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November 13, 2013

Should The GOP Be Trying To Pass Any ObamaCare Fix Or Remediation?

On Friday the House will take up a bill sponsored by Energy and Commerce Committee Chair Fred Upton (yes, he's Kate's uncle) that purports to let people who have health insurance polices keep them regardless of the ACA and HHS regulations. I say "purports" because it's unclear that the damage done by ObmaCare can be undone in time to prevent people from losing coverage on January 1st.

The question is, should the GOP try and do this at the risk of either "saving" ObamaCare or being seen as equally culpable in its failures. To date, the GOP has stayed mostly on the sidelines, keeping their fingerprints off the debacle (they helped pass a minor tweak in the original 1099 reporting requirements in the bill)?

Conn Carroll argues that Upton's, "Keep Your Health Plan" bill has a major flaw...it makes the same promise Obama did and is just as unlikely to be able to deliver on it.

But unlike the competing Senate bill, sponsored Sens. Mary Landrieu (D-LA) and Dianne Feinstein (D-CA), the Upton bill does not force insurance companies to offer the old plans. It only allows them to do so.

This, as Capretta points out, would take pressure off Obamcare and Democrats, and move it to evil insurance companies who are refusing to let people keep their insurance.

Why on earth would Republicans want to bail Democrats out on Obamacare by supplying them with a villain to scapegoat?

Liberals on the other hand worry that if Upton's bill becomes law it will kill the whole notion of the exchanges and take the entire system with it.

Nicholas Bagley, a professor of health law at the University of Michigan, pointed out that those who currently have policies on the individual market tend to be healthier than most -- if not, they'd probably be priced out or locked out due to a preexisting condition. "If those relatively healthy people can keep their current plans outside the exchanges, they won't enter the same risk pool as everyone else on the exchanges," he said. "That means the exchanges will have a higher proportion of unhealthy people shopping for insurance than anticipated."

"In the long run, that will drive up the cost of insurance on the exchanges," Bagley said. "In the short run, it could mean that the prices at which insurers are selling their plans are too low to cover the medical costs of those who enroll. Because the adoption of the Upton bill would wreak havoc with their actuarial models, insurers are likely to resist its adoption."

There's the rub...getting people out of the individual market and into the exchanges was a necessary part of the plan. It's why Obama had Health and Human Services write the rules to get as many people made ineligible for grandfathering in the first place, they need them to subsidize the poor and sick who are getting covered.

The bottom line is this is a political move masquerading as policy. The GOP has to be seen doing something. That's just reality. Millions of people who played by the rules are losing their insurance and quite possibly their doctors as well. It's simply not an option for a political party to say, "Wow, that sucks for you. Should have voted for us, huh?". Campaigns are about generating future support, not punishing voters for past lack of support.

The upside is that the GOP is doing this in a way that panders completely to the people who just, "want something done" but is also a poison pill to the Democrats. Obama doesn't want to "fix" what isn't a bug in the system but from his point of view, a necessary feature.

The risk in all of this is that the Democrats say "yes". I have my doubts that the Senate will take up the Landrieu bill let alone pass Upton's. And the odds of Obama signing any of them are zero (he never has to face voters and he cares more about his plan than some random Democrats).

Could this all go south and wind up with the GOP sharing blame for Obama's failure? Theoretically, yes. But doing nothing isn't risk free either. Lacking any attempt to help people who were lied to, voters are more likely to say "a pox upon both of you". On balance it seems trying to do something that won't actually happened seems to me to help spotlight the damage the Democrats have done.

Added: To be clear, personally I'd prefer full repeal or Let it Burn. I'm just looking at this from a real world political point of view. As I've written before, the interests of conservatives and the GOP have diverged.

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posted by DrewM. at 11:15 AM

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