The House GOP yanked its health-care bill on Thursday ahead of a planned vote, and perhaps they’ll reconvene on today or later. The House bill to repeal Obamacare is a realistic compromise that can improve health-care markets, and no one has offered a better policy alternative to the American Health Care Act that could pass the House and Senate. The obstacle to progress has been the 29 or so Members of the House Freedom Caucus, who have the power to deny House Speaker Paul Ryan a majority of 216 with a mere 22-vote margin of error. The Freedom Caucus blocked incremental reform progress after the GOP took Congress under President Obama, and the question is whether they will indulge the same rule-or-ruin tactics now against Mr. Trump.
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The House health-care bill is gaining momentum, and on Monday night the GOP posted amendments meant to add fence-sitters to the coalition. Don’t discount the stakes: The vote scheduled for Thursday is a linchpin moment for this Congress, and a test of whether the GOP can deliver on its commitment to voters.
For seven years and across four elections, Republicans have promised to repeal and replace ObamaCare if entrusted with the Presidency and House and Senate majorities. Now they have the opportunity to dispose of the failing law and begin to stand up a more market-oriented, patient-centered system. The reform isn’t perfect, and no bill ever is, but the reality is that a no vote is a vote for the ObamaCare status quo.
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Republicans are talking about repeal-and-replace as “three pronged”—pass the current House bill, deregulation through Mr. Price’s executive action, and then measures that can later be attached to must-pass bills. Mr. Price’s letter is the beginning of prong two.
Republicans have an obligation to try to revitalize insurance markets, and not only because Americans depend on coverage. Repealing and replacing ObamaCare is also an opportunity to show that conservative ideas can work in health care. The reason the opposition is so furious is that liberals fear they might succeed.
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Almost 30 years after leaving office, Ronald Reagan is widely considered one of America’s greatest leaders and the icon of the conservative movement. As a Republican member of Congress, I often speak at Lincoln-Reagan Day dinners and other events honoring his legacy.
Yet as I watch the debate over our House Republican plan to repeal and replace ObamaCare, I’m struck by a question. Would President Reagan be acceptable to some of today’s conservatives? Does anyone remember that Reagan was a master of advancing his principles by looking for common ground and finding consensus?
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Lawmakers will undoubtedly concern themselves with many policy objectives as they consider modifications to the AHCA. They would be prudent, however, to ensure that anything signed into law repairs some of the fiscal damage done by the ACA. This will require them to be cognizant of real-world fiscal effects that may not be fully captured in Congress’s current scorekeeping methods. Three factors contribute to confusion about the ACA’s damaging fiscal effects: 1.) Many of the provisions designed to finance its expansion of insurance coverage haven’t borne fruit, 2.) Scorekeeping rules Congress imposes on the Congressional Budget Office require the CBO to compare the effects of legislation to a baseline that differs from actual law in various critical respects, and 3.) Misinterpretation of intermittent CBO reports over the past several years on the evolving cost estimates for the ACA’s coverage expansion.
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The furor over the Congressional Budget Office’s report on the House GOP health bill is concentrated on predictions about insurance coverage, which suits Democrats fine. Lost amid the panic is that CBO shows the bill is a far-reaching advance for the market principles and limited government that conservatives usually favor.
The CBO is not omniscient, but if its projections are even close to accurate then ObamaCare repeal and replacement is the most significant government reform in perhaps three decades. Under conventional (static-revenue) scoring, the bill cuts spending on net by $1.22 trillion and eliminates a raft of new taxes worth $883 billion through 2026.
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According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You’d think that eligible individuals would need no prodding to sign up for such a benefit.
And yet, according to its analysis of the GOP ObamaCare replacement, the CBO believes that there are five million Americans who wouldn’t sign up for Medicaid if it weren’t for ObamaCare’s individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance.
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The white smoke rose Monday afternoon from the Congressional Budget Office as the fiscal forecasters published their cost-and-coverage estimates of the GOP health-care reform bill. Awaiting such predictions—and then investing them with supposed clairvoyance—are Beltway rituals. The coverage numbers weren’t great for Republicans, but they shouldn’t allow an outfit that historically underestimates the benefits of market forces to drive policy.
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The House GOP’s bill to reform health care is hardly a surprise: Its key elements were part of the “Better Way” agenda championed last year by Speaker Paul Ryan. Republican lawmakers discussed the principles in several special conference meetings. The legislation was then written from the bottom up by the appropriate committees instead of being imposed from the top down.
The bill would repeal much of President Obama’s framework for government-run, highly prescriptive, one-size-fits-all health care. In its place would stand conservative reforms to unleash market forces, give consumers choice, and return power to the states.
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The do-or-die moment for the Trump Administration and the GOP Congress arrived on Monday, as House Republicans rolled out their ObamaCare repeal-and-replace bill. The question now is whether they can deliver on their reform promises and govern to improve the lives of American voters.
The American Health Care Act would be the most consequential GOP social-policy reform since the welfare overhaul of 1996. Not only does the bill repair the failures of the Affordable Care Act, it starts to correct many of the government-created dysfunctions that have bedeviled U.S. health care for decades.
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