The debate over the future of America’s health system is just beginning. Democrats are certain to use every opportunity to defend Obamacare as a success. So what better time to debunk some of the biggest misperceptions about health policy that liberals have been pushing for decades? Ridding our healthcare debate of these fallacies is vital to building a successful health sector from the ruins of Obamacare. Sally Pipes, President of the Pacific Research Institute, highlights myths such as: “Universal coverage should be the ultimate goal,” “Health care and health insurance are the same thing,” and “No one should ever have to pay out of pocket for health care.”
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In new research for the Mercatus Center, I argue that one of the central aims for the ACA replacement should be to reduce government bias toward comprehensive insurance. Policymakers should instead focus on realigning incentives, removing government mandates and regulations, and directing government financial support to consumers instead of to insurers and providers. Doing so would lead consumers and providers to make decisions that lead to greater value from the massive amounts of money we spend each year on health care.
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Republican leaders in Congress have announced their intention to repeal key parts of Obamacare in early 2017, but delay the implementation of that repeal until 2019 or 2020. Some conservatives are complaining about this delay, arguing that the GOP should replace Obamacare immediately. But GOP leadership is right—and here’s why.
The fundamental problem is that in order to fully replace Obamacare, Republicans need to come up with a bipartisan plan that can attract the 60 votes necessary to overcome a Democratic filibuster.
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An important part of Donald Trump’s healthcare agenda is his pledge to let consumers and employers avoid unwanted regulatory costs by purchasing insurance licensed by states other than their own, a change that would make health insurance both more affordable and more secure. The Congressional Budget Office has estimated that allowing employers to avoid these unwanted regulatory costs would reduce premiums an average of 13%. That’s a nice contrast to what Bill Clinton calls ObamaCare’s “crazy system where…people [who] are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half.”
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In a recent podcast, Weekly Standard editor Bill Kristol made the observation:
if Obamacare had worked, Hillary Clinton would be the president-elect, right? I do think those those premiums going up two weeks before the election probably moved the necessary number of votes.
That got me to thinking how one might prove this empirically. The short answer is that I cannot prove this proposition beyond a shadow of a doubt, but the evidence is stronger than one might suppose.
To be sure, national exit polls showed that the most important issues in this campaign were the economy (52%), terrorism (18%), immigration (13%) and foreign policy (13%). However, according to David Wasserman’s definitive vote tallies at Cook Political Report, a swing of only 38,595 votes in 3 states (MI, PA, WI) would have given the election to Hillary Clinton. This represents 0.0293% of votes cast, making it the 7th closest presidential election in history in terms of this metric (p. 330). The issue for our purposes here is whether we could make a good case that Obamacare was the factor that led these crucial election-deciding voters to pull the lever for Trump rather than Clinton.
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President-elect Donald Trump’s decision to name Georgia Rep. Tom Price as the new secretary of the Department of Health and Human Services gives us a good idea of how Republicans will repeal Obamacare. Price, a doctor, understands both health care and policy. He introduced his own Obamacare replacement plan in 2013 and updated it in 2015.
Price’s plan, which seeks to create a consumer-driven health care model and is already in legislative language, is very similar to House Speaker Paul Ryan’s “A Better Way” health care reform outline released earlier this year. All of which means the Price plan will likely provide the framework for the Republican plan.
The three main components of the Price bill are: 1. Provide tax credits for those without employer coverage, 2. A solution for those with preexisting conditions, and 3. Expand Health Savings Accounts.
The Urban Institute released a new analysis yesterday of the impact of a bill that Congress passed last year to repeal large parts of the Affordable Care Act (ACA). Urban’s analysis is based on many uncertain assumptions, including the implausible one that the incoming Trump administration and Congress, despite numerous campaign promises, will not provide any flexibility for people to purchase non-ACA-compliant products after repeal. Urban’s projections should be treated with significant skepticism because of the large uncertainty about its assumptions as well as substantial mistakes Urban has made in the past about the impact of the ACA.
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Price is of the view that we are going to end up subsidizing the health care of the poor and the indigent one way or the other. We can do it through cost shifting and subsidies conferred on impersonal hospital bureaucracies or we can give the money to the people and let the bureaucracies compete for their patronage. The Price tax credit would be refundable and it would vary by age. But unlike the Obamacare credits, Price’s credit would be the same, regardless of income.
That last feature is huge. The most important reason why the exchanges have been so dysfunctional is the need to verify income.
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On Tuesday, President-Elect Donald Trump announced that he will nominate Rep. Tom Price (R., Ga.) for Secretary of the U.S. Department of Health and Human Services. It’s a strong pick, and one that increases the likelihood that Republicans will succeed in repealing and replacing Obamacare. Here’s why.
Price, who chairs the House Budget Committee and represents the northern suburbs of Atlanta, has long been one of the House of Representative’s foremost policy wonks. He previously chaired the Republican Study Committee and the Republican Policy Committee, two of the most significant Congressional engines of conservative policy thinking.
And he has long been passionate about, and constructive on, health care reform.
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The health care crowd in the Beltway is abuzz this morning with press reports that president-elect Donald Trump has named Georgia Congressman Tom Price, M.D. as Secretary of the Department of Health and Human Services. In a related move, he will name longtime Mike Pence aide Seema Verma to the critical role of administrator of the Center for Medicare and Medicaid services. As a result, there’s a raft of interest in how Obamacare “repeal and replace” will now proceed.
It’s important to not get ahead of ourselves here and reflect on what a huge pro-taxpayer accomplishment Obamacare repeal will be. By all accounts, Obamacare will be off the books early in 2017, perhaps before the Patriots win their fifth Super Bowl in NRG Stadium in Houston on the first Sunday in February. Understandably, most of the attention has been focused on the health care aspects of this. But this action will be an enormous tax cut for the American people, with implications for tax reform later in the year.
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