What to Expect from ObamaCare’s Replacement

By Michael D. Tanner
This article appeared on New York Post (Online) on January 12, 2017.

Republicans have officially begun the long and complex road to repealing and “replacing” ObamaCare. And if you believe congressional Democrats, various special-interest groups and much of the media, the Four Horsemen of the Apocalypse are about to be unleashed.

Former Senate Minority Leader Harry Reid paused on his way out the door to warn, “People are going to die” if the health-care law is repealed. His successor, New York Sen. Chuck Schumer, was only slightly less gloomy, warning of “chaos” and claiming ObamaCare repeal would “make America sick again.” New York Times columnist Paul Krugman suggested Republicans were preparing to “snatch insurance away from millions,” while a CNN report claimed that repeal would lead to the loss of 3 million jobs.

Let’s all get a grip.

In general, most consumers will find themselves with more and better insurance choices after ObamaCare is repealed.
Initially, any changes will be very small and incremental. Repeal won’t happen overnight, or all at once. Rather, Republicans are likely to establish a sunset date, three or four years from now, allowing time to craft a replacement. Still, sooner or later, we’ll be living under a very different health-care system. Therefore, over the next few days, we’ll take a look at what it’s really going to mean for health-care consumers, patients, doctors, hospitals, insurers, businesses and taxpayers.

One of the first things most Americans are likely to find is that they’ll have more choices when it comes to buying insurance. You may have to pay more for insurance that covers some providers and conditions, but you’ll also be able to buy cheaper, less-comprehensive insurance if you want to.

ObamaCare required all insurance to cover a wide-ranging — and expensive — “essential benefits package.” Repeal will mean more of an a la carte approach to insurance, based on individual consumer preference.

In fact, this is likely to be one of the first changes to ObamaCare. While the law requires that there be an essential-benefits package, it gives the president a great deal of discretion in determining what that package should be. President Trump can take action by executive order to repeal some of the requirements that President Obama included.

People will even have the choice not to buy insurance at all, since the much-reviled individual mandate will be gone. Going without insurance may not necessarily be a wise choice, but it does re-establish a fundamental limit to state power over the individual. And it allows young and healthy people to purchase low-cost catastrophic coverage that makes much more sense for them.

Most people will find more choice to be a good thing, but there’s a downside. If people opt out of services that they won’t use — such as men choosing not to buy maternity coverage — it will drive up the price for those who do use those services.

Consumers won’t just find more options in the types of plans; there should also be more insurers to choose from. Recently, insurers have been abandoning ObamaCare exchanges in droves. Roughly a third of US counties have only one insurer participating in their exchange. Repeal will lure insurers back into the market.

Finally, a replacement plan will almost certainly let you shop for insurance out of state. Today, it’s illegal for someone living in New York to buy insurance in, say, Pennsylvania even if a plan there is cheaper. This gives a near monopoly to a small cartel of New York insurers. Allowing consumers to shop across state lines will force some much-needed competition into the insurance market. It will also help prevent New York regulators from recreating the failures of ObamaCare at the state level.

Those changes will mostly affect the individual insurance market, but the majority of Americans who get their insurance through their employer are also likely to see more choice. That’s because any ObamaCare replacement is expected to significantly expand Health Savings Accounts.

HSAs shift control of health-care spending from employers to employees. An expansion of HSAs will most likely allow much larger tax-free contributions to these accounts, and allow them to be used for more health-related expenses, including insurance premiums. That would mean that you — not your boss — would be able to choose your insurance plan.

Expanded HSAs would also mean increased portability for health insurance. Because you could use your HSA to pay your premium, you wouldn’t be as likely to lose your insurance if you changed or lost your job.

In general, then, most consumers will find themselves with more and better insurance choices after ObamaCare is repealed. Still, there are likely to be some people who face challenges, including those with low incomes and those with pre-existing conditions. Tomorrow, we’ll look at what repealing ObamaCare means for them.

Rubio rips Obama, says his plans will hurt middle class

Senator (R-FL) Marco Rubio

Claiming Barack Obama thinks a “free enterprise economy” is “the cause of our problems” — not, as he sees it, the solution — Sen. Marco Rubio argued Tuesday that the president’s proposals would hurt middle class citizens more than help them. “Mr. President, I don’t oppose your plans because I want to protect the rich,” the Florida Republican said in his rebuttal to Obama’s State of the Union address. “I oppose your plans because I want to protect my neighbors.” The 35-year-old lawmaker, viewed as a possible presidential candidate and declared by Time magazine as “The Republican Savior,” was tapped to give his party’s response to the speech. Sen. Rand Paul, R-Kentucky, also rebutted Obama on behalf of the conservative tea party caucus. Rubio largely kept to his prepared remarks, except when he abruptly stopped talking about halfway through to reach for a drink of water.

The son of Cuban immigrants referred emotively to his personal story and that of his family, though his policy criticisms and proposals were largely in line with prevailing mainstream and, in some cases, conservative Republican thinking.
On immigration, for instance — on which Rubio has been one of his party’s most outspoken proponents of efforts to “modernize” the current system — he didn’t mention his past support of a route to citizenship for undocumented immigrants now in the United States. The senator did generally advocate “a responsible, permanent solution to the problem of those who are here illegally.” But he added that first, “we must follow through on the broken promises of the past to secure our borders and enforce our laws.” Speaking about gun control measures — one of the most emotional parts of Obama’s State of the Union speech — Rubio said he was for “effectively” dealing with such violence, then added, “But unconstitutionally undermining the Second Amendment rights of law-abiding Americans is not the way to do it.”

He sharply criticized Obama on many fronts. The president, Rubio claimed, had unfairly cast Republicans as opposing the environment and seniors, and only caring about rich people. He contended that it was Obama who — if his plans are enacted — would hurt the majority of Americans by preventing the economy from growing. “The tax increases and the deficit spending you propose will hurt middle class families,” Rubio said, referring to Obama. “It will cost them their raises. It will cost them their benefits. It may even cost some of them their jobs.” His remarks often reflected the sharp partisan divide on budgetary matters. Top Democrats, including Obama, have consistently said that increased government revenues should be paired with spending cuts to bring down the deficit.

Congress already raised tax rates on top income earners as part an agreement in January to avert the worst aspects of the so-called fiscal cliff. And now, Obama and Democrats want to eliminate some tax breaks and loopholes to further raise revenue. Republican leaders have sought to reduce the size of government and, therefore, generally oppose any increase in tax revenue. They have called for aggressive spending cuts and steps to overhaul entitlement programs, while rejecting any new attempts to increase revenue as part of further steps to reduce the deficit.

Obama’s “solution to virtually problem we face is for Washington to tax more, borrow more and spend more,” Rubio said. The president did, in fact, propose several new programs aimed at bolstering the economy, though he insisted they wouldn’t add to the deficit.

“The idea that more taxes and more government spending is the way to help hardworking middle-class taxpayers, that’s an old idea that has failed every time it’s been tried,” Rubio said. “More government isn’t going to help you get ahead. It’s going to hold you back.” Rubio said he agreed with Obama on lowering the corporate tax rate, but didn’t mention the president’s support for closing tax loopholes that inordinately benefit the rich.

Rubio backed school choice for all parents, and said that student financial aid should evolve to help more “non-traditional students.” On energy policy, the senator derided Obama’s administration for “wasting … taxpayer money on so-called clean energy ventures like Solyndra.” Rubio favors “reform” of energy regulations and opening up “more federal lands for safe and responsible (oil and gas) exploration” — both common Republican themes.

He spoke, too, of Medicare — the government-run health insurance program for seniors — arguing that changes are needed for it to continue. The president suggested he’d support “modest reform” of this entitlement program, but Rubio said Obama does not go far enough.

“I would never support any changes to Medicare that would hurt seniors like my mother,” he said. “But anyone who is in favor of leaving Medicare exactly the way it is right now is in favor of bankrupting it.” Near the end of his speech, Rubio prayed that Democrats and Republicans “can come together to solve our problems” — contending that, if they don’t, the consequences will be stark. “If we can get our economy healthy again, our children will be the most prosperous Americans ever,” Rubio said. “And if we do not, we will forever be known as the generation responsible for America’s decline.”

Where are those ObamaCare premium price cuts?

Want to know how to tell you’re going to have a bad day in Washington? A man walks up to you and says, “Hi, I’m Jason Mattera, and I want to ask you a question.” Actually, since Jason is a friend of mine, that would be a good day for me, but not so much for politicians. Jason, the senior investigative reporter for Talk Radio Network and a New York Times best-selling author, gave Hot Air an exclusive first look at his latest video produced for the Andrea Tantaros Show, which features Rep. Jim McDermott (D-WA) attempting to walk away from a good question — whatever happened to those health-care premiums price cuts Barack Obama and Democrats promised when they passed ObamaCare three years ago?

McDermott’s answer is priceless:

“Who’s paying you? The cock brothers?” Er, that’s Koch brothers, as Jason corrects McDermott. McDermott tries to first walk away from Jason, but then later engages him by arguing that all other Western nations have national health-insurance management. “Every industrialized country in the world takes care of its people,” McDermott replied, which doesn’t actually answer Jason’s original question but does address his follow-up. Why not just turn around and offer the answer in the first place? Probably because there is no good answer, as premiums spike upward and the promise to bend cost curves downward turn out to be empty.

The only politician who ever actually used the right approach to Jason was Al Franken, who is otherwise well known for refusing to engage with any reporter not from Minnesota. Whether one agrees with Franken or not, he was smart enough to challenge Jason right back.

POSTED AT 12:01 PM ON FEBRUARY 11, 2013 BY ED MORRISSEY