The Republican House health-insurance reform bill would replace Obamacare with a more consumer-driven system. Rather than having many provisions take effect in 2020, Congress should pass it soon and make it effective next year. But it is getting attacked from both the right and the left. What’s missing from the news coverage is improvements in the new bill. Here are six:
1. No employer mandate.
2. Refundable tax credits to buy health insurance.
3. Expansion of HSAs and FSAs.
4. Move Medicaid patients to regular coverage.
5. Lower costs for the young.
6. Incentives to keep coverage.
. . .
The shaky case for the individual mandate is based on mistaken premises, faulty economic analysis, short-sighted politics, and flawed health policy. Opponents have found the mandate to be administratively challenging, politically unsustainable, economically unnecessary, beyond the proper role of government, and constitutionally questionable. Arguments in favor of the individual mandate usually present it as a necessary, though far less popular, means to more laudable ends.
. . .
Following an Obama administration order, the IRS had been set to require taxpayers to indicate on line 61 on their form 1040s whether they had maintained health coverage in 2016 or paid the penalty. The IRS would have rejected returns if taxpayers failed to report their coverage status. But the IRS announced this week it would not reject returns that failed to check the appropriate ObamaCare boxes—an early indication of the administration’s efforts to provide relief from ACA mandates.
“This year, the IRS put in place system changes [initiated by the Obama administration] that would reject tax returns during processing in instances where the taxpayer didn’t provide…information [attesting that the taxpayer had health insurance].
“The recent executive order [issued on day one of the Trump administration] directed federal agencies to exercise authority and discretion available to them to reduce potential burden. Consistent with that, the IRS has decided to make changes that would continue to allow electronic and paper returns to be accepted for processing in instances where a taxpayer doesn’t indicate their coverage status.”
. . .
Trump administration officials have a lot of work ahead of them, but also a tremendous opportunity to make history. Returning the executive branch to its proper role under the Constitution will also spur Congress to enact reforms that make health care better, more affordable, and more secure.
Michael F. Cannon, Director of Health Policy at the Cato Institute, outlines 14 ways Trump-administration officials can restore the Constitution’s limits on executive power, provide relief to Americans suffering under Obamacare, and hasten repeal.
. . .
Congressional Republicans are facing their first big decision on taxes under President Trump: Which ones to scrap in the repeal of ObamaCare.
Republicans have in the past sought to erase most of the big tax hikes in the healthcare law, and the chairmen of the tax-writing committees have expressed support for eliminating the taxes in a repeal bill.
“After spending seven years talking about the harm being caused by these taxes, it’s difficult to switch gears now and decide that they’re fine so long as they’re being used to pay for our healthcare bill,” Sen. Orrin Hatch (R-Utah), the chairman of the Senate Finance Committee, said Wednesday.
. . .
No one’s interested in trying to save Obamacare’s centerpiece as it faces certain death.
Even as the healthcare industry heavily lobbies Republicans to keep the Affordable Care Act’s other main components, such as its subsidies and Medicaid expansion, doctors, hospitals and insurers are stepping away from the law’s individual mandate for people to buy insurance or pay a fine.
Not even Democrats are campaigning to keep the mandate, which was once viewed as the key to making Obamacare successful. The thought was that the mandate would prompt enough healthy young people to buy coverage to keep premiums stable. But nearly everyone agrees it didn’t work as well as intended. And repealing it is top of list for Republicans.
. . .
The news is all full of supporters of the Affordable Care Act warning about how the health insurance system will collapse if, as various Republican repeal programs propose, the “individual mandate” is immediately gutted while parts of the ACA briefly solider on. It’s not that the people issuing the warning aren’t correct. Repeal of the individual mandate without some immediate replacement will clearly reduce the stability of whatever markets would otherwise remain as the ACA continues its death march. It’s just that many of them are hypocrites.
It was the Obama administration and supporters of the ACA who essentially gutted the individual mandate.
. . .
President Obama will be leaving office with the Affordable Care Act, his signature policy initiative, in deep peril. An incoming Republican president and Congress, concerned with the cost of ACA exchange plans jumping by an average 25 percent next year and employee health care costs rising, have pledged to repeal the law. For his part, the President sought to shift the blame for rising out-of-pocket cost from the ACA’s flaws to employers and insurers. During a recent speech defending the law, he said the ACA has had no impact on the affordability of employer-provided health care benefits “except to make it a better value.” As the President put it, “if your premium is going up, it’s not because of Obamacare. It’s because of your employer or your insurer — even though sometimes they try to blame Obamacare for why the rates go up. It’s not because of any policy of the Affordable Care Act that the rates are going up.”
. . .
The 40% “Cadillac” Tax on expensive employer-sponsored health insurance is on a deathwatch because both parties in Congress dislike it. It would be best if Congress were to replace the Cadillac Tax with a simple and clear limitation on the tax preference for employer-paid premiums, as is called for the House GOP’s “Better Way” health plan. For decades, economists have complained that the open-ended tax break for employer-paid health insurance premiums is a major distortion in the marketplace. This approach is fair and promotes more transparency in the health care marketplace.
. . .
The House on Tuesday passed a bill that would allow people who enrolled in failed health insurance “co-ops” under the Affordable Care Act to skip this year’s penalty for not having coverage. The Republican-backed bill passed on a mostly party-line vote of 258-165, but 16 Democrats broke with their party to support the measure. “It’s just wrong, it’s wrong, to hold these working families financially responsible for a co-op’s failure because it went under due to factors beyond their control,” said Rep. Charles Boustany Jr. (R-LA). President Obama says he will veto the bill if it reaches his desk.
. . .