There are two things you don’t want to see being made – sausage and laws.
I think we witnessed the reason for that with the attempt to repeal and replace the Affordable Care Act.
The repeal of Obamacare has passed several times through the House and the Senate, only to die on the president’s desk. The American Health Care Act added a replacement component to the bill. It is easy to repeal – many are unhappy with Obamacare. It is much harder to build a consensus for a new health care plan.
To start with, a brand-new plan would require 60 votes in the Senate. The GOP didn’t believe they could get 60 votes. The alternative is to do legislation under the budget reconciliation procedure that requires 51 votes to pass. However, if there is a component of the bill that wasn’t related to a budget issue, it can get stopped in the Senate.
That is the reason the American Health Care Act looks like Obamacare “light”.
The American Health Care Act was to be the first phase of healthcare reform. Other changes would come in Phase 2. The new secretary of Health and Human Services, Tim Price, had the authority in the Affordable Care Act to make changes. Further improvement would come with changes in regulations.
The last phase of reform was to include legislation that allowed health insurance companies to go across state lines – making a larger risk pool. This is currently allowed by professional associations with life insurance and disability insurance.
So why couldn’t the GOP find a compromise with the American Health Care Act? There seemed to be two sticking points: Medicaid reform and what to include in health insurance.
More Medicaid expansion costs would be absorbed by the states, although more control was given to the states. In Idaho, Governor Otter didn’t accept the Medicaid expansion, anticipating the Federal government would quit funding it and leave it on the shoulders of the state. What should Federal funding of Medicaid support be?
The second issue is what needs to be included in a basic health care plan. One consensus was government shouldn’t mandate any part of health insurance – let the free market create a viable product. Yet many citizens across the nation like keeping kids on health insurance until age 26 and elimination of pre-existing conditions. Covering pre-existing conditions drives the cost up.
So, where are we? The Affordable Care Act remains in place, although it isn’t so affordable. I do believe as a nation we are becoming better health care consumers.
Obamacare is in a death spiral and won’t likely continue much longer. Very few insurance companies are participating in the state health insurance exchanges. Eventually Congress will have to craft a plausible solution or let Obamacare die and the market find its own solutions.
I also believe health care has passed from a privilege to a right. Expect this heated discussion to continue. You can find quality information on the website for Kaiser Foundation, www.kkf.org. Kiplinger Letter also monitors the activities of Washington D.C. and the economy.