The GOP Senate majority has released its discussion draft of its plan to repeal and replace Obamacare, which Senate Majority Leader
Mitch McConnell said on the floor that “There will be ample time to analyze, discuss, and provide thoughts before legislation comes to the floor.”
The American people should be pleased that Senate Majority Leader Mitch McConnell has not rushed to bring the final version of the Senate proposal to repeal and replace Obamacare to the floor, for there is much to discuss.
The discussion draft ends the tyranny of the individual and employer mandates, phases out Medicaid expansion although perhaps not soon enough but also provides states more flexibility in implementing Medicaid.
The Senate bill even improves on the House version by eliminating the “continuous coverage” penalty—which as reported by Kaiser Health News, “increases premiums for people who buy insurance if they have gone 63 consecutive days without a policy during the past 12 months. Their premiums would rise by 30 percent and that surcharge would last for a year.” That’s gone now, leaving no vestige of the individual mandate.
Overall, the Senate bill appears to stick to many of the parameters of the House legislation, including creating a meaningful opt-out for states to get out from under Obamacare’s crushing Section 1302 regulations as the House version did via the MacArthur amendment.
These state waivers should be strengthened by providing for automatic approval as the MacArthur Amendment does, that way, a future president cannot attempt to administratively re-institute Section 1302 nationwide. This is critical. State opt-outs were the cornerstone of the compromise that got through the House, and should be fully reflected in the Senate version—and protected to avert any future implementation of Obamacare regulations without a vote of Congress.
Elsewhere, there is obviously more that can be done.
Neither the House nor Senate bills end the American Medical Association’s monopoly on doctor certification via control of medical schools, the Food and Drug Administration monopoly on approving new drugs, and the government-created state-by-state insurance monopolies. They do not address medical malpractice reform.
Also, solo physicians and small practices could be given a waiver to MACRA, which requires electronic medical records in order for doctors to treat Medicare patients. At a time when there are more seniors than ever entering the Medicare program, they will need as many doctors as possible to treat them.
Forcing electronic medical records on Medicare doctors is compelling many doctors to simply stop treating Medicare patients. With a limited waiver for smaller practices, seniors could get at least a few more options for care.
Other obvious areas for improvement would be to give consumers the option of going across state lines to purchase insurance, as Republicans have been promising on the campaign trail for several election cycles.
Sens. Ted Cruz (R-Texas), Ron Johnson (R-Wis.), Mike Lee (R-Utah) and Rand Paul (R-Ky.) opened the door for additional changes focused upon lowering consumer healthcare costs in a joint statement saying, “Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current healthcare system but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their healthcare costs.”
And this is how legislation should happen, drafts proposed, individual Senators providing input and negotiating changes, the public informed in advance of votes, and eventually passage through both houses with the President’s signature. A far cry from the you’ll have to pass it to read it approach taken by Obama, Reid and Pelosi that delivered the nation the failed Obamacare plan.
The framework for a deal is basically in place, and if through the efforts of Cruz, Johnson, Lee and Paul the health care system becomes more free market and less state-control focused providing more individual choices, the legislative process will have worked the way it is supposed to. And most importantly, the American people will no longer be compelled to buy health insurance packages that they cannot afford with deductibles that make it useless in all but the most extreme circumstances.
The Obamacare replacement bill has turned an important corner and with a few improvements, will hopefully soon be heading for home.