The IRS scandal means House Republicans can defund Obamacare for
good.
The IRS scandal provides Republicans and conservatives with the
opportunity to repeal and replace Obamacare now. The House
Republican majority should refuse to fund the expansion of the IRS
necessary to manage Obamacare. Without that funding, and hiring
thousands of additional agents, the IRS cannot even begin to manage
Obamacare.
President Obama may throw a fit. He may refuse to sign funding
bills to keep the federal government open. No matter. Let him close
his government down if he wants. Nobody wants the IRS playing
political games with their health care and health records, like it
did with the constitutional rights to freedom of speech and Equal
Protection of Tea Party and conservative organizations. Contribute
to the Republican Party? Attend a Tea Party protest? Good luck
getting your Obamacare health insurance tax credit application
approved. Good luck finding a doctor the government will pay to do
that operation your kid needs.
Obama can flail away all he wants. The public will now back the
Republicans in this fight, just as it did in the sequester battle.
But won’t the public feel that the Republicans would be
irresponsible to just refuse to fund Obamacare, leaving the health
system in chaos?
That is why the Republicans need to back up their IRS Obamacare
chokehold with legislation proposing free market, Patient Power
health care reforms to replace Obamacare. (A comprehensive,
free-market health reform plan to replace Obamacare has already
been proposed by John Goodman and myself in our NCPA paper,
“
Health Care for All
Without the Affordable Care Act.”)
Going for the Jugular of
Obamacare President Obama sold Obamacare to
the 40% of the nation that supports it on the grounds that it would
provide universal health insurance. But the Congressional Budget
Office (CBO) scores the legislation as still leaving 30 million
uninsured 10 years after full implementation.
It will be much worse than even that, however. In fact, for the
reasons I explain below, it is quite possible there will be
more people uninsured after Obamacare goes into effect
than before. That is the exposed jugular of Obamacare. Those who’ve
been supporting it have done so because they believe in universal
health care. If Obamacare is going to make the problem worse rather
than better, for all of its costs, then public support for
replacing it with a better plan will explode. As I will also
explain, the free market, Patient Power plan that Republicans
should now advance would assure
universal health care for
all, with no individual mandate, and no employer mandate, at a cost
savings of at least $2 trillion over the next 10 years, as compared
to current law.
The employer mandate under Obamacare doesn’t just require
employers to provide health insurance to their employees. Employers
must provide the health insurance that HHS Secretary Kathleen
Sebelius specifies that they must buy, to satisfy the employer
mandate requirement. That will include, of course, every
politically correct benefit and coverage, which will make the
required insurance very expensive, in the range of $15,000 to
$20,000 for a family plan. But under Obamacare, employers can just
pay a fine of $3,000 per employee, and forego the much higher cost
of the mandated health insurance altogether. Even many employers
who currently provide health insurance will see this as a better
deal, and terminate coverage, especially since they will no longer
be free to choose their own coverage. Kathleen Sebelius will be
choosing it instead, forcing the costs of their current coverage
up.
This is why even the Washington Establishment CBO reported in
February that “in 2019, an estimated 12 million people who would
have had an offer of employment-based coverage under prior law will
lose their offer under current law.” CBO estimated that the number
losing their employer-provided health insurance could rise as high
as 20 million.
But that is surely an underestimate as well. As the response of
dropping employer coverage grows, competitive pressure for more and
more employers to do so and avoid Obamacare’s costs will rise,
spreading the practice further. Former CBO Director Douglas
Holtz-Eakin estimated in a study for the American Action Forum that
42 million workers will lose their employer-provided coverage under
Obamacare. Given the strong incentives for doing so, it could be
two or three times higher.
Other employer practices for avoiding the costs of Obamacare
will further increase the number of uninsured. The employer mandate
only applies to full-time workers, defined as those working more
than 30 hours a week. But already we see a marked trend in the
labor market of millions of workers suffering cutbacks to 29 hours
a week, another practice that may well accelerate as more employers
do it, and it consequently becomes more accepted in labor markets.
The employer mandate also does not require any coverage for
dependents of their workers. So expect to see many more uninsured
as employers drop their family coverage. Employers will not even
pay any employer mandate penalty for these practices.
We will see dramatic steps to avoid the costs of Obamacare in
the individual health insurance market as well. The penalty for
failing to comply with the individual mandate is only $2,000, so
the savings for avoiding the costly Obamacare health insurance will
be even greater. Moreover, even this penalty is not enforceable
under Obamacare. When an amendment to remove the power of the IRS
to garnish wages or seize assets to enforce the penalty was put to
a vote, Congress did not want to go on record authorizing such
measures. So we can expect millions more in the individual health
insurance market to become uninsured as well.
In addition, everybody will know that under Obamacare’s
guaranteed issue regulation, insurers must accept everyone who
applies for coverage no matter how sick and costly they have
become. Moreover, under Obamacare’s community rating regulation,
insurers cannot charge those sick applicants any more than they
charge others. So everyone can just wait until they get sick with a
costly illness to get coverage, at no extra cost, meaning millions
more uninsured.
Of course, that will drive up the cost of health insurance even
more, just as it would for fire insurance if homeowners could wait
until their homes caught on fire to call for coverage, at no extra
charge. That is why health insurance experts are estimating that
Obamacare will double and triple premiums for many workers and
small businesses, particularly for coverage for young and healthy
workers. That will cause millions more to drop coverage, the lower
cost young and healthy in particular. A market survey conducted for
American Action Forum found that 17 percent would drop coverage if
premiums rose just 10 percent, 35 percent would drop coverage if
premiums rose 20%, and 45% would drop coverage if premiums rose 30
percent.
Of course, if the low cost young and healthy drop out, that will
just drive up premiums for the remaining sicker even more. That
will mean still more healthy people dropping their coverage. The
resulting financial death spiral would quite likely drive some
insurers out of business altogether, meaning still more uninsured.
This all could quite possibly mean
more uninsured under
Obamacare than before.
Universal Health Care Without
ObamacareBut the NCPA study referenced above shows
how health care for all can be assured, with no individual mandate,
no employer mandate, and a savings of at least $2 trillion as
compared to Obamacare.
To assure health care for the poor uninsured, Medicaid would be
reformed with block grants sending the federal funding to the
states, just as was done for the old Aid to Families with Dependent
Children (AFDC) program in 1996. Those AFDC block grants reduced
the cost of that program by 50% from where it would have been
otherwise under prior trends. CBO has scored Medicaid block grant
legislation already drafted and introduced by Congressman Todd
Rokita (R-IN), as designed by the Carleson Center for Welfare
Reform, as by itself saving $2 trillion over the next 10 years.
States could provide the poor with health insurance vouchers to
buy the private health insurance of their choice in the market,
where competition would drive down costs. The poor could use those
vouchers to choose Health Savings Accounts, with proven, market
incentives to drive health costs down further. When the Bush
Administration granted Rhode Island a waiver allowing the state the
same flexibility as with block grants, the state signed the poor up
with managed care institutions ensuring their access to health
care.
Such reform would greatly benefit the poor, because Medicaid so
badly underpays doctors and hospitals that the poor on the program
face grave difficulties finding timely, essential care. They are
documented in studies to suffer worse health outcomes as a result,
including premature death. But with private, market health
insurance, they would enjoy the same health care as the middle
class, because they would have the same health insurance as the
middle class. The Rhode Island reforms were documented to improve
health care access for the poor over Medicaid as well.
To assure health care for the sick uninsured who have become too
costly to buy health insurance for the first time in a private,
competitive market, states would receive federal assistance to set
up High Risk pools. Those who could not buy insurance in the
private market because they were already too ill would go to the
High Risk pool to get coverage. They would be charged premiums
based on ability to pay, with state subsidies covering remaining
costs. Such High Risk pools have been established in 30 states, and
have worked well at quite modest costs, because few people actually
become too sick to buy private health insurance in the market.
These High Risk pools would also provide the solution for
pre-existing conditions as well, because those who could not get
private coverage for those conditions could go the High Risk
pool.
The law has long provided that those with health insurance
cannot be cut off from such insurance after they become sick.
Indeed, that is prohibited under common law fraud. That prohibition
was federalized under the Kennedy-Kassebaum legislation of 1996. If
the law needs to be updated to close any loopholes, it should
be.
The NCPA-healthcare-for-all-without-Obamacare plan also provides
for a Consumer Choice Tax Credit that would expand the same tax
benefits of employer-provided health coverage to everyone. Everyone
would be eligible for a refundable tax credit of $2,500 to $3,000,
which would go to employers that provided health coverage as well
as to individuals who obtained health coverage on their own. This
would replace both the Obamacare health insurance tax credits, and
the current employer health insurance tax benefits, at an
additional savings of a trillion dollars or more over 10 years. The
NCPA plan even provides that for those who fail to use this tax
credit to buy health insurance, the subsidy per person would go to
the local government where they reside to be used for indigent
care.
Consequently, everyone would be assured of health care when they
need it. Those who already have coverage would be assured they
could keep it. Those who were too poor to buy health insurance
would receive assistance to buy it. Those uninsured who became too
sick to buy health insurance for the first time in the market would
be able to get essential coverage from the High Risk pools. That
provides a solution for pre-existing conditions that cannot be
covered in the private market as well.
Additional provisions in the federal legislation for this NCPA
plan can provide for the interstate sale of health insurance,
creating a national, competitive market that can further drive
health costs down. It can provide for medical malpractice reform as
well, for a complete health cost strategy. And the hundreds of
bureaucracies created for Obamacare can also be abolished, for
further savings.
Unlike Obamacare, this truly American health reform plan greatly
expands Patient Power and choice, providing better health care,
while reducing costs through market competition, incentives, and
choice.
End of Article
------------------
*****
If
you found this article useful and enlightening, please consider my
published book which contains other insight and understanding on problems and solutions facing our country.
The book is available at amazon.com at the link here:
http://www.amazon.com/This-U-S-Citizen-Thoughts-Concerns/dp/1451509979/
This U.S. Citizen
*****