don’t want people to get hurt….What I think should happen and will happen is the Democrats will start calling me and negotiating.”

. . .

A majority (61 percent) of the public say that because President Trump and Republicans in Congress are in control of the government, they are now responsible for any problems with the ACA moving forward. About three in ten Americans (31 percent) say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it.

. . .

President Donald Trump has reiterated on several recent occasions that the effort to repeal and replace the ACA is far from over. Whether Republicans will hold another vote before the August recess, or even before the end of the year, remains uncertain.

For this second attempt at reform to succeed, the GOP needs to get back to the market- and patient-centered basics it’s spent years trumpeting to the public—and thereby lay the foundation for a competitive health insurance marketplace that offers affordable, quality care to all Americans.

. . .

By ending federal matching funds and shifting managerial responsibility to the states, Republicans propose to modernize Medicaid’s funding and give local authorities greater flexibility to design program innovations that are more specific to each state’s needs. The reason Medicaid costs less than private insurance is because it provides less. Medicaid provides “comprehensive coverage,” but coverage isn’t care. It is easy to write down a long list of services that are covered. Think of it as having a coupon for free health care—a coupon that is difficult, sometimes impossible, to redeem. Per capita allotments or block grants may result in reduced federal spending, but their primary purpose is to bring about reform of Medicaid.

. . .