Judd Gregg: GOP must avoid healthcare trap

Riding into box canyons is never a great idea but this Republican Congress has already managed to do it on several occasions.  

Now the GOP Congress is about to find itself in another predicament, as the Supreme Court could potentially rule that ObamaCare subsidies should be denied to people who are in states that did not set up insurance exchanges.

{mosads}Those in the party who have trumpeted the need to challenge ObamaCare using the Supreme Court’s possible decision are once again showing the ability to snatch defeat from the jaws of victory. 

People are generally frustrated with ObamaCare — its excessive regulation, its misdirection as to whom you can have as your doctor, its exaggerated claims that it would address the uninsured and that insurance premiums would go down.

The law has been in the process of self-destruction. It has more going wrong with it than going right. It is about to grandly compound this fact, since implementation of the small-employer mandate and individual mandate is looming.

Left to its own path of elitist ineptitude, ObamaCare will be a major political burden for Democrats in 2016 — unless Republicans give them an escape hatch. 

Paradoxically, perhaps, a Supreme Court decision against ObamaCare could easily provide the Democrats with a path to avoid political pain, especially if the issue is handled by the GOP in as inept a fashion as the threatened shutdowns of earlier in the year.

Democrats will be in a position to make the debate about Republican insensitivity and parsimony, instead of facing appropriate blame themselves for passing a law that does little of what it was represented to do and is creating significant pockets of chaos.

Although Republicans deserve considerable responsibility for having created this trap, they still should not fall into it.

If the Court rules that these subsidies do not apply and thus arguably strips 7 to 9 million people of their insurance, the Republican Congress should act immediately to restore the coverage and pay for it. 

This should not be tied to some larger effort to bandage up ObamaCare by eliminating the individual mandate, the small-employer mandate, or other egregious items in the Affordable Care Act. 

To do so would result in a double win for ObamaCare and the Democrats. Although the president and his party colleagues would protest profusely at such an elimination, they would actually be glad to see these political losers off their backs going into 2016.

The correct approach for Republicans would be to use a Supreme Court decision that bans these subsidies as another example of the total failure of good health policy represented by ObamaCare.  

The Republicans should also use such a decision as an opportunity to set forth a real, significant and effective health care program of their own. 

It should be a dramatic and clear alternative to ObamaCare. It also needs to be something that makes people think that Republicans do care about their healthcare not just about beating ObamaCare.

There are many good ideas in this arena. One that would be effective in terms of both policy and politics, would focus on a major shift of the reimbursement system, so that cash flowed on the basis of outcomes and quality, rather than on the basis of utilization, as at present.

Couple this with a national catastrophic-cover proposal so that no one is financially wiped out by a health event. Use this type of program to promote better healthcare using the marketplace. 

Protect people’s access to their existing doctors and insurance while controlling costs and covering major health events as the juxtaposition to the dysfunction that is ObamaCare.

Instead of heading up this box canyon if the Supreme Court rules as expected, move to take the high ground.  

Let ObamaCare die from its own self-inflicted wounds. Put forward real, effective, people-oriented health policy.

Join the debate from a position of strength, rather than defensiveness, and make this one of the essential issues that differentiate the parties in 2016 in a constructive manner.

Judd Gregg (R) is a former governor and three-term senator from New Hampshire who served as chairman and ranking member of the Senate Budget Committee and as ranking member of the Senate Appropriations Foreign Operations subcommittee.