There is a lot of chatter about avoiding any "fixes" to Obamacare. The right is united about seeing Obamacare repealed, but I don't think any of the various factions of the center-right coalition are being realistic about how precisely repeal can occur.
2012 was the last best chance to avoid the morass of Obamacare. The American vote blew that opportunity, and our options at this point are particularly great. We have to brace ourselves for the storm, and that means being realistic about what the pathway to repeal looks like and what will happen in the eyes of the public as millions of lives are thrown into chaos on matters relating to healthcare.
I have a lot of respect for Erick, talk radio, and the conservative blogosphere. However, the difference between forcing the House to vote on the Landrieu plan vs. the House simply not voting on the Landrieu plan is hardly a huge chasm. If the Landrieu plan passes the Senate (which it likely won't), pressure will be brought to bare on the House. This is unavoidable. All sorts of pressure is going to be brought on the House. If the House is not strong enough to avoid voting in favor of bad policy, the battle is lost. As the ACA collapses, there are all sorts of difficult votes/non-votes that people are going to face as the public starts to hollar about their particular difficulties.
Are we ready for when the D's propose and pass increased one-time premium subsidies for people who have lost their coverage? That is a far more difficult vote than a vote on the Landrieu fix. Temporary expansions to medicaid? Early eligibility for Medicare? As this ship goes down, there are lot of D proposals that are going to arise. We are in the morass. What we do in the morass matters. Difficult votes, uncomfortable chaos, and being part of the morass are at this point inevitable. We need to acknowledge that there is no universe of activity where the R's will get away with simply doing nothing.
Repeal of the ACA is not going to happen until 2017, if at all. There are however things we can do that will help ensure the collapse of the ACA. Those things may appear to be "fixes" but what they really are additional nails in the coffin for the ACA.
We need to make the ACA fail in the same way that the ACA was intended to make capitalism fail. Propose "fixes" that actually help to repeal the ACA. By way of example, the ACA cannot survive as one system amongst many. Income redistribution schemes don't work if people can opt out. Without young people signing up on the exchanges, the more quickly the ACA will fail. The more that people can be excluded from the ACA, the more quickly it will fail, the more dramatically it will fail, and the easier it will be to have two houses of Congress and a President actually repeal the law.
Our public policy proposals should be focused on "fixes" that:
(1) sound good; and
(2) hasten the demises of Obamacare by liberating more and more people from its requirements.
Better to spend time proposing and losing on HSA carveout provisions for Obamacare then letting the D's control the debate, and propose increase subsidies for people who are suffering. We are being short sighted if we think the R's can avoid difficult votes. Better to be on offense, and propose "fixes" that we know will not be accepted, but allow our side to highlight the weaknesses of the ACA, highlight how markets benefit consumers, and keep the D's on the defensive.
Romney once said that he would administratively issue waivers on Obamacare to every state and individual. We don't need that to sink this monsterous policy framework. We need to keep people off those ACA exchanges so that the ship goes down. Propose carveouts to Obamacare requirements. Don't limit those carveouts to prexisting plans, but include preexisting plans in those carveouts.
These aren't fixes to the ACA, they are a pathway to repeal by weakening the ACA in ways that many democrats are dumb enough to join in on.