Republicans on Capitol Hill don’t support the Affordable Care Act (ACA) and didn’t support it when in 2010 when it passed, but now Capitol Hill Democrats are also running away from the Affordable Care Act, which they once felt comfortable calling ObamaCare, as fast as they can. In fact, a recent poll by CBS shows that in the last month Democrat support of the Affordable Care Act has slipped from 74% all the way to 58%. That is a 16% loss in support that will almost undoubtedly continue at the same rate for another month. Of course this was easy to predict. Not only is the website, healthcare.gov, broken, but the policies that underlie the legislation have no chance of working. See (here, here, and here).
So, it is time to break up with the Affordable Care Act. Of course like any smitten lover Congress isn’t going to listen to my sage advice yet, but this is only the beginning of the signs that Congress needs to break up with the ACA, but it will happen at some point.
They say that breaking up is hard to do
Now I know, I know that it’s true
As we all know breaking up isn’t always easy to do though, but when it happens we can’t just go running back into the arms of the previous health care system. While it was marginally less broken than the Affordable Care Act, it definitely brought its own baggage to the relationship. Government interference in the marketplace created perverse incentives to overcharge for services, it created incentives for the overuse of healthcare, it kept us tethered to our employers, and it acted more like pre-paid healthcare than true insurance.
Furthermore, when the breakup with the Affordable Care Act happens and Congress recognizes that we can’t return to our previous long term relationship, they will still need to guard against making a bad decision while on the rebound. Fortunately, there are quite a few quality policy ideas that they already have to choose from. Congressman Tom Price has a serious policy proposal called the Empowering Patients First Act which among other good ideas attempts to end the tax preference for employer based insurance, allows interstate competition, and comes close to balanced billing for Medicare patients. The Republican Study Committee has proposed a plan called The American Health Care Reform Act that expands HSAs, equalizes the tax treatment between the individual market and the employer market, and like Representative Prices’s plan allows competition between state lines. Dr. Paul Broun has the Option Act which includes a new Medicaid block grant, 100% deductibility of health care expenses, increased contribution levels to HSAs, and like the others it allows interstate competition. Lastly, I couldn’t write about options on the “John Goodman Health Policy Blog” without mentioning the John Goodman Plan which would create fairness, universality, and portability.
For now we just all need to be ready for the breakup, ready to console our politicians, and then to make sure that they don’t pick a new plan too fast. They need to take their time to find a bipartisan solution that everyone can support and that works.