The Wall Street Journal

When the authors of the Affordable Care Act promised to “bend the cost curve” in health care, it was typical Washington doublespeak. Voters likely heard those words as a promise that costs would go down, but the intended meaning was merely that they would rise more slowly than before.

Yet even by that meager standard, ObamaCare is a failure. Costs are rising faster than before, and there’s no real prospect of a reversal. The key provisions of the law that were supposed to produce savings and efficiencies either haven’t worked or will never be implemented.

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The seemingly imminent repeal of the Affordable Care Act’s insurance requirement, which could happen next week as part of the final passage of Republicans’ broad tax overhaul, has focused attention on Congress’ potential next moves on health care, including a bipartisan plan to shore up the insurance markets.

But that plan, sponsored by Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.), is losing support as more health analysts say it could raise costs for many consumers. The bill would restore payments to insurers, allowing them to cut premiums, but in doing so it would reduce the tax credits that are pegged in part to the premium costs of certain plans.

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American Democrats are following Bernie Sanders in embracing single-payer health care on the Canadian model. But when they get sick, our neighbors to the north increasingly find that the only way to get “free” medical care is to wait for weeks or months.

The Fraser Institute’s new report, “Waiting Your Turn: Wait Times for Health Care in Canada” in 2017, documents the problem. The Vancouver-based think tank surveyed physicians in 12 specialties across 10 provinces and found “a median waiting time of 21.2 weeks between referral from a general practitioner and receipt of treatment.” This is worse than 2016’s wait of 20 weeks, making it the longest in the history of Fraser’s annual survey and 128% longer than the first survey in 1993.

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With Congress seemingly on the brink of repealing the Affordable Care Act’s centerpiece requirement that most people get insurance or pay a penalty, Democrats are warning such a move would be disastrous, and Republicans are anticipating a sweeping symbolic victory.

Senate Republicans included a measure to repeal the mandate in their recently passed tax overhaul; the House didn’t, leaving GOP leaders to hammer out a final agreement for the compromise bill they hope to pass by year’s end. President Donald Trump on Friday night threw his weight behind the push to strike the mandate, promising a crowd in Pensacola, Fla., that it would soon be gone.

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Mr. Summers offers various caveats along with his prediction of a mass-casualty legislative event. But he largely accepts the Congressional Budget Office’s guess that 13 million more people will choose not to enroll in government health plans if insurance is no longer required (Summers rounds the guess down to 10 million), and he basically credits his former colleague Kate Baicker’s research suggesting people are more likely to die if they are not enrolled in a health insurance plan.

Mr. Summers is not alone among ObamaCare defenders in wanting to persuade people that the number of people covered by government insurance is the true measure of health. But the vast expansion of such coverage engineered by his old boss doesn’t seem to have made Americans healthier.

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Congress is headed for a showdown on whether to insert several pressing health measures in year-end bills, reviving partisan fights that threaten to derail Republicans’ goal to close out the year with a raft of legislative successes.

Former President Barack Obama and his advisers claimed that their 2010 health insurance law would create incentives to provide better and more efficient patient care. A new study suggests that one of their bright ideas has since gone disastrously wrong.

Republicans are right to want to repeal the mandate that fines Americans who don’t buy health insurance. Their dual motive is to repeal the most loathed part of the Affordable Care Act as well as to make tax reform comply with the Senate Byrd Rule that dictates no deficits outside a 10-year budget window. Some Americans no doubt would decide not to buy insurance if they aren’t hit with a tax, but that would be their choice. Republicans aren’t denying them anything. No other ObamaCare rule or mandate would be changed, and no benefit formula would be altered. Anyone who still wants an ObamaCare policy could still buy it.

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If you were deliberately trying to design the most arbitrary, painful and pointless tax possible, how would you go about it?

First, you would structure it to inflate the cost of an essential product. Then, you’d create exemptions so vast that only 5% of taxpayers were subject to it. You might even ensure that it hit people only when they were particularly vulnerable—like when they’d lost a job. Finally, you would use it to drive enrollment in entitlements, so that it increased the federal deficit by $338 billion.

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Republicans in Congress are plowing ahead on tax reform, and one obstacle is the complexity of Senate budget rules that limit how much taxes can be cut. The good news is that for once Washington’s fiscal fictions could be deployed to improve policy by repealing ObamaCare’s individual mandate as part of tax reform.

The Senate Finance Committee on Thursday released the details of its tax proposal, which includes a permanent 20% corporate rate and more. Senators Pat Toomey and Bob Corker cut a budget deal to allow for $1.5 trillion in net tax cuts over 10 years without accounting for faster economic growth (and more revenues) as a result of reform.

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