Michael Steele: How Republicans should fix Obamacare

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Last summer when the Supreme Court delivered its surprising affirmation of the Patient Protection and Affordable CareAct (a.k.a “Obamacare”), liberals rejoiced and sang the praises of the very court they had, up until then, vilified; and conservatives scratched their heads at the perceived betrayal by  Chief Justice  John Roberts and renewed their call to “repeal and replace” the law after the November elections.

But Obama won, Democrats picked up two seats in the Senate and Republicans lost 8 seats in the House.

We’ve come a long way since those heady days. And still, the news on Obamacare has not been all that great.

Recently, one of the architects of the legislation, Senator Jay Rockefeller (D-W.Va.), actually admitted that the Affordable Care Act “is beyond comprehension”; while another, Senator Max Baucus (D-MT) called it a “train wreck.” But it was Henry Chao, Obama’s chief technical officer in charge of putting in place the insurance exchanges mandated by the law, who caused heads to turn when he said “I’m pretty nervous . . . Let’s just make sure it’s not a third-world experience.” With supporters like that…

Certainly, actions taken by the White House and the Department of Health and Human Services (HHS) leading up to implementing the convoluted law have not helped assuage the perceptions of members of Congress, let alone the American people.  Forced to suspend the employer mandate to offer insurance to employees, the Administration finds itself in a mad scramble to play down the administrative SNAFU by playing up lower premiums for all while blaming those pesky Republicans for putting the administration in this situation in the first place.

But House Republicans (like Senate Democrats) only get to vote up or down on legislation. It is the agencies and departments of government (run and managed by the administration) that must implement the law. And for this administration, the hit parade of problems continue to mount. For example, while most Americans were enjoying their 4th of July holiday and not paying attention, HHS sheepishly announced, in a “final ruling” it will not attempt to verify individual eligibility for insurance subsidies. Instead it will rely on individuals “self-reported eligibility”. So I get to tell HHS I’m eligible and they write a check subsidizing my insurance? I can’t think of a more sublime invitation to massive fraud.

HHS also announced that Obamacare is racking up twice the estimated cost to establish the all-important state insurance exchanges.  That’s where consumers, who aren’t covered by an employee healthcare program, are supposed to compare and purchase their healthcare coverage. HHS now expects to spend $4.4 billion by the end of the year on these exchanges; and given the delays and unanswered questions still remaining it appears there will be very little coverage in place from which to choose.

Furthermore, thousands of complaints continue to flood into HHS opposing the agency’s coercive mandate that requires almost all employers to provide health insurance coverage of abortion, contraception and sterilization regardless of moral or religious objections. The Obama administration recently made a slight alteration regarding some freedom of religion concerns—allowing only houses of religious worship to get a reprieve—and then declared its work on matter done. Countless other employers such as schools, hospitals, social service agencies and businesses are still being forced to comply regardless of their religious affiliation.

Recall when House of Representatives Minority Leader Nancy Pelosi, D-Ca., infamously said, “We have to pass the bill so that you can find out what is in it.” Boy, are we finding out!

Interestingly, now that we know what’s in it, Sen. Dick Durbin (D-Ill.)—another architect of Obamacare—thinks Republicans need to step up and help “change and improve” Obamacare.

But some conservatives smell a trap; and in response to Senator Durbin’s suggestion, RedState editor Erick Erickson emphatically says “Hell no.” In fact, Mr. Erickson made clear his disappointment “with the House GOP wanting to delay implementation of the individual mandate. I think Obamacare needs to go forward as designed by the Democrats. I think someone should sue the Obama administration over delaying the employer mandate. It should happen on schedule …. The American public voted for Barack Obama twice. They should be made to care about the policy choices they have enabled by having those policies go into effect exactly as the Democrats intended …. Republicans are under no obligation to mend what they were sent to Washington to end.”

I have to admit Mr. Erikson has a very good point and raises the question: Do the rest of us want to save the Democrats in Congress from themselves?

The partisan in me says “nope”! But, at the end of the day, the rational answer is it should be about saving the American people from bad public policy. The Obama administration persists in bureaucratic tinkering with a deeply-flawed mandate and plans to spend billions of dollars more on implementation than even most proponents ever imagined.

But, the persistent effort by Republicans to “repeal and replace” Obamacare carries no legitimacy with the American people if it does not answer the question: “replace it with what?” Some Republicans are beginning to realize that after three years of beating that drum the idea of just scrapping the Affordable Care Act is not a strategy.

While I like the idea of repeal, I’m realistic enough to realize it likely won’t happen (remember when Republicans abolished the Department of Education? Exactly.) But there is still so much about the implementation of this law that not only worries but frightens employers and patients alike. Such genuine concern should be enough for the GOP to begin to lay out concrete policy proposals that pushes the conversation towards positive patient-centered reforms.

Congressman Tom Price (R-GA), a physician, offers a way to begin. In his bill, H.R. 2300, yes, Rep. Price proposes the repeal of Obamacare (surprise!) but more importantly, he offers up solutions that extend tax deductions for health insurance to those who buy as individuals; gives patients—not their employers—the power to own their insurance which allows them to take their insurance with them when they change employers; empowers doctors and not insurance companies (or the government) to make treatment decisions; and reforms medical liability laws (which was never addressed in the Affordable Care Act).

Such proposals are certain to cause eyes to roll from those who want to implement a one-size fits all, top-down, bureaucratic healthcare system.

But hey, such proposals are a start and may be enough for Republicans to pivot from only talking about repeal to making a fresh credible argument for avoiding this “train wreck.”