GOP is delighted, but where’s a plan?

Published 9:23 pm Saturday, November 16, 2013

By Staff Reports

 

These are heady days for Republicans who oppose the Affordable Care Act. The failure of the HealthCare.gov website is only the start of Obamacare’s collapse, they predict.

If that’s so — and it’s not a sure thing, by any measure — Republicans had better be ready with something better. Because the American health care system, based largely on employer-based insurance, is broken. The repeal of the Affordable Care Act will only further expose just how broken it is.

Writing for Forbes magazine, the usually reserved Steven Hayward predicts Obamacare will be repealed — soon.

“Even if HealthCare.gov is fixed by the end of the month (unlikely), Obamacare is going to be repealed well in advance of next year’s election,” he claims. “And if the website continues to fail, the push for repeal — from endangered Democrats — will occur very rapidly. The website is a sideshow: The real action is the number of people and businesses who are losing their health plans or having to pay a lot more. Fixing the website will only delay the inevitable.”

Hayward is wrong, and here’s why. Full repeal would require the approval of Congress — and President Barack Obama. How likely is a lame-duck president, with no other accomplishments of note, to stand by and watch his “signature achievement” dismantled? Not very.



Hayward does recognize the very real danger we’re left with: minor changes, but failure to fix a badly broken system.

“The hazard of the moment is that a compromise ‘reform’ that drops the mandate and attempts to restore the insurance status quo ante could leave us with an unfunded expansion of Medicaid and a badly disrupted private insurance market,” he acknowledges. “Republicans should avoid both the political traps and a new fiscal time bomb by being ready with a serious replacement policy…”

But Republicans have already pledged to keep the popular parts of the Affordable Care Act — which happen to be the most costly bits. In March, House leaders including Speaker John Boehner and Majority Leader Eric Cantor sent a letter to the White House reaffirming their support for provisions in the law that require insurance companies to enroll people with pre-existing conditions.

And that puts us exactly where we are with Obamacare. In order for insurance firms to be financially viable while signing up sick people, they need to sign up lots and lots of healthy (and young) people. And that isn’t likely to happen without an individual mandate.

There’s one more wrench in the works of the health care system that’s unrelated to Obamacare, but a worrying trend that can’t be ignored. The system is based on employees getting insurance as part of their compensation. That worked reasonably well in years past, but we’re a graying nation and the lingering effects of the Great Recession both mean that not as many of us are employees anymore.

According to the Bureau of Labor Statistics, the workforce participation rate is at a 35-year low.

If Obamacare does collapse, Republicans had better have a Plan B. The ship might be sinking, but we’re all on the deck.