Conservative critics of the Senate healthcare bill are still right

Some right-of-center pundits are lining up to attack Sen. Mike Lee (R-Utah) for his decision to publicly oppose the current GOP healthcare bill. They are not only wrong, but in one particular case, are blatantly mischaracterizing the position of Sen. Lee, the reality of the Senate bill’s policy provisions, and the relative importance of his decision in the actual result. Indeed, there has even been the laughable suggestion that Sen. Lee now “owns ObamaCare.” This is facially absurd.

First, consider that in the path to getting to this precise moment, howls of protest have been directed at conservatives who dared to question whether the various iterations of so-called repeal bills did, in fact, repeal ObamaCare (hint: they did not). The legislative effort has been a muddled mess from the beginning with mostly closed-door negotiations and no meaningful deliberative process. Nevertheless, conservative critics have attempted to make good faith efforts to improve the policy along the way.

{mosads}Second, it’s important to keep in perspective that dozens of senators have either voiced concerns or refused to take a position on the bill. Sens. Rand Paul (R-Ky.), Jerry Moran (R-Kan.), and Susan Collins (R-Maine) are publicly opposed to the bill as well. And Sen. Ron Johnson (R-Wisc.) disclosed that the deceptions advanced by Senate leadership on Medicaid had created a breach of trust, jeopardizing his support.

Third, the bill was not ObamaCare repeal. The bill cemented ObamaCare’s massive Medicaid expansion with senior Republicans saying behind closed doors would never be curtailed (the source of Sen. Johnson’s breach of trust), retained subsidies up to 350 percent of the federal poverty level, included an ever-expanding insurance company “stability” (i.e. bailout) fund to the tune of $182 billion, retained the entirety of the underlying ObamaCare regulatory architecture as the federal default, and maintained a large number of the ObamaCare tax increases.

Fourth, there are claims by those attacking conservatives that the minor regulation changes achieved in the Senate bill (the product of constant efforts by conservatives over the last 5 months) were significant and according to CBO would result in a 30 percent reduction in premiums in the individual market by 2020 from their current levels.

There are multiple problems with this claim. It’s an admitted finger-in-the-air analysis by CBO, it makes assumptions based on limited, optional state waivers that may or may not be sought or granted, and it ignores what may still be a significant negative impact to employer-provided insurance with removal of the employer mandate while keeping the cost-driving regulations in place. This to say nothing about the highly flawed plan to dump the regulated and less regulated plans together in a single pool.

Furthermore, the suggestion that actuarial value and adjustments to the age band rating are enough to drive down premiums is highly questionable. The bill maintains the entirety of ObamaCare’s regulatory scheme as the federal standard and the flawed mechanism by which only a handful of the regulations can be partially waived (not repealed outright) by states is both limited and optional. The Senate bill would not meaningfully reduce premiums.

Lastly, there is the line of attack against conservative opponents that rests on the so-called 2015 “repeal bill,” which we are reminded “doesn’t repeal the regulations.”  The assertion is that Sen. Lee is hypocritical to have opposed the GOP plan for modifying or waiving a couple of the regulations when he supported the 2015 bill which repealed none. But one tiny little detail is materially different — the occupant of the White House.

Putting aside that the 2015 bill was not fully agreed upon as the best approach even at that time, it was offered while Obama was president and thus the primary objective was to pass something substantive to finally force the certain veto. The debate existed then as it does now about how much can be repealed via the so-called budget reconciliation process. The short answer is that we don’t know until the Senate Parliamentarian provides her ruling, but that it was academic when Obama was president.

Now it is not, and we know that the Senate can rule as a body with the vice president presiding that the regulations have a non-incidental budgetary impact, and therefore can be repealed if the Senate merely has the will. In other words, the 2015 approach was always a baseline and the Senate should push through a full repeal — including all the regulations.

The fact is no one wants to admit that the GOP has been lying for years about ObamaCare repeal. Attacks on Sen. Lee and other conservatives actually committed to repealing this law are a disservice to the debate and false on their face. They misrepresent the deep and thoughtful efforts by Sen. Lee and others to offer constructive amendments to get the bill to a place where conservatives could support it in good conscience.

Senate leadership failed and Sen. Lee publicly offered his reasons why. All eyes should now be on Majority Leader Mitch McConnell (R-Ky.), who should not just hold a vote — but should work to honor the promises made to the American people and pass an actual full repeal measure.

Chip Roy is director of the Center for Tenth Amendment Action at the Texas Public Policy Foundation.

Drew White is a senior federal policy analyst at the Texas Public Policy Foundation.

The views expressed by contributors are their own and are not the views of The Hill.