Fewer than 12 months ago, some people—aka, yours truly—raised a warning about Obamacare’s cost-sharing reductions. The text of the law nowhere provided an appropriation for them, meaning that, as I wrote last May, the next President could shut them off unilaterally. At the time, I contacted several reporters, pointing out that such a move could have major implications for the health care law. None showed any interest in writing on the topic, and to the best of my knowledge, few if any reporters did.
Having now under-reacted regarding the issue during most of 2016, the media are compensating by over-reacting now. Since the House failed to pass “repeal-and-replace” legislation, breathless articles in multiple publications have examined the issue, whether the Trump Administration will cut off the subsidies, and whether insurers will bail on the Exchanges en masse as a result.
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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.”
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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.
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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.
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