By Douglas V. Gibbs
Author, Speaker, Instructor, Radio Host
Senate Majority Leader Mitch McConnell, despite the fact that four Republican members of the U.S. Senate say they oppose the GOP's bill, is still seeking a vote on the Republican Health Care Bill next week. Rand Paul says the bill "sounds like Obamacare." Democrats say the bill is a tax cut (wait a minute, when they were pushing the Affordable Care Act into place, didn't the Democrats argue it was not a tax?). Elizabeth Warren went so far as to accuse the GOP bill of being "blood money". Senator John Cornyn told Fox News this morning that "it's not a perfect bill," but what they have is based on "The art of the possible."
Remember, all of the Republicans demanded a repeal of Obamacare during the last 8 years of the reign of Obama, but now that they have full control and a supporting Republican President, they want to try and fix the health care law they proclaimed was "unconstitutional" and a law that has nothing good in it in the first place.
Some conservative members of the Senate are calling out their GOP colleagues. Four dissenting Republican Senators say the Republicans are not seeking to repeal Obamacare, but to tweak what the Democrats unconstitutionally sought in the first place. Senators Mike Lee (Utah), Ron Johnson (Wisconsin), Ted Cruz (Texas), and Rand Paul (Kentucky) call the GOP bill "Obamacare lite," and wish to remove the federal government out of health care as much as possible, and give the power back to the States.
Ted Cruz denied the accusation he is an obstructionist. He said, "I have been clear from Day 1, I want to get to yes... but we've also got to get it right"
From a strict constitutional point of view, there are no expressly enumerated authorities granting to the federal government any allowance to meddle in the health care industry. The Affordable Care Act was enacted by the Democrats so that it could eventually lead to the communist concept of a "single payer system." Therefore, if the Republican Senators wish to abide by their oath to protect and defend the U.S. Constitution, only a full repeal of Obamacare, and a creation of laws releasing any federal control over the industry is permissible.
Ted Cruz's "Path to Yes" is essentially designed to follow along those ideas in regards to constitutionality, while it does allow for limited federal influence.
1. Consumer Freedom Option. Obamacare's insurance mandates caused premiums to skyrocket. To fix that problem, the bill should add a provision that says that any insurance company that offers at least one plan that meets the mandates can also sell any other plans that consumers desire.
2. Real Flexibility for Medicaid. Each state should have full flexibility to design creative and innovative ways to provide care for our most vulnerable. That flexibility should be automatic and codified in statute, not dependent on seeking waivers from an HHS Secretary who may have a different policy view.
3. Enact the "consensus" market reforms. Specifically: (a) allowing consumers to purchase insurance across state lines; (b) expanding association health plans, so those in individual or small group markets can join together in large groups to get lower rates; (c) allowing people to pay health insurance premiums from health savings accounts, which lowers premiums immediately by letting them be purchased with pre-tax dollars; and (d) giving a bonus in federal medicaid matching funds to states that enact caps on punitive damages in medical malpractice lawsuits.
4. Reach a real agreement to rein in the long-term growth of Medicaid: Every Republican campaigned on stopping the out-of-control debt that threatens our future. If we squander this unique opportunity to implement meaningful entitlement reform - if we double the historic growth rate of Medicaid, as the current bill does - we would not be honoring our promises. Instead, we should bend the cost curve downwards, enacting structural reforms to ensure long-term fiscal sustainability.
Which brings us back to John Cornyn's statement about "The art of the possible."
Ideally, the federal government should have no influence on health care whatsoever, and the system should be a purely free market system with no third party payer. A patient/provider relationship would drive down the cost of health care, and increase the quality. True competition always does.
However, currently the federal government meddles as much as it can in issues it has no business being involved in. Over 85% of the federal government's activities are either unconstitutional, or inadvisable. It took us over 200 years to evolve into the mess we are in, and it will likely take as long to get out of it (if we have the intestinal fortitude to carry out long term plans from generation to generation).
So, we must ask. Is the GOP plan a betrayal, and should we applaud the four conservative constitutional Republicans for standing in the way of allowing Obamacare-lite to become law, or is the GOP plan a step in the right direction that we should embrace with the promise that it will continue to become smaller and smaller with each passing bill?
While I have never seen government voluntarily reduce their grip on our throats, a full reversal of federal intrusion into the health care industry seems unlikely as well.
The truth is, history has proven time and time again that if you let the market do its thing, and completely remove governmental interference, the market prospers. However, the political class has established so many goodies for voters that to pull the rug out from under them could create a situation where people could suffer under the new rules, thus establishing a permanent opposition to constitutional laws that seek to reduce federal influence on issues like health care. We must also remember to argue in favor of State Sovereignty. While the federal government as no authority over health care, the States do. If the States want to have safety nets, programs to care for those who can't afford care, or even socialized medicine as is being proposed in California, they have the authority to do so. As Cruz offers, the federal GOP plan should be to ween America off of federal control, and return many of those controls back to the States where they belong. At least then, if the consequences are a bad thing, it only hurts that State, and not the entire country like with what we saw regarding Obamacare.
-- Political Pistachio Conservative News and Commentary