Divided Republican senators are scrambling to repeal and replace the wizened monster called Obamacare. Most conservatives want more consumer choice. Some moderates want more money for Medicaid expansion and opioid-addiction treatment.
To bridge this gap, McConnellcare should offer more voluntary features and expand medical freedom: Give doctors and patients more options. For conservatives, these can be the spoonsful of sugar that make the Medicaid go down. For moderates, giving patients numerous paths to health takes nothing from anyone.
These ideas would help:
- All Americans should be free to open voluntary Health Savings Accounts (HSAs) that they would own and control. Funds could be spent on insurance premiums, drugs, medical devices, or saved for future health needs.
- All Americans should be free to buy insurance across state lines. Indeed, insurers should be allowed to offer coverage from California to Maine in a single, national free market. Visualize GEICOcare.
- All Americans should be free to purchase simple, low-cost, catastrophic coverage.
- All Americans should be free to launch and join association health plans (e.g. Junior Leaguecare or UCLA Alumnicare).
- Sen. Ted Cruz, R-Texas, wisely proposes that any insurer that offers an Obamacare-compliant plan also may sell whatever other policies that it wishes. This could include stripped-down, inexpensive coverage with few if any of Obama’s paternalistic mandates, especially Community Rating (by far, Obamacare’s most explosive cost accelerant) and Essential Health Benefits. It is grotesque for Washington to force gay couples to purchase mandatory "free" birth control and compel childless Americans to buy pediatric dental benefits for offspring they never offsprung.
- End Community Rating. The idea that everyone in a community should pay the same for health insurance — whether they are skinny, vegan yogis or bulbous, chain-smoking, couch potatoes — is as absurd as charging 16-year-old boys and 56-year-old grandmothers the same price for auto insurance. Insurers should be free to adjust prices to reflect risks.
- If sedentary, obese Americans are likelier to get sick, their insurance should be costlier. Avoiding higher prices will incent them to get fit. Letting older, unhealthier people underpay their fair share for health insurance swindles younger, healthier Americans who overpay their fair share for coverage.
- Liberals’ relentless quest for identical results across a wide, diverse population is yet another destructive unicorn hunt. As John F. Kennedy explained, "It’s very hard in military or in personal life to assure complete equality. Life is unfair."
- Rather than a $50 billion insurance-industry bailout, to subsidize pre-existing-condition coverage, any such funds should reach patients. Either through HSA deposits or vouchers ("health stamps"), they would buy coverage that satisfies them.
- Come 2018, Medicaid should stop enrolling able-bodied, childless people whose incomes exceed pre-Obamacare limits. Thereafter, Medicaid patients could volunteer to receive their benefits as HSA deposits. Such funds could buy private plans, medication, etc. This would turn passive aid recipients into active healthcare consumers who compare prices, evaluate quality, ask questions, and economize. This lowers medical costs.
- Sen. Rand Paul, R-Ky., (a physician) prescribes bifurcation: Moderate Republicans and Democrats should pass a bill that funds Medicaid. Conservative and moderate Republicans should adopt another measure that encompasses these market-oriented reforms.
While not ideal, this would be far better than a hard-Left, Republican-led RINO bill — repeal in name only. Otherwise, the GOP might abandon seven years of anti-ObamaCare promises and enrage Republicans, independents, and even some Democrats who yearn for emancipation from Obamacare’s dungeon. These betrayed voters justifiably will torture Republican incumbents in November of 2018.
But if Republican senators calm down and approve legislation like this, and then renovate and reduce taxes, Americans will rejoice. The GOP then would be poised to keep the House, win at least eight net Senate seats (among 25 that Democrats are defending), and secure a filibuster-proof Senate majority. With President Donald J. Trump wielding his signature pen, Republicans can spend two to six years implementing the conservative agenda. Democrats — like Palestinians at the U.N. — would be reduced to observer status.
That is the prize on which Republicans should keep their eyes.
Deroy Murdock is a Manhattan-based Fox News contributor and a contributing editor with National Review Online. He has been a media fellow with the Hoover Institution on War, Revolution and Peace at Stanford University. Read more opinions from Deroy Murdock — Click Here Now.
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