So the Supreme Court upheld the federal subsidies in Obamacare, or Scotuscare, or whatever you want to call it. This leading everyone to assume health care will be frozen as a political issue until January 2017.
It doesn’t have to be, though. Republicans in Congress and in the General Assembly can still propose serious reforms that can make the health care and the health insurance markets less government-mandated and better for Americans (or Virginians).
I’ve proposed these about a week ago, but I still think they are valid. Here’s what Congressional Republicans can do:
Replace the subsidies with individual tax credits: The subsidies (the economic one, not the Democrats’ usual political addiction to them) were supposed to level the playing field between individual market policies and employer-bought group policies (which have been tax-deductible wage benefits since World War II). Switching to tax credits can make the “mandate” penalty obsolete (and easier to repeal), while preserving the incentive towards acquiring health insurance. Also, the credits can be set up to end the loss-of-work trap that the Insert-Name-Here-Care subsidies have.
Remove the policy restrictions for the federal exchange: The exchange itself is far less a problem than the restrictions on what policies can be listed (like this). The rank corporatism in the restrictions should be junked.
Privatize the exchange itself: There’s no reason for it to be run by HHS – and given the 2013 website fiasco, plenty of reasons it shouldn’t be.
Add in the traditional GOP health care reform ideas, such as ending state-only insurance, tort reform, etc., plus one more: Break the AMA-CMS pricing lock, and you have a serious, pro-market set of reforms that the president will likely oppose, but voters won’t. As Margaret Thatcher put it, “first you win the argument’ then you win the election.”
The General Assembly can get in the game, too, with state versions of all of the above (or, to be more precise, as the Feds for a waiver to do all of the above), plus some focus on taking apart the COPN racket. Admittedly, Terry McAuliffe might balk, but the folks who choose his successor will probably appreciate it – and they’re the same folks who will decide who runs the General Assembly in a few months.
Democrats have endlessly told voters that the government is their friend where health care is concerned. Republicans have been far less consistent in countering that message. They can still do so, and not just with rhetoric, but actual proposals to move health care and health insurance toward individual autonomy.
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