Rand Paul: House bill didn’t repeal Obamacare; Senate CAN

Senator Rand Paul, R-Ky., knows full well the American Health Care Act passed by the House did little to fix our broken health care system. So now he’s urging his fellow members in the Senate and President Trump to do something about it.

In a guest column for FoxNews.com, Sen. Paul notes that while “virtually every Republican ran on dismantling the abomination of Obamacare,” the House bill falls short of that promise.

“There were many areas of reform considered – repealing regulations, cutting taxes, and introducing free market reforms into the system. The bill so far falls short on two of the three (it cuts taxes),” Paul writes. “But most importantly it falls short on free market reforms to lower prices and provide better, less expensive health care to millions of Americans.”

During negotiations in the House of Representatives, the conservative House Freedom Caucus argued that the original version of the AHCA did not go far enough to repeal Obamacare and solve the problem of unaffordable health insurance.

Moderate Republicans insisted on keeping so-called “consumer protections” — the insurance mandates and preexisting conditions regulations (largely responsible for driving up costs) — in the bill for fear of backlash from entitlement-stricken constituents. Enough conservatives and moderates eventually compromised on an amendment by Rep. Tom MacArthur, R-N.J., that would allow states to apply for waivers from Obamacare regulations — still well short of the promised full repeal.

Sen. Rand Paul hopes that the Senate version of healthcare reform will look more like a full repeal of Obamacare — reforming the health insurance market to look like … an insurance market.

“Insurance, historically and logically, only works if you are buying insurance against some event that is unknown but whose occurrence can be predicted with some accuracy. It also works best if you are spreading the risk among a large pool of people,” Paul writes. “Both of these issues can be addressed in the Senate version of the bill.”

The first step is deregulation, to give insurance companies the flexibility to succeed. Then, to empower the consumers to better negotiate with the companies, Sen. Paul suggests legalizing “national buying groups” — where individuals can band together in a buying pool to negotiate for health insurance policies and drug prices.

The trouble with any potential repeal of Obamacare, or even just reform, is the Senate’s arcane budget process. Democrats in Congress adamantly refuse to join with Republicans’ ACA-repeal efforts, depriving the GOP conference of the votes needed to overcome a legislative filibuster. To get around the Democrats, Republicans have long pledged to use a process known as “budget reconciliation” to pass their Obamacare bill with a simple majority, not subject to the filibuster.

The issue is that under budget reconciliation, every measure of the bill must have a direct impact on the budget. Health insurance reform measures, like allowing the sale of insurance across state lines, do not technically have a direct impact on the budget. And so, under Senate rules, some argue, it cannot be placed into the Obamacare reform bill.

To overcome this obstacle, Sens. Paul and Ted Cruz, R-Texas, are urging their colleagues in Republican leadership to change the procedural rules of the Senate to repeal all of Obamacare at once — instead of in three phases (or “buckets,” as Sen. Cruz explains).

“We’re not getting eight Democrats on anything,” Sen. Cruz told Politico on Tuesday. “And so what I’ve been urging for the past several months is take everything in bucket three and everything in bucket two and put it in bucket one. That the only thing passing is reconciliation.”

Many Republicans are reluctant to overcome Senate precedent and tradition to institute such a rule change. That is supremely disappointing because, as Sen. Paul states: “Capitalism, competition, and freedom do work! But only if government gets out of the way.”