Everyone in Washington is being intellectually dishonest.
Both Obamacare and the GOP replacement plan are insolvent precisely because they have the same core flaws: government-run healthcare mixed with a zombie private sector that’s animated by regulations and subsidies instead of consumer demand. And now we have a new Congressional Budget Office analysis. Clearly CBO is wrong about Obamacare, but it’s right about the GOP’s Affordable Health Care Act, albeit for some of the wrong reasons.
Nobody is articulating a vision for free market health care and health insurance. That’s why conservatives need to disentangle themselves from this mess, stand on their own two feet, and propose their own plan.
CBO ignores the past and present, but knows the future?
CBO is right: the GOP bill is unstable. But it is for the same reasons Obamacare is unstable. Ironically, they close their eyes to the past and present, but somehow know the future? They ignore that the overwhelming majority of the country liked their plans before Obamacare. Now, they pay three times more for double the deductible and less coverage. That is a fact.
It’s also a fact that Obamacare is losing insurers in almost every state. Hundreds of counties are now owned by one insurer. Take a look at this map and tell me: How is this solvent for even one year?
Just this week, Blue Cross announced it was exiting another individual market. Soon, 25 counties in Missouri won’t have a single insurer.
None of this is factored into the CBO score.
So how in the world could they predict that in 10 years, Obamacare will be solvent instead of crashing? How do they figure repealing it will make the already-insolvent market … insolvent?
While the GOP’s half-baked repeal has the worst sort of political glass jaw with all the liabilities and none of the benefits, the entire premise of CBO’s coverage numbers is wrong. No, 23 million people will not lose insurance under true repeal of Obamacare. It’s false to say 20 million people obtained private insurance under Obamacare in the first place. The only way people who have coverage now will actually lose it is if we don’t repeal Obamacare. And the AHCA will cause people to lose coverage precisely because it doesn’t really repeal Obamacare!
Consider the following:
Most of the coverage is Medicaid: As much as 84 percent of all the coverage gained under Obamacare is from the terrible Medicaid program or the expansion of SCHIP, not from private insurance. But nobody is being thrown off and almost all of the newly covered patients would remain insured by the government, even under the conservative plan. The only question is the rate of subsidization.
The conservative plan would bring down the cost of health care, meaning less need for subsidies.
Only 16 percent of the 20 million, on net, gained “private” coverage under the market-destroying ACA. So why should we destroy the rest of the market just because of Medicaid expansion that we’re keeping anyway?
Obamacare gains were from the individual market:Most people under 65 get insurance from employers. I don’t know anyone with an employer plan who is happier with the higher premiums, fewer benefits, and narrower networks under Obamacare. “The rise in premiums has been associated with $19 billion in lost wages, 10,130 fewer business establishments, and nearly 300,000 lost jobs,” according to one study.
The remaining people in the individual market actually lost our insurance under Obamacare and were forced to purchase a plan three times more expensive. CBO is not factoring in people who lost coverage and were forced into insolvent coverage. Sure, if you throw people out of their homes and then shove them into a new home, lock the door, and light a fuse inside, “Everyone now has a house.” It’s just burning to the ground.
The decrease in unemployment fueled much of the coverage increase: The “coverage boom” coincides with the job market recovery in which unemployment went from almost 10 percent to less than 5 percent. More people working means more people have insurance through their workplaces. That’s true whether we have Obamacare or not. It’s the type of coverage, the cost, and the distortion of the broader health care market that are more important than the dubious measure of coverage numbers.
Coverage gains were mainly young, healthy people who didn’t want insurance and could have purchased it for cheap: Almost all private insurance growth under Obamacare is from enrollees under 30. Most of these weren’t dying in the streets before Obamacare — they just didn’t feel a need to purchase a plan, even though insurance was much cheaper then. Of course they’re covered now that they’re subsidized and forced to purchase insurance. But those regulations and subsidies have tripled the cost of high-deductible plans.
In fact, for those above the age of 26, Obamacare has caused a decline in private coverage (outside of Medicaid and SCHIP).
Why conservatives should evacuate from this health care mess and stand alone
To be clear, the GOP bill doesn’t repeal Obamacare. That is why it is insolvent.
There is a kernel of truth to the CBO claim that eliminating the individual and employer mandates (but not getting rid of the regulations!) will make millions lose insurance. But the real problem is that the GOP bill doesn’t repeal the rest of Obamacare. We’ll continue with the same insolvent market that is government-run, subsidized, and monopolized. This is not the fault of “repeal”; it is the fault of Obamacare that is, ironically, maintained by the Obamacare repeal bill.
In the fight among the two parties and CBO, there are no good players. They are all wrong.
Which is why it’s time for conservatives to disengage and present their own plan that truly repeals Obamacare and implements our supply-side reforms. Then, they must get an outside group to conduct an independent analysis of their bill. These reforms will reduce costs, spur innovation, drive competition, diminish the need for subsidization, and limit the pre-existing condition problem, freeing up public funds to help. We must:
- Break down state lines
- End coverage regulations
- Expand HSAs
- Eliminate the anti-trust exemption
- Provide equal tax treatment of all insurance
If conservatives don’t rally around this plan, we’ll be forced to choose between the health care equivalent of Iran and Al Qaeda.
The sad reality is that, either way, Republicans won’t to repeal Obamacare or even pass the fake repeal bill. The only thing they will accomplish is making Obamacare popular and distorting our views.
Let’s stand on our own two feet so we can live to fight another day. It’s time to take our destiny into our own hands.
Author: Daniel Horowitz
Daniel Horowitz is a senior editor of Conservative Review. Follow him on Twitter @RMConservative.