In healthcare reform, GOP must let bad ‘ObamaCare lite’ bills fail

“The trouble with conservatives,” Dr. Robert Strausz-Hupe is said to have once remarked, “is that they do not retrieve their wounded.” We’ll see, because there are certainly quite a few left writhing on the field following the aftermath (cease-fire?) of this year’s healthcare battle.

Republicans have enjoyed electoral successes across the country since 2010, and a key reason has been the unpopularity of the paradoxically titled “Affordable Care Act,” more succinctly known as “ObamaCare.” Republicans campaigned on its repeal, and widespread opposition to the act and its deleterious effects on the health care market prompted voters to install GOP majorities in both the House and Senate, and, ultimately, a nominally Republican president in the White House.

Which is why the inaugural attempt at “repeal and replace” was so disappointing.

GOP lawmakers vote to allow option for fast-tracking healthcare vote https://t.co/DsQZRrbZru pic.twitter.com/yjizbVZhhm

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It is tempting to assign blame for the failure to one segment or another of the Republican Party, depending on which wing one identifies most with; but neither the conservative Freedom Caucus, nor the moderate Tuesday Group — nor Speaker Ryan, or any individual for that matter — is predominantly responsible for the American Health Care Act’s (AHCA) misfire. It failed simply because it was a bad bill that could not deliver on what was promised.

The primary reason the AHCA floundered as a policy document was because it kept too much of the structure of a structurally flawed act in place. ObamaCare’s combination of subsidies and excessive regulation — funded by egregious tax increases — resulted in healthcare costs for most Americans going through the roof. This is a systemic, structural defect with ObamaCare which piecemeal or partial efforts cannot correct.

{mosads}The AHCA was an attempted political solution to a complex policy problem. It never had a chance because it failed to address the issues which have resulted in millions of Americans losing health insurance, or watching their premiums skyrocket. This was not an example of the perfect being the enemy of the good — a situation we see all too often — but rather a case of missing the target altogether in favor of near fanatical accommodation.

Likewise, ad-hoc fixes, thrown together in a desperate attempt to “Do Something,” will similarly fail. Plans to kick the problem to the states through a limited waiver option, for instance, will accomplish little, simply because those (predominantly Democrat-controlled) states which bought into the ObamaCare fantasy (such as myopically expanding their Medicaid rolls) are not about to admit they made a mistake by waiving themselves out of it.

States should, of course, have far more control over healthcare policy, but this was a federally-created problem which needs to be corrected federally before any systemic repairs can be applied. Good policy does not come out of haste and desperation any more than it does from pure political calculation.

While the initial, lackluster repeal effort did fail, there are a few bright spots, as well as lessons and opportunities, for Republicans. The most obvious is that the AHCA’s miscarriage saved the GOP from being shackled to a policy that would have effectively been little better than ObamaCare.

NEW: GOP healthcare bill faces major obstacle over pre-existing conditions provision https://t.co/wNgXLQ6xRe pic.twitter.com/6XTqojjW1u

— The Hill (@thehill) May 2, 2017

There are times, of course, when the House Freedom Caucus can be overly intransigent and unrealistic; there are also times when Republican moderates are too willing to be flexible on principle for the sake of striking a deal. But in this case, Republicans of varying stripes worked together — purposely or not — to keep an unworkable bill from seeing the light of day.

By keeping so much of the framework of ObamaCare, the AHCA would have inherited the fundamental economic problems that have caused health care to be inordinately expensive — primarily the disconnect between what health care costs and what most people actually pay. Any future Republican solutions would be evaluated in this light, and be deservedly viewed with, at the very least, suspicion among those who look to the Republican Party for deliverance from the economic sophistry and failed experimentation of the last eight years.

It is an opportunity then, because the House GOP can now go back and take the time required to draft a better bill that more adequately reflects both sound free-market policy and the promises made to voters — voters who, after all, asked for reasonable policy solutions to come out of Washington, not continued political expediency.

We all know that any decent bill from the House will be watered down in the Senate, where the majority is narrower and the rules somewhat more constrictive. What will emerge from the process will be the result of a negotiation, making it all the more important for the House Republicans to craft something that will provide a profitable starting point. It is a skill that the left mastered long ago, and one that the GOP needs to learn if they are to be effective in solving the nation’s problems.

The objective for Republicans in Washington is straightforward, if the process is complicated: take your time, apply sound principles (without being so obdurately rigid that you allow no room for maneuver), follow through on campaign promises, and produce a competent health care policy that fully replaces ObamaCare with effective free-market solutions that will work for everyone.

Kelly Sloan is a Denver-based public affairs consultant and policy fellow at the Centennial Institute. Follow him on Twitter @KVSloan25.

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