What the GOP Ought To Do After The 60-40 Cloture Vote on Health Care

Now that the U.S. Senate has just voted 60-40 for cloture on the Democratic health care bill, I think the main thing the GOP needs to do is offer a substitute bill that ensures all Americans get critical life-saving care without breaking the bank. That would give more members of Congress cover to derail the upcoming reconciliation process, and would instead hold out the prospect of a real bipartisan effort.

Without a solid GOP alternative bill, the best the GOP can hope for is probably the bill that survived a cloture vote tonight, with perhaps some Stupak language included (which would be a definite improvement).  I don’t think it’s enough for the GOP to simply advocate an incremental one-step-at-a-time approach, without indicating what those steps will be.

If the GOP wants to take the position that the federal government does not have constitutional power to enact universal insurance coverage, then that’s a perfectly legitimate position, but it does not excuse the GOP from presenting an alternative plan that could be approved by both Congress and willing states. Article I, Section 10 of the Constitution gives Congress general power to approve interstate agreements, so the GOP could propose a joint federal-state health care agreement.

One thing I’d like to see is a clause saying that illegal aliens are not covered by the bill, and if the courts determine that any part of the bill is unconstitutional because it does not cover illegal aliens then the whole bill becomes void. Care for illegal aliens ought to be a separate matter from this legislation.  Other provisions might include a ban on insurance denials due to pre-existing conditions, and a portability requirement so that people will not lose coverage if they leave their jobs.

The main GOP argument against the Democratic proposal has been that it is unaffordable for taxpayers and the country as a whole; i.e. that it would break the bank. Or, as Senator McCain puts it, the Democratic plan amounts to inter-generational theft.  So, let’s have an alternative plan that does not commit inter-generational theft.

The Constitution prohibits states from entering into any interstate health care agreement without the consent of Congress: “No State shall, without the Consent of Congress, lay any duty of Tonnage, keep Troops, or Ships of War in time of Peace, enter into any Agreement or Compact with another State, or with a foreign Power, or engage in War, unless actually invaded, or in such imminent Danger as will not admit of delay.”  So, even if Congress alone lacks power to ensure universal health care coverage, Congress combined with the states has plenty of power.

Besides including Stupak language, a GOP bill ought to avoid a command-and-control scheme, in favor of a market-oriented scheme. In other words, it shouldn’t be excessively bureaucratic and intrusive. And, if the essential goal is to make health insurance affordable for everyone, then a million words of legalese are not needed.

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