Obamacare is here to stay?

Sam Baker in the Hill yesterday:

President Obama’s reelection, and an expanded Democratic majority in the Senate, dealt the final blow to Republicans’ hope for repealing the Affordable Care Act. And though conservatives still say the law will be a disaster once it’s fully implemented, they’re finally acknowledging that it will, in fact, be fully implemented.

“Repeal of the whole thing, I just don’t see now how that’s possible,” said Grace-Marie Turner, president of the Galen Institute, a conservative healthcare think tank. The Wall Street Journal’s conservative editorial page also admitted defeat Wednesday. With Obama in the White House for another four years, the healthcare law “will spread like termites in the national economy,” the paper wrote.

Austin, I, and a number of others said this yesterday, but even I’m surprised to see it confirmed so quickly on the right. I’m curious to see if this means that there will be no more “repeal” bills in the House. It would make me extremely happy to see us turn to productive discussions on how to make the law better. David Frum offers some suggestions.

1) One of the worst things about the Democrats’ plan is the method of financing: an increase in tax on high-income earners. At first that tax bites only a very small number, but the new taxes will surely be applied to larger and larger portions of the American population over time.

Republicans champion lower taxes and faster economic growth. We need to start thinking now about how to get rid of these new taxes on work, saving and investment — if necessary by finding other sources of revenue, including carbon taxes.

2) We should quit defending employment-based health care. The leading Republican spokesman in the House on these issues, Rep.Paul Ryan, repeatedly complained during floor debate that the Obama plan would “dump” people out of employer-provided care into the exchanges. He said that as if it were a bad thing…

3) We should call for reducing regulation of the policies sold inside the health care exchanges. The Democrats’ plans require every policy sold within the exchanges to meet certain strict conditions.
American workers will lose the option of buying more basic but cheaper plans. It will be as if the only cable packages available were those that include all the premium channels. No bargains in that case. Republicans should press for more scope for insurers to cut prices if they think they can offer an attractive product that way.

4) The Democratic plan requires businesses with payrolls more than $500,000 to buy health insurance for their workers or face fines of $2,000 per worker. Could there be a worse time to heap this new mandate on smaller employers? Health insurance comes out of employee wages, plain and simple. Employers who do not offer health insurance must compete for labor against those who do — and presumably pay equivalent wages for equivalent work.

I agree with some of these more than others, but if we could have a debate on these points instead of whether the law stays or goes, I’d be a happy man.


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