Tags: Donald Trump | Healthcare Reform | IRS | insurance | medicaid

With Courage, Trump Can Fix Obamacare Now

Image: With Courage, Trump Can Fix Obamacare Now
President Donald J. Trump with HHS Secretary Tom Price in the Oval Office of the White House in Washington, D.C., on March 24, 2017. With prospects in doubt for repealing Obamacare, some Republicans have said the Trump administration can rewrite regulations and take other actions to undo much of the healthcare law on its own. (Pablo Martinez Monsivais/AP)

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Tuesday, 01 Aug 2017 01:54 PM Current | Bio | Archive

So the U.S. Senate has been unable to do anything on Obamacare and the end is near?

For months it's been obvious that those Keystone cops did not have the courage to act.

Conservative Republicans do not even have a real majority in the Senate or the U.S. House and will not for the foreseeable future. Sen. Lisa Murkowski, R-Alaska, actually lost her GOP primary.

Rep. Rohit "Ro" Khanna, D-Calif., thinks so highly of government health insurance that he predicts Democrats will pass universal healthcare when they win back the presidency in 2020, and will do so with a simple majority in the Senate.

Congressional dysfunction is why this space has been urging President Donald Trump to reform Obamacare all by himself. This space has outlined how he should do it.

Let's start with what should have been done the day Health and Human Services Secretary Tom Price was sworn in: deferring to the House of Representatives in the House v Price federal lawsuit which Speaker Paul Ryan, R-Wis., won in the lower courts by ruling that President Barack Obama did not have the constitutional right to impose insurance company subsidies — without House approval.

All the president had to do was to order the secretary and attorney general to withdraw the Obama administration appeal and the subsidies — which have continued during the appeal — would have ended with the insurance companies themselves abandoning Obamacare’s failed health insurance market.

President Trump did issue an executive order five months later on May 22, 2017 but it was to defer any decision regarding the lawsuit for another 90 days.

It is time to stop deferring and do the legal and constitutionally correct thing and end the subsidies now.

Second, President Trump did issue an executive order in January telling Secretary Price to minimize Obamacare’s regulatory burdens, to "waive, defer, grant exemptions from, or delay its rules."

HHS has already told states it would grant waivers for those who want to experiment more broadly with such possible reforms. It is time use that authority to help states impose work requirements for the able-bodied, allow charging premiums to the millions above the poverty level added to the poverty program Medicaid, and to delegate rule-making to the states generally.

Third, while overly permissive and expensive mandated benefits for preventive care are broadly defined by statute, HHS can more narrowly define them to make them truly cost-effective, by fixing the greatest problem — with the Obamacare marketplaces.

Insurance is required to reimburse for low-cost preventative care for everyone that the overwhelming majority can afford to pay themselves. But the large numbers compensated for them increase total expenses so much that high deductibles and low reimbursements for serious illnesses and injuries must be imposed to balance out costs. The whole Obamacare plan is backwards — which is why it is failing.

Fourth, President Trump can end the mandate to purchase an Obamacare healthcare plan by permanently eliminating the tax penalty enforcing it. He has already told the Internal Revenue Service (IRS) not to enforce the penalty for the time being following President Obama’s similar order.

The president should make this permanent by following his predecessor further, expanding his waivers for hardship cases which certainly include everyone today; none of whom have been able to keep their old healthcare plan as promised.

Finally, President Trump can end President Obama’s preposterous decision to designate members of Congress and their staff as "small businesses," which allowed them to be covered under the District of Columbia exchange but unlike everyone else they kept their old healthcare plans with a real subsidy up to $12,000 a year, or 70 percent of their premiums.

Would Congress be happy with this? No, but they had their chance. Would the health industry be pleased? No, they have fattened themselves on the subsidies, but in the long run their industry would be saved. How about the people? If the president acted upon this fast enough they might even see a functioning market before the next election.

The media would portray this as the end of the world. But what's new about that?

De facto repealing of Obamacare is easy. All the president needs is the courage to act.

Donald Devine is senior scholar at the Fund for American Studies, the author of "America’s Way Back: Reclaiming Freedom, Tradition and Constitution," and was Ronald Reagan’s director of the U.S. Office of Personnel Management during his first term. For more of his reports, Go Here Now.

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Congressional dysfunction is why this space has been urging President Donald Trump to reform Obamacare all by himself. All the president needs is the courage to act.
insurance, medicaid
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2017-54-01
Tuesday, 01 Aug 2017 01:54 PM
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