As expected, Speaker of the House Paul Ryan and his House ‘leadership’ team dropped their long-awaited ACA replacement legislation earlier today. To put it mildly, it is utterly underwhelming to conservatives. It does eliminate the individual mandate, the subsidies, the Medicaid expansion, and the taxes.
However, the Medicaid expansion repeal wouldn’t take effect until 2020, and ACA enrollees would actually be grandfathered in, so they can keep ACA coverage! Perhaps worse, the bills include a new entitlement in the form of a tax credit for people to buy insurance! It keeps the requirement of coverage for people with pre-existing conditions, which defeats the purpose of insurance, and the dreaded “Cadillac tax” on high-end health insurance plans still appears in 2025. It would also attempt to make younger, healthier people purchase coverage, by allowing a 30% premium increase on anyone who’s had a gap in health insurance coverage!
Needless to say, this should be rejected out of hand by conservatives and libertarians. Hill Republicans are terrified of the political consequences of repealing Obamacare. ‘Oh no… what if the federal government isn’t providing insurance to as many people as the Democrats did with the ‘Affordable’ Care Act? People will be angry with us. We mustn’t upset the apple cart!’
Wrong. THIS is EXACTLY why conservative grassroots hold Congress in utter disdain. They pander to the weak sisters of the Republican party, like Rob Portman, Shelly Capito, Lisa Murkowski, and Susan Collins. They’re so busy worrying about the inevitable demagoguery of the left that they never even pursue any serious rollback of the progressive agenda of the last… what, century? We’re tired of the excuses, the whining, the lying, the cowardice, the failure. Newsflash: the left is going to demonize you NO MATTER WHAT YOU DO. Get your money’s worth, and roll back the progressive expansion of big government. Then we’d be proud of you, and fight for you, no matter what happens at the ballot box in one cycle or the next. Do as the Democrats do, and lean on your flaky caucus members, and get your agenda passed. The GOP likes to crow about having stopped the Democratic agenda when it has control of Congress. Not good enough. The grassroots deserve the rolling back of our opponents’ agenda, and the enaction of our own, after helping Republicans win power. This is akin to when Del. Jimmie Massie stood in front of a State Central Committee meeting and bragged about how great GOP House of Delegates leadership is, because they stopped McAuliffe’s agenda with a 2-to-1 edge in the House. Nothing anyone should be bragging about. They’re going to have to do better than that.
For all his many flaws, Donald Trump wasn’t afraid to make bold, sweeping pronouncements about building a wall, securing the border, deporting illegals, repealing the ACA, you name it. And he certainly wasn’t worried about offending anyone. We all, particularly myself, expected this would doom him in the general, especially combined with his lack of specifics or knowledge of actual policy. But what the hell do I know? The lesson from that is that people are TIRED of business as usual. People want their representatives to stand for something, then go fight for it.
Establishment Republicans have been complete failures at limiting the growth of government, to say nothing of actually cutting it back. George W. Bush and his gang stuck us with No Child Left Behind, Porkulus Part I, TARP, and my personal favorite, the Medicare prescription drug boondoggle. Again, these were Republicans. Paul Ryan himself said this a few weeks ago: “I believe that the current premium support system with Part D works extremely well… I think there’s some real success stories … and I think we need to tell that story.” Are you kidding me???
We really need to get back to a proper understanding of insurance. What we have now is not insurance, as traditionally understood. That’s not what we’ve got right now. True insurance would involve risk calculus, and would cover large medical expenses associated with serious health events, what was once called ‘catastrophic insurance.’ Run of the mill medical expenses, such as preventative care, would be paid for through a fee-for-service model, and would be far less expensive as a result of not having all of the outside third-party actors invested in keeping the gravy train going. We are so far from that system now that it will be very difficult to get back to. It’s not insurance, by definition, if it covers pre-existing conditions. Do you buy fire insurance while your home is already on fire?
House Freedom Caucus, Rand Paul, Ted Cruz, and Mike Lee, the republic needs you right now. Stop this bill, and force Paul Ryan and Mitch McConnell to support S.222, Sen. Paul’s bill, and Rep. Mark Sanford’s House companion… or something very much like them. No more excuses. You all promised full repeal in 2010 and 2012, before ‘replace’ crept into the conversation. Make it happen.