The First Step on the Road to Real Health Care Reform

January 13, 2017

This Thursday at about 1:30 pm, the United States Senate took the first step on the road to real health care reform: repealing Obamacare.

By a 51-48 margin, the Senate approved a budget resolution that instructs the relevant committees in the House and Senate to produce a bill by January 27 that will repeal Obamacare. Once that bill has been drafted, it can then be passed through both the House and Senate by simple majorities before it is signed into law by President Trump.

As big a victory as that will be – fulfilling a campaign promise that virtually every Republican has been making for the past six years – our work will only have just begun.

Although our nation’s health care system was far from perfect before the misnamed Affordable Care Act became law, it only got worse under the weight of Obamacare. So, it will take time to undo the damage Obamacare has caused and develop common-sense, consensus policies that actually improve our health care system. But the schedule included in this week’s budget resolution gives us the time – and the deadlines – we need to craft these fixes.

Many congressional Democrats do not want an Obamacare repeal effort to succeed, so they are spreading false stories to scare up opposition to Republicans’ reform plans.

They claim that repealing the floundering Affordable Care Act would immediately throw low-income families off Medicaid or raise insurance premiums for those with pre-existing conditions. This is nonsense.

Just as it took years for Obamacare to be implemented, it will take years for it to be undone. The repeal bill that passed the Senate and House last year included a two-year window for the existing Obamacare infrastructure to stay in place, during which time the architecture for a new system could be installed. The repeal bill that will come at the end of this month will look much the same.

What we do not want to do is repeat the same mistake that Democrats made in 2010: use a secretive process, driven by wealthy political insiders, to craft a multi-thousand-page bill that few people have read and even fewer understand, and then ram it through Congress on partisan lines.

Instead, we should develop a series of smaller, more targeted bills designed to increase the quality of health care while bringing down the costs, by removing unnecessary and harmful federal regulations and mandates. We should unbundle health insurance and health care by making it easier for Americans to buy catastrophic health insurance and use Health Savings Accounts. We should block grant Medicaid funding to the states so that they can tailor the program to the specific needs of their diverse populations.
All of this can be done separately, one policy change at a time. And we may well get some Democrats to help us.

But before we can make these reforms, before we can make affordable and high-quality health care available to all Americans, first we have to repeal Obamacare. And after this week, we are one step closer to accomplishing that.