The Senate Bill Is An Imperfect Healthcare Compromise. It Just Might Work.

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For months now, the country has waited with interminable patience to see what the Trump Administration would do with healthcare policy. Few believed the Affordable Care Act—Obamacare—was ever a perfect solution, and Republicans spent 7 years campaigning on its immediate repeal.

But even though several healthcare exchanges are collapsing and millions around the country are in danger of losing healthcare services provided by Obamacare, Republicans have had a difficult time figuring out how to go from the party of “no Obamacare” to the party of healthcare solutions.

After much wrangling, the House eventually passed a bill that was imperfect in its approach, and was essentially a punt to the Senate to come up with a better solution. It was clear the Senate’s job was to make the House plan more palatable to the voting public. Reduce costs, reduce taxes, take away the “individual mandate,” but still ensure people that want healthcare have the ability to purchase it.

Up until now, those goals have been elusive.

Released yesterday, the new Senate healthcare plan—modified by Sen. Ted Cruz—gets Republicans most of the way there, and may actually stand a chance of passage. Under the modified plan, federal Medicaid costs would be decreased at the state level, and most Obamacare taxes and penalties (many of which weren’t complied with anyway) would disappear. Gone will be the day when my butcher Roland (who is healthy) is required to pay a $700 penalty each year he doesn’t sign up for an overly-expensive government-mandated plan he can’t afford.

But, you might ask, without “penalties,” who will step in to “subsidize” the cost of high-risk patients whose plan costs are capped? The answer in the Cruz plan is finally market-driven, not government-mandated. By allowing healthy Americans the opportunity to buy cheaper, high-deductible health plans that would otherwise not qualify for Obamacare, the insurance industry essentially gets a subsidy, allowing it to decrease the cost of health plans for those that truly need coverage.

And, millions of average Americans, like my friend Roland, will be able to afford catastrophic coverage that they will likely not use, but will provide peace-of-mind should tragedy strike.

Is the Senate plan perfect? Definitely not, even with the Cruz compromise. Does it contain “give-aways” to get moderate Senators on board? I don’t see how else you could categorize giving $45 billion to moderate mid-Western states to “combat the opioid epidemic.” Is it the pure “repeal” that very conservative Republicans have clamored for since 2010? It, unfortunately, is not.

But what it is, is a workable—and possibly passable—alternative that fixes many of Obamacare’s worst problems, and returns power to the states, and to individuals.

Opening up the healthcare marketplace to the power of capitalism is the right way forward. More government mandates and additional taxes and regulation are not. If nothing else, the Senate’s new healthcare plan takes a step in that right direction.

View Comments(2 comments)
Joyce GoldensternI disagree with the logic in this article about small, risky expensive pools.  I don't believe any savings that insurance companies might make in healthy pools will be passed on to the risky pools.  The whole idea of the healthy pools is to allow cheap (inadequate) coverage to healthy people -- to keep those pools cheap will preclude savings to pass on to the risky pools full of people with preexisting conditions. Furthermore, I believe it is irresponsible offering cheap (inadequate) insurance to healthy people. Those people might as well throw their money in the garbage for their cheap insurance will not cover all their expenses if they get seriously sick.  Anyone can get seriously sick and that is why we need one large pool -- insurance is about risk management, and the bigger the pool, the more risk is managed at an affordable rate for all.  Today's healthy person could be tomorrow's disabled person with preexisting conditions.  I believe single payer (Medicare for all), based on one large pool, is a good solution.
@seladaAn attempt to jutify what is really unjustifiable - not only because the Republican party has done as much as they could to detonate the ACA - by making the insurance companies very nervous about their investments that of course the premiums have gone sky high. But there is a very real moral issue at stake here: