Heartland Institute Experts Comment on Plan to Repeal Obamacare Now, Replace Later
‘Repealing Obamacare and starting from scratch will likely result in a far more free-market replacement bill than the one recently considered by the Senate.’ – Peter Ferrara
Senate Majority Leader Mitch McConnell (R-KY) on Monday announced the Senate leadership is giving up on its latest attempt to repeal and replace the Affordable Care Act (ACA) simultaneously because the leadership’s proposed bill, the Better Care Reconciliation Act, lacks the votes to succeed. McConnell said he will instead seek a vote on a repeal of Obamacare with a two-year delay “to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.” This is the strategy President Donald Trump advocated in favor of a few weeks ago.
The following statements from health care policy experts at The Heartland Institute – a free-market think tank – may be used for attribution. For more comments, refer to the contact information below. To book a Heartland guest on your program, please contact Media Specialist Billy Aouste at firstname.lastname@example.org and 312/377-4000 or (cell) 847/445-7554.
“Repealing Obamacare and starting from scratch will likely result in a far more free-market replacement bill than the one recently considered by the Senate—especially if the future replacement bill includes Medicaid block grants, giving more power and control over the program to the states. State-run uninsurable risk pools established for covering pre-existing conditions should also be emphasized in future legislation, rather than guaranteed issue or community rating.
“The repeal would kill far more in taxes, spending, regulations, mandates, the Independent Payment Advisory Board, and everything else so wretched and oppressive about Obamacare than the BCRA would have. It also means the dreamy-eyed, far-left nutcakes who continue to defend the failing ACA won’t have as much ammunition to use against reformers at the start of this process.”
Mr. Ferrara is the author of Power to the People: The New Road to Freedom and Prosperity for the Poor, Seniors, and Those Most in Need of the World’s Best Health Care (2015), and The Obamacare Disaster (2010).
“Obamacare has been an unmitigated policy disaster, the likes of which haven’t been experienced since President Lyndon Johnson’s detrimental ‘Great Society’ policies of the 1960s. Yet, some Republicans and the entire Democratic Party would have Americans continue to suffer with inferior care, growing debt, fewer health insurance options, and skyrocketing premiums and deductibles. Republicans were elected in large part to end the Obamacare death spiral and enact health care policies that will improve the lives of all people in this country. The time for talking is over. Members of Congress must repeal Obamacare now and enact better policies in its place soon after—or find new jobs better-suited for people disinterested in halting the United States’ health care crisis.”
“Congress and President Donald Trump should repeal Obamacare, just as they repeatedly promised, and multiply freedom from there. It’s better to start counting from zero than from in the hole, which is where Obamacare has put us.
“The collapse of congressional Republican revisions of Obamacare carries some poetic justice, considering Republicans called for the full repeal of Obamacare for seven years before settling on keeping its regulatory structure in place.
“Improvements made by the Republican plans would not have manifested until years from now, so had the Senate bill passed, the forthcoming round of Obamacare failures would have been heaped at Republicans’ feet. The failure of the Senate bill means Obamacare’s failures will continue to be owned by Democrats.”
“Now that the ‘Obamacare lite’ measure has failed, it is time for our leaders in Congress to have a real conversation with the American people. It starts with this truth: While we have traditionally offered assistance to those in our society who cannot provide for themselves, our best programs only do so for those in emergency situations and with chronic conditions. Besides the outright takeover of the American health care system, the signature failing of Obamacare is that it attempts to be responsible for every American. Such a scheme will never work, but it may bankrupt us all.
“The feds should enact reforms allowing policies to be sold across state lines and the creation of very large tax-deductible health savings accounts, and they should adopt malpractice reform, among other things. But in the meantime, lawmakers should repeal Obamacare and work to create a space for state and local governments to assist those truly in need while setting up federal parameters for the rest of the health care market to be as competitive as possible.”
“I think a clean repeal should have been the starting point. Those who vote against it will show themselves as liars. Let those who want to keep their special-interest benefits at the expense of all of us try to sell it to the majority instead of making a backroom deal to buy their one vote on the renege-rename bill.
“The replacement should be freedom. As Thomas Sowell wrote: If you put out a fire, why would you want to replace it?”
“Why two years? Why prolong the suffering? Six months should be enough time for people to make a change. End all the mandates and taxes that have driven up medical costs. End the Medicaid expansion to able-bodied working adults. Medicaid expansion and insurance subsidies have only enriched the executives of insurance companies and hospitals while doing little to increase access to care.
“The Affordable Care Act is an atrocity that must end as soon as possible. Once it is gone, Democrats will have a chance to work with the Republican Congress to craft something that will be best for the people. Expanded health savings accounts, affordable high deductible insurance without the networks, direct primary care, and return of Medicaid dollars back to the states are all ideas that need to be carefully considered.”
“The big question isn’t why this bill failed or why is Sen. Mitch McConnell (R-KY) trying this strategy now; it’s why didn’t he go this direction six months ago, when President Donald Trump first took office? Instead of trying to pass a bill that left in place most of Obamacare—one that had no buy-in from industry, conservatives, or the population at large—he should have immediately went about a strategy of trying to repeal as much of Obamacare as possible. Once the slate was cleaned, he could have then turned to a strategy of trying to come up with a sustainable bill that would have lowered health insurance prices while still maintaining some level of access for most individuals, something the latest Senate bill did not do.
“I am glad to see McConnell finally appears to be going that route, but I can’t understand the strategy that caused the Republicans to invest so much time and political capital trying to pass bills that no one wanted and that wouldn’t solve any of the problems caused by Obamacare.”
“There is a lot to be said for McConnell’s position, but if Obamacare is repealed, the Republicans will still face the problems that have caused the current effort to fail. More fundamentally, public opinion is opposed to the individual mandate, but public opinion demands that insurers accept applicants with pre-existing conditions. That latter demand makes no sense without an individual mandate.
“Add to that the fact that Obamacare contains some ‘goodies’ that make no policy sense—such as the requirement that ‘children’ as old as 25 must be covered by their parents’ policies—but which the Republicans aren’t willing to take away. Then there is the fact that Republicans are likely to lose at least a few seats in the House of Representatives in 2018.
“As bad as Obamacare is—and as easy as it is for a policy wonk to specify what a better program would look like—the political outlook is rather ugly.”
“It’s become clear that some Republican members of Congress would rather live with Obamacare than do the heavy lifting required to replace it with a better plan. Without a replacement plan, Americans will be forced to endure the Affordable Care Act until it collapses, at which time it will be more painful to reform.”
“It will probably take more than two years to begin to overcome the political brainwashing that insurance should have anything to do with our individual medical care. Insurance companies are financial institutions focused on actuarial statistics and collective outcomes, because that is what generates their profits. In sharp contrast, medical care should be an individual empathic process.
“The politicians have put financial companies in the position of intermediaries and controllers of our most pronounced personal decision-making. How insane is that? Beware of the onset of the ultimate collective groupthink: single payer. Always remember the cheapest form of medical care is to let sick people die. Do you want the politicians making decisions about life and death?”
“Perhaps in the long run this is the best option. It appeared the GOP was missing a once-in-a-lifetime opportunity to change the incentives away from an insurance-based and controlled system back to a free-market, consumer-driven system. A clean repeal may give them just that opportunity.”
“The inherent problem with overhauling Obamacare is finding the political will to decouple regulatory policy from the grips of Washington, DC Medicrats. Taking time out by repealing Obamacare and starting afresh makes sense only if lawmakers start with the simple proposition that all medical care must begin with the ability of patients to make decisions in concert with the physicians who care for them. As Dr. Michael Ainslie of Minnesota has famously said, ‘Give patients the money and then get out of the way.’
“If the GOP’s purpose is to find common ground on how best to fashion federal control of individual health care, then the failures of Obamacare will only snowball. Congress, give us our health care freedom. We will be responsible, we promise.”
“A well-thought-out and compromised ‘repeal and replace’ solution appears not to be an option in the near future. However, simply repealing the Affordable Care Act immediately without any type of replacement plan would be devastating to patients and likely result in huge financial loss in both the health care and private sectors of the economy. Passing legislation that would enact a full repeal, while giving a transition period to allow for new legislation and solutions to be put in place for those that would lose coverage, does make some sense.
“If during the transition period, free-market solutions, expansion of health savings accounts—including the use of them for direct primary care—pre-existing conditions protections, and affordable options for coverage for vulnerable patients can come to pass, then this route may be a viable option. On the other hand, if the repeal passes and no progress is made during the transition period on these issues, then patients may be at increased risk.”
“Going back to the drawing board is the right move for Republicans. The Senate legislation left many pieces of Obamacare’s structure intact, which is unacceptable for conservatives. The Republican caucus would benefit from regrouping and coming out with a proposal that all conservatives can support.”
“Medicaid is financially unsustainable in its present form. The individual health insurance markets, both inside and outside the Obamacare exchanges, are collapsing because of adverse selection. At some point, Obamacare reform must occur. Republicans should seize this moment to repeal the Affordable Care Act and deliberately provide a patient-focused alternative.”
“I am no fan of Obamacare, and I am no fan of what preceded Obamacare. But given the choice of the two, I’d pick our pre-Obamacare health care system, hands down. Repeal of Obamacare with no replacement is a step up from our current situation. Obamacare has benefited only one group: insurance companies. Due to Obamacare, patients have seen premiums skyrocket as their access to health care has diminished. Medicaid expansion has cost state budgets to explode while not producing any measurable improvement in the quality of health care.
“Our health care system is in desperate need of a ‘federal goverment-ectomy.’ The more the federal government is involved in health care, the worse it becomes.”
“Republicans made a commitment to the American people. They committed to repealing Obamacare, and Americans put them in office to do it. Now, Republicans have a chance to finally do the right thing for the American people. They must simply repeal every word of the Affordable Care Act. A vote on a two-page repeal bill will end the needless quibbling and ongoing drama about the details of a bill that was never full repeal in the first place. Full repeal has always been the only answer. We call on the Senate to put a real repeal bill up for a vote.”