Dear Senate Republicans:
It’s crunch time.
Since 2010 you have sworn over and over that, with a majority, you would repeal and replace the ghastly artifice of Obamacare.
But while the market distortions, skyrocketing premiums and deductibles, the restrictions on doctors and scarcity of coverage – all predicted in 2010 – have become today’s O-care reality, you have failed us.
Spectacularly.
The American people gave you what you have been asking for – GOP control of the government. You, in turn, have given us nothing but excuses and broken promises.
Squabbling on the O-care repeal effort in July, many of you voiced support for repeal and replace, but only if it didn’t affect the increased government funding to your states that resulted from O-care.
Really? You think that’s a tenable position as a Republican?
Others tethered to purity, considered anything less than 100 percent repeal of O-care in a single act,to be a betrayal of its own. And you, John McCain – despite my bottomless respect and affection – you voted against repeal because the bill did not have any Democrat votes, a nod to a bygone era of bipartisanship, which is unlikely to ever be restored on the issue of health care.
Americans are hurting.
While O-care has made insurance available to the 15 percent that did not have it in 2010 – and there are success stories as a result – it has come at the expense of the 85 percent who had coverage before O-care, but now suffer from of ruinous cost and disruption.
What about us?
All that high-mindedness and constituent focus has left the nation mired in the spiraling morass of Obamacare. This is patently unacceptable.
However, thanks to the work of a small group of your colleagues, you now have a shot at redemption in the form of Graham-Cassidy. Don’t let this chance to do something meaningful pass you by. The bill is not only good politics, it’s good policy.
First and most importantly, Graham-Cassidy identifies the singular failure of O-care and the GOP repeal efforts since; one size does not fit all. Remember the deals that Harry Reid had to cut in order to get O-care in the first place? And those same kind of state-specific exceptions were echoed by Republicans seven years later.
New York is not the same as Texas.
Second, Graham-Cassidy implicitly understands that in seven years, O-care has woven itself into the fabric of America. No entitlement passed by Congress has ever been successfully repealed in American history, and early GOP efforts with Obamacare prove it.
Graham-Cassidy side-steps this issue by moving the discussion from spending levels and regulations to control. The bill combines the existing Obamacare funding levels into a pool and sends the cash to the states as a block grant. The grant levels are based on a formula derived from the number of elderly and disabled in the state, and the number of people at or below the federal poverty line.
Democrats and the media are in near hysteria that one survey guesstimates that 34 states will see lower federal funds for healthcare under Graham-Cassidy – as if those levels were written in stone someplace to begin with. You’ll be under pressure here. But consider that four states currently eat up 40 percent of Obamacare’s national support. Is that fair? And if the block grant formula in Graham-Cassidy is based on state figures for those in poverty, sick or disabled, isn’t the modified formula a better use or resources in targeting those at risk?
Crickets from the left.
But that is only the beginning.
The bill kills the individual mandate and the employer mandate. People over 30 can again buy high deductible “catastrophic coverage” policies. The limit for Health Savings Accounts (HSAs) is nearly doubled to $6,750.00. States will be able to appeal for waivers from Ocare’s misnamed, “Essential Healthcare.” Policies can be then customized according to need, similar to car insurance. Men will no longer have to buy costly policies that provide mammograms, pre-natal vitamins and well-baby care.
Politically controversial, but with eminent financial sense, the bill allows states to loosen regulations on coverage for pre-existing conditions. While coverage is still guaranteed, states will be allowed to price policies based on medical history. If you are an obese diabetic chowing down on Mickey Dees daily, with COPD and a 3 pack a day habit, you will have to pay more than a healthier person in your cohort.
In future years, the bill will end Medicaid as an open-ended entitlement – which currently is fiscally ruinous for the nation – and caps outlays on a per person basis, containing costs and helping the budget deficit.
Perhaps more important than any single measure in the bill, Graham-Cassidy will unleash a wave of innovation.
Governors and legislatures will now make decisions about health care in their states, based on their demographics and values. California and New York may opt to keep Ocare intact, or create a Single Payer system for their residents. Other states can experiment in truly competitive market places, which allow for customized policies, transparent pricing, and competition to lower costs and create better value. National examples of excellence, created in state laboratories, can catalyze national trends in innovation that may help bridge the divide over health care in America, and form the foundation of consensus on best practices.
With so much to gain, this bill is a win-win for you.
But the cherry on top is unspoken. It is the bill’s deceptive brilliance. If Congress passes Graham-Cassidy, you will have put a wooden stake through the heart of national Single Payer.
That is why the Left is in such an uproar. They know it.
The kind of innovation catalyzed by Graham-Cassidy is a clear and present danger to the concept of Single Payer, by permitting the creation of true market-based alternatives to government-run healthcare in other states. In the competition of ideas in practice – socialism loses every time.
As the failures of O-care moved progressives to Single Payer, so Graham-Cassidy can prove that the failure of O-care is not a failure of the market. Once states have successfully crafted their plans, they – and their citizens – will be loath to give that power and money back to DC bureaucrats to fund a failed and bloated system that raises taxes, redistributes wealth and enforces healthcare scarcity; all in the name of “compassion.”
The next week is going to be hard for many of you. Progressives are going to throw everything and the kitchen sink at you. The media, including comics, apparently, are in a full frenzy.
Ignore it.
CBO will likely come back with some colossal number of people who will have no insurance (though most of this will be as a result of repeal of the mandate, not that people will actually not seek insurance). But in this instance, with this bill, CBO’s guidance is even less useful than normal. There is no way to score what states will do with the funds once they have them. It hasn’t been created yet. Match the market place of ideas with the free market and anything is possible. It is impossible to score today.
Life doesn’t offer many second chances. You now have one. It makes political sense. It makes policy sense. It makes fiscal sense. It makes ideological sense. And you get to keep your word. Paul Ryan has said, if you pass it, he’ll immediately take it up in the House where it will pass. It is now, all on you.
So suck it up, Senator Buttercup, it’s time to go all in for America.
If you don’t, you – personally – will own Obamacare.
We will not forget.