To fix ObamaCare it needs to be taken completely apart and most of it discarded. In other words, ObamaCare needs to be repealed.
But maybe there is another solution!
Building a Case for Compromise
In January, Republicans will take full control of congress and most certainly could pass legislation to repeal ObamaCare but it is unlikely that enough democrats would untie themselves from the party line to muster the super majority vote needed to override a presidential veto. With President Obama hell bent on preserving the only feather he has in his presidential cap, attempting to repeal ObamaCare would be the same exercise in futility Republicans have tried in the past. Or would it?
The federal mandate which requires uninsured individuals to obtain healthcare insurance is a documented failure. With enrollment of the uninsured expected to be only half to one third that of the administrations original 13 million projection for 2015, it will become politically damaging for democrats to argue in defense of the costly and poor performing healthcare law in the coming months and years ahead.
ObamaCare caused Democrats to lose their House majority in 2010. And again, in 2014, Democrats suffered a second major blow losing their Senate majority due in part to the increasing unpopularity of ObamaCare.
Not wanting to suffer a three-peat, Democrats are looking for ways to cleanse their soiled party brand and prevent having to turn over the keys for the White House to Republicans in 2016. So maybe, if given a way out that would allow at least a partial ObamaCare victory to be claimed, Democratic lawmakers might be able to persuade President Obama in to consider a compromise. Democrats are well aware that they are going to be saddled with the burden of ObamaCare long after the president leaves office unless big changes are made. As well, if Republicans take the White House in 2016 the law will likely be repealed anyway.
How a Compromise Might Look
Taking advantage of the comprehensive nature in which the ObamaCare legislation is written, key provisions such as the Medicaid expansion and a funding mechanism for the Guaranteed Issue, something similar to that which was created for the stopgap Pre-Existing Condition Insurance Plan provision, could be extracted from the law and crafted in to stand alone legislation. In exchange, the individual and employer mandated could be scrapped along with the practice of providing subsidies as the means of lowering the cost of insurance premiums. This would be a significant first step towards responsibly re-writing ObamaCare. Also, by maintaining the integrity of key components of the original law both Democrats and the President would still be able to claim a victory.
Of course, for such a compromise to take place, Republican lawmakers would have to be ready to lay out a roadmap to reform and be prepared to aggressively pursue it, hopefully in a bi-partisan manner. Unraveling what has already been done would take both time and cooperation from all parties and you can bet your bottom dollar that the insurers have already been working the problem. Insurers have known from the start the uncertainty as well as unpopularity of the massive healthcare insurance reform and have not been sitting idly by waiting for a shoe to drop.
There Would Be Hurdles
One of the greatest hurdles that would have to be overcome is patience. People, particularly politicians who are always looking to score points and an opportunity to criticize their opposition, will need to be patient. Healthcare reform has been a point of contention for decades and once it was finally tried, a massive piece of incredibly complicated, partisan legislation attempted to do too much too fast. Of course the party behind any plan wants quick results as it bodes well for them politically however, in the case of healthcare reform, the better good of the nation would need to be put ahead of political posturing for the next election cycle.
The second hurdle to be cleared affects only Democrats who would have to let go of the idea of Universal Healthcare. This should not be too difficult seeing’s as how ObamaCare did not deliver Universal HealthCare to them anyway. All parties would need to grow comfortable with the prospect of a market based healthcare system, such as the plan proposed by George W Bush in 2007, a system which hands control over to the state.
If the President would be willing to accept a compromise and these two hurdles could be overcome then there is a real chance that actual healthcare reforms could finally be achieved. Fair legislation could be introduced that would set the necessary federal minimum standards to which states would have to meet as part of their mandate to reform their states healthcare system in a manner which best suites their particular set of circumstances and needs. At the same time, cost reforms from within the healthcare industry could be addressed in a bipartisan manner such as reining in the out of control costs in pharmaceuticals and taking an honest swing at tort reform.
Taking A New Approach to Reform
There are a variety of approaches that could be taken to entice individuals into obtain healthcare insurance and under some form of federal incentive, each state should be allowed to decide which path they choose to take. From the federal level, legislation would be needed that clearly defined certain minimal guidelines to which all states would have to adhere to. Federal assistance could also include helping with such ideas as expanding the role of healthcare savings accounts and bringing equality to how individual and employer provided insurance plans are taxed. Each state could then take responsibility in devising and executing a plan best suited to their particular needs. Federal oversight could also be established to ensure each states plan was able to pass some form of litmus test before being imposed on its people, however this might be viewed as an overreach by some.
Of course, none of this can happen overnight. Unlike ObamaCare, which injected immediate affordability into healthcare premiums through large subsidies paid for by a mountain of new taxes and cost redistribution, a more responsible and stepwise approach could be adopted that would affect actual cost savings through reform over time.
The Cost of Doing Nothing
Undoing ObamaCare does come with a cost as the obligation to make whole on the deal brokered with insurers to participate on the healthcare exchanges would still exist. But the costs faced by unraveling ObamaCare would be just a fraction of the cost if ObamaCare were left to collapse on itself which seems more an inevitability each passing day. At the very least, if left alone, the shortcomings of ObamaCare are going to add tens of billions of dollars to the federal debt, the very thing the law was created to reduce.
Insurers would likely be happy to see changes to the ObamaCare law as well, as their guaranteed payments end in 2017 at which point they would be stuck picking up the pieces if the troubled healthcare law did in fact collapse.
Why Would the President Compromise?
If ObamaCare had worked as envisioned, by those who wrote the law, insurers stood to profit handsomely from the 25 million uninsured that were projected to participate on the individual insurance marketplace. However, at the administration’s own admission, enrollment on the healthcare exchanges will be less than half of what was projected leaving 39 million or more Americans uninsured over the next decade.
President Obama has become desperate to hold on to the single check mark on his presidential ‘To Do’ list and also knows that his namesake legislation is getting harder and harder to defend. Even more troubling to the president is the fact that he knows he is running out of time and therefore he may be receptive to a compromise on ObamaCare if one is presented to him that would allow both he and his party to save face.
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