Health care: What happens now?
For Republicans, it’s finally “time to move on,” said Michael Brendan Dougherty in NationalReview.com. The Republicans’ seven-year campaign to repeal President Obama’s Affordable Care Act finally came to a humiliating end last week with Sen. John McCain’s dramatic “no” vote, after GOP lawmakers produced a series of half-baked proposals that “were as popular as throat cancer.” Republican Sen. Lamar Alexander, a committee chairman, signaled this week that he’s willing to work with Democrats on measures to “stabilize and strengthen” the current health-care system, rather than ripping it up and starting from scratch. The failure of repeal was “entirely predictable,” said Paul Krugman in NYTimes.com. For seven years Republicans claimed Obamacare was failing, and that they would replace it with a system that would somehow lower premiums and deductibles while providing better care to more people. This was a “web of lies.” Obamacare “has, for the most part, worked as advertised,” and every replacement plan the GOP came up with would have raised costs, stripped coverage from millions of mostly low-income Americans, and handed a $1 trillion tax cut to the rich. Now that their “stark dishonesty” on health care has been exposed, “maybe, just maybe, Republicans will work with Democrats to make the health system work better.”
The dream of repeal isn’t dead, said Reihan Salam in Slate.com—“at least not yet.” In fact, “Republicans are regrouping” already around a new plan by Sens. Lindsey Graham and Bill Cassidy that would restructure Obamacare’s insurance subsidies as block grants, to give states the power to decide how health-care funds are spent. For Republicans to abandon repeal would be “to give up on everything conservatives stand for,” said Avik Roy in NationalReview.com. What they need now is a “full-throated agenda” to lower medical costs by reducing government regulation and letting insurers offer cheaper plans covering essential care and emergencies. Customers would then enter the market voluntarily, without the coercive, premium-inflating bureaucracy of Obamacare.
Meanwhile, said Jordan Weissman in Slate.com, a furious President Trump still wants “to deal a death blow to Obamacare.” Because of a still-unresolved lawsuit from the Obama years, the president can unilaterally cancel the cost-sharing reduction (CSR) payments that help insurers extend coverage to low-income Americans. If Trump scraps CSRs, premiums in the state exchanges will spike by an estimated 19 percent nationally—that’s if insurers don’t decide to abandon the exchanges altogether. The Republicans who control Washington would be blamed for such sabotage, but the vengeful Trump may not care. “Like Samson chained to the pillars, Trump just wants to bring Obamacare’s whole structure tumbling down, even if it might kill his presidency too.”
Protecting Obamacare is important, said Amanda Marcotte in Salon.com, but if Democrats are bold and “strike now,” they may have a chance to achieve something truly historic. The failure of repeal confirmed that most Americans now believe in the goal of universal coverage—affordable, good-quality health care for everyone. Democrats should push to expand the growing pool of Americans covered, perhaps by creating a Medicaid “buy-in” system that would serve as an alternative to private insurers. Thanks to social programs like Medicaid, Medicare, and the ACA, said Jonathan Chait in NYMag.com, “the U.S. is a more humane place” than it was when tens of millions couldn’t afford to see a doctor. Whatever Trump and the Republicans do next, “the world before Obamacare will never return.” ■