Republicans are in a pickle, and have been since the moment Obamacare was passed.
You might think they’re in a good position, because the Supreme Court is considering overturning the state Obamacare exchanges and subsidies because of wording in the statute, and this would throw the entire Obamacare system into turmoil. The case in question is King v. Burwell, and it could be decided any day now.
But there’s one catch, and it’s a biggee: if the ruling goes against Obamacare, the press and the left will rail at the Republicans for being the big bad meanies who took away a lot of people’s subsidies. That was part of the beauty of Obamacare for the left, and one of the many many reasons they were so extraordinarily eager to pass it and pass it as quickly as possible: they wanted to create a dependence and an expectation, otherwise known as an entitlement, that would be tremendously hard to reverse.
But what do the American people actually want if SCOTUS throws out the state exchanges and therefore the state subsidies? A substantial majority appear to want Congress to fix Obamacare rather than re-establish the state exchanges, according to this poll. But what would that actually look like?
Some indications here* (and the whole thing is worth reading for more details):
Voters view ObamaCare as having done more harm than good. They blame Congress for a poorly written law and they expect Congress to fix it. And they want those fixes to help everyone, not just those getting subsidies. They want those changes to make sense: more choices, the ability to buy insurance any time, and subsidies that follow people, not just exchange plans.
Voters understand that setting up ObamaCare exchanges will put states on the hook for the high operating costs to run those exchanges. They recognize that doing so will put more employers and individuals at the mercy of the IRS as it enforces more ObamaCare mandates. And they’ve seen the disastrous rollouts other states have experienced in setting up those exchanges. This is a problem created by the federal government. They don’t expect or want states to bail out Congress to vote against their state lawmakers the next time they’re up for re-election if they set up a state exchange.
But why, if Congress was so bad at setting up Obamacare in the first place, would it be so good at fixing it? And that’s true even though the first feat was accomplished by Democrats and the second would be performed by Republicans, because we know that the latter aren’t necessarily so great, either. Another thing the poll indicates is that respondents still seem wedded to subsidies, they just want them to not be tied so closely to policies sold on an exchange.
Those who say Republicans have no plan are right in that they have no unified and universally agreed-on plan, but they certainly have no lack of plans, plural. A new one was recently outlined by Louisiana Senator Bill Cassidy, who is a doctor. The entire article is worth reading, but here’s an excerpt (and I think Cassidy’s statements are interesting not only for his plan itself but for the reasoning behind it):
Freshman Sen. Bill Cassidy (R., La.) wants the GOP to start thinking like the left.
In proposing the Patient Freedom Act, Cassidy believes he is doing just that—slowly chipping away at Obamacare by bringing federalism back into the health care system and getting the federal government out.
“Of course it would be wonderful [to repeal Obamacare now],” Cassidy told the Washington Free Beacon. “But as Paul Ryan says, President Obama is not going to sign a repeal of Obamacare.”
“The left was really good for decades—they were pushing, and pushing, and pushing [for health care reform],” Cassidy said. “We’re impatient. We want it all at once.”
“I think we have to be as strategic as they,” he said. “Plant those seeds, water, show people our alternative, and inch back.”
Cassidy…narrowly focused his bill to be a response to a ruling in favor of Burwell, which would take away subsidies in states that are operated by the federal exchange….
[Cassidy’s] Patient Freedom Act would give states the option of keeping Obamacare by establishing a state-based exchange, or using existing funding to provide tax credits to create Health Savings Accounts (HSAs) for the uninsured, averaging $1,500 per person…
“The president, I’m sure, will make it easy [to set up a state exchange], because he wants his law to take root,” he said. “If we don’t have a better plan, it will take root.”
If states chose Cassidy’s option, they could do away with various mandates under Obamacare, including the individual and employer mandates and requirements for minimum essential coverage. The legislation would also equalize tax treatment, and require health providers to publish cash prices for services reimbursed from an HSA…
Cassidy’s bill borrows from other Republican alternatives to Obamacare in Congress, such as Rep. Tom Price (R., Ga.), whose replacement plan also offers tax credits. Cassidy said his is the only plan that would solve the gap in coverage if the Supreme Court does away with Obamacare subsidies.
Note also Cassidy’s statement about Obama wanting his law to “take root.” That’s exactly the sort of thing that happens with entitlements—they take root, and the roots are thick, deep, and tangled. Good luck pulling them out.
[* NOTE: One thing I noticed about the poll is that the demographics are based on the voting in the 2014 election. But the 2014 election was atypically small and atypically Republican, so the poll probably skews to the right.]
[Neo-neocon is a writer with degrees in law and family therapy, who blogs at neo-neocon.]DONATE
Donations tax deductible
to the full extent allowed by law.