Many of us have taken it for granted that all Republicans would work for full repeal of Obamacare. After all, not a single Republican voted for it. However, it is always important to understand the reasons why politicians support or oppose a piece of legislation.
When you listen to many prominent Republicans voicing their disdain for Obamacare, you generally hear the following complaints: it raises taxes, it cuts Medicare, it contains death panels, it is 2,700 pages long – and most notably – the individual mandate.
The problem is that these are all ancillary to the crux of what is so offensive about Obamacare. The overarching concern about Obamacare is that it harnesses the factors that have already driven up the cost of healthcare and health insurance, most prominently, the mandates and subsidies, and multiplies them to the nth degree. The tax increases, Medicare cuts, and individual mandate are merely tools to fund those interventions. Many Republicans never had a problem with them. This is why they were never repulsed by Romneycare, which doesn’t contain tax hikes and Medicare cuts. As for the individual mandate of MassCare, they contend that there is nothing wrong with a state mandate.
As such, it comes as no surprise to read these tidbits in Politico:
If the law is partially or fully overturned they’ll draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions. Ripping these provisions from law is too politically risky, Republicans say. […]
On Tuesday, the major options were discussed during a small closed meeting of House Republican leaders, according to several sources present.
Then on Wednesday, Speaker John Boehner (R-Ohio) gave the entire House Republican Conference a preview of where the party is heading. His message: “When the court rules, we’ll be ready.”
But Boehner warned that they’ll relegislate the issue in smaller, bite sizes, rather than putting together an unwieldy new health care bill.
“If all or part of the law is struck down, we are not going to repeat the Democrats’ mistakes,” Boehner said, according to several sources present. “We have better ideas on health care — lots of them. We have solutions, of course, for patients with pre-existing conditions and other challenges.”
If Politico was the only source promulgating this, I wouldn’t be worried. Unfortunately, top GOP leaders have expressed their desire to keep the slacker and pre-existing mandates in place on numerous occasions. This sentiment has also been evident in the GOP’s partial repeal strategy in which they target the most “unpopular provisions.” These mandates are emblematic of the worst provisions in the law – the ones that will drive up the cost of private insurance and force everyone into government-run healthcare.
I’ve long struggled with the question of whether Republicans lack a full understanding of the free market or whether they simply lack the communication skills and fortitude to articulate free market positions to the public. I suspect that with most members there are elements of both.
Boehner is definitely correct is asserting that we should not make the same mistake as the Democrats by offering all our conservative reforms in one shot. We obviously cannot expand HSAs, enact tort reform, institute premium-support Medicare, reform Medicaid, and eliminate all the insurance mandates in one bill. But whatever piece-meal approach we take must reflect a conservative free market view, and it must only take place after full repeal of Obamacare, especially of the slacker and pre-existing conditions mandates. It is better to give out pure subsidies to the real sick for healthcare than to destroy the entire system with the paradoxical pre-existing insurance mandate.
We better pray that the Supreme Court rules in our favor on severability and strikes down the entire law.