Prepare now to repeal ObamaCare later

 After Sen. John McCain’s negative vote condemned Republican efforts to repeal ObamaCare in 2017, the party leadership largely abandoned the effort and turned to other matters. Congress repealed the individual mandate penalty as part of its tax cuts legislation; Republican attorneys general unsuccessfully tried to use this action to convince the courts to repeal the law; President Trump has promised to replace ObamaCare with a better plan. The senses. Lindsey Graham and Bill Cassidy came up with their own plan, but Republican leaders never presented it and seemed happier to forget about the whole healthcare topic.

Republicans need to be better prepared the next time they control both houses of Congress and the White House. President Biden’s declining polls and Democratic infighting could give them that opportunity three years from now. To avoid another failure to repeal ObamaCare, Republicans must convince voters they have a viable replacement.

Liberals attack conservatives by forcing them to defend the worst aspects of the status quo, even though today’s dysfunctional health care system falls short of the Conservative champion of the patient-centered system. Republicans should go beyond simply opposing bad liberal health care reforms and coming up with their own vision for reform. By now proposing a series of progressive conservative health care reforms, GOP lawmakers would increase their chances of success and provide a back-up plan should they fail again.

Proposing standalone amendments to the next Democratic social spending juggernaut would force Democrats in swing districts to choose between representing their constituents by backing popular proposals and following their party’s hardline leadership. Reforms may increase voters’ appetite for a more patient-centered healthcare system, in the same way that limited scholarship programs and limited charter school enrollment led to comprehensive legislation on the school choice. Here are some ideas:

• Continually expand access to telehealth services. During the pandemic emergency, Medicare waived site of origin and geographic restrictions. These regulations could be abolished permanently.

• Allow broader use of health savings accounts. These accounts allow patients to pay for personal expenses with pre-tax dollars, giving them more control. Legislation could increase contribution limits, unbundle accounts from high-deductible insurance plans, codify coverage for additional preventive care for chronic conditions, and classify direct primary care, in which the patient pays a fixed monthly fee to a doctor instead of an invoice for specific services, as an eligible expense. Medicaid and Medicare should also be allowed to reimburse and contract with direct primary care providers.

• Repeal rules that limit health insurance options. Allow Americans to purchase any health plan approved by their state insurance commissioner, including catastrophic coverage. Repeal the ACA’s employer insurance mandate, allowing more flexibility to help employees pay for health services. Codify Trump administration rules that loosen restrictions on how health care is reimbursed, association health plans, and short-term, limited-duration health plans.

• Codify state authority to implement work requirements and modest premium and cost-sharing requirements in Medicaid. This would involve repealing recent Biden administration actions and court rulings and giving states more flexibility to shift their Medicaid programs toward premium support solutions and direct subsidies and away from all-or-nothing coverage. , single.

At the state level, lawmakers are expected to propose similar health care reforms. They should codify pricing transparency requirements, remove barriers to telehealth adoption, allow small employers to pool resources to offer their employees group health coverage through community health plans, remove state restrictions on short-term and limited-duration insurance, allow alternative health benefits for membership-based organizations like Farm Bureau health plans, expand the ability of patients and physicians to use the direct primary care model, discourage frivolous lawsuits and unnecessary defensive medicine, enforce antitrust laws against the consolidation of health systems and plans, and strengthen competition by repealing the certificate of need, allowing providers to practice up to within the scope of their training and authorizing interstate medical licensing.

None of these reforms goes far enough on its own, and that is the point. Democrats have steadily increased the government’s role in health care through decades of incremental steps, culminating in ObamaCare. Republicans should use the same strategy to reverse course and empower patients over bureaucrats. Twelve years after ObamaCare was signed into law, repealing and replacing it remains the Republican goal. This will seem less risky to voters if it is preceded by successful steps in this direction.

Bobbie Jindal served as Assistant Secretary for Health and Human Services (2001-03), United States Representative (2006-08) and Governor of Louisiana (2008-16).

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