Such credits should form the foundation of the GOP response to a King decision. Republicans should advance legislation that effectively allows states to opt out of Obamacare’s entire regulatory and subsidy structure and into a far simpler and more flexible system that points in the opposite direction: toward a competitive, consumer-centered marketplace for coverage. In that system, state residents not offered health coverage by their employers could receive a federally funded, age-based credit for the purchase of any state-approved health-insurance product—including those bought outside of any exchange and regardless of whether they meet Obamacare’s coverage requirements. Anyone who remained continuously insured in this system would be shielded from higher premiums or exclusion from coverage based on a preexisting condition, giving consumers a strong incentive to buy coverage without a mandate to do so. And all other insurance regulation would be up to the states.
A new poll by McLaughlin & Associates finds that Americans strongly support having Congress advance a conservative alternative in the context of King v. Burwell.
The poll asked (question #7),
“If the Supreme Court rules that the Obama administration has been illegally paying out Obamacare subsidies in 36 states, what do you think Congress should do in response?”
Likely voters replied as follows:
“Do nothing and let people in those 36 states lose their subsidies and perhaps their insurance”: 4 percent
“Negotiate fixes to Obamacare with the Obama White House in exchange for turning the subsidies back on”: 20 percent
“Turn the subsidies back on temporarily but don’t try to fix Obamacare”: 5 percent
“Propose to effectively repeal and replace Obamacare in those 36 states with a conservative alternative that aims to help people get coverage and reduce costs”: 26 percent
“Give the states a choice between Obamacare and switching to a conservative alternative that aims to help people get coverage and reduce costs”: 25 percent
“Something else”: 8 percent
“No opinion”: 13 percent
Support for having Congress propose a conservative alternative (either for the 36 states in question or for all states that choose to switch to such an alternative) was 64 percent among Republicans and 55 percent among independents, while the most popular answer among Democrats (34 percent, compared with only 10 percent among Republicans and 12 percent among independents) was that Congress should negotiate fixes to Obamacare.
Republicans need a strategy that is easy to understand, broadly popular and difficult to oppose. It must unite Republicans and divide congressional Democrats, while empowering Republican governors and legislators to resist administration pressure. I believe that strategy is what I would call “the freedom option.” Every American should have the right to decide not to participate in ObamaCare: If you like ObamaCare and its subsidies, you can keep it. If you don’t, you are free to buy the health insurance that fits your needs.
The freedom option would fulfill the commitment the president made over and over again about ObamaCare: If you like your health insurance you can keep it. If Republicans crafted a simple bill that guarantees the right of individuals and businesses to opt out of ObamaCare, buy the health insurance they choose from any willing seller (with risk pools completely separate from ObamaCare), millions of Americans would rejoice and exercise this freedom. Such a proposal would be easy for Republicans to articulate and defend. And it would be very difficult for Democrats to attack.
Event | Overcoming Obamacare: Three Approaches to Reversing the Government Takeover of Health Care | Cato InstituteFebruary 23, 2015
February 24, 2015
Featuring the author Philip Klein, Commentary Editor, Washington Examiner; with comments by Avik Roy, Senior Fellow, Manhattan Institution; Jeffrey H. Anderson, Executive Director, The 2017 Project; and Michael F. Cannon, Director of Health Policy Studies, Cato Institute.
Contrary to myth, Obamacare’s opponents have many alternatives to the health care law that is once again before the Supreme Court. The Washington Examiner’s Philip Klein, a leading conservative health care writer, takes us inside the debate on the right over how to overhaul the health care system along free-market lines in the wake of a ruling in King v. Burwell, and possibly in the wake of Obamacare.
Drawing on eight years of experience reporting on the issue, and dozens of interviews with prominent health policy experts, Klein lays out a free-market vision for health care and presents three competing approaches to getting there: reform, replace, and restart. Join us to hear from Klein, as well as from leading proponents of each school of thought.
If you can’t make it to the Cato Institute, watch this event live online at http://www.cato.org/live and follow @CatoEvents on Twitter to get future event updates, live streams, and videos from the Cato Institute.
There are, of course, countless unworkable Obamacare provisions that have yet to be repealed due to Obama administration intransigence. One of the most obvious of these is the employer mandate, which is universally reviled by policy experts of all political persuasions. As I wrote in this space last year, even the left-leaning Urban Institute has called for its repeal in a report titled, “Why Not Just Eliminate the Employer Mandate?” Likewise, Obamacare-friendly policy wonks such as Professor Timothy Jost admit that the mandate’s 50-employee threshold has constrained job growth and forced some employers to “cut the hours of part-time employees.”
The complete list of such counterproductive provisions is far too lengthy to cover in a single column, but there are enough to guarantee that PPACA will never work. Yet, even as the news was breaking about the law’s latest failures, HHS Secretary Burwell published a column in USA Today in which she offers this all too predictable assurance: “The Affordable Care Act is working.” The public isn’t buying it. A recent AP survey shows that only 26 percent of adults support Obamacare. Why so few? Because, no matter how often the President, his bureaucrats, or the media tell us otherwise, it’s blindingly obvious that Obamacare just isn’t working.
In case you’ve forgotten — and to compound the irony — Gruber is the Obamacare architect who received negative media attention recently for some controversial comments about the stupidity of the average American voter. In Health Care Reform, Gruber focuses mainly on two topics: an attempted diagnosis of the American health care system, and how the Affordable Care Act (the ACA, or Obamacare) will solve them. I could write a PhD thesis on the myriad fallacies, half-truths, and myths propounded throughout the book. But instead, let’s explore eight of Gruber’s major errors.
The American Enterprise Institute published a health reform white paper, titled “Best of Both Worlds”. The white paper, referred to in this report as the Proposal, offers alternative policy suggestions to those that were implemented under the Affordable Care Act (ACA).  Key aspects of the proposal include a “Basic Plan” available to all individuals at no cost, eliminating the tax exemption for employer sponsored insurance premiums, eliminating most of the Medicaid program, and instituting a safety net for the uninsured, among others. This report details the findings of the Center for Health and Economy’s (H&E) Under-65 Microsimulation Model on the Proposal’s impact on health insurance premium prices, insurance coverage, provider access, medical productivity, and the federal budget. While our estimates are associated with some degree of uncertainty, the summary of our findings is as follows:
- Premium Impact: The Proposal is projected to decrease the total premium cost of private health insurance coverage, with the largest impact on Bronze and catastrophic coverage plans.
- Coverage Impact: The Proposal is projected to lead to 19 million more insured persons by 2025 relative to current law. The increase in coverage is the net effect of a growing individual market and shrinking enrollment through employer-sponsored insurance and Medicaid.
- Provider Access: The Proposal is projected to initially result in greater patient access to providers. According to the H&E Provider Access Index, access for the insured population will be 4 percent greater than under current law in 2016. By 2025, average provider access under the Proposal will be roughly equal to current law.
- Medical Productivity: The Proposal is expected to lead to greater productivity than under current law. According to the H&E Medical Productivity Index, productivity is projected to increase by 8 percent by 2025.
- Budget Impact: Compared to current law, the insurance coverage provisions of the Proposal will increase the federal deficit by $940 billion between 2016 and 2025.