By Holman W. Jenkins, Jr
Republicans are the only ones who can fix President Obama’s broken promise now.
The problem is simply stated. Millions will be losing their individual insurance policies that they were promised they could keep. They will be expected to buy more expensive ObamaCare-approved policies than they want or need, and to do so from ObamaCare exchanges that aren’t working.
Mr. Obama’s fix, which he proposed on Thursday and which was quickly debunked by the insurance industry and its state regulators, can’t work because Mr. Obama can’t let it work. He has to fight to preserve the central purpose of ObamaCare—to use the individual mandate and ObamaCare’s compulsory benefit list to capture money from unwilling buyers of ObamaCare’s gold-plated insurance policies to subsidize others.
Let’s understand: The stumbling block to fixing Mr. Obama’s broken promise is Democrats clinging to the central redistributive scheme embedded in ObamaCare. There is no reconciling the two.
Americans are beginning to understand that the essence of the Affordable Care Act is that millions of people are being conscripted to buy overpriced insurance they would never choose for themselves in order to afford Mr. Obama monies to spend on the poor and those who are medically uninsurable due to pre-existing conditions. Both Mr. Obama and Republicans are blowing smoke in claiming that the damage done to the individual market by the forced cancellation of “substandard” plans (i.e., those that don’t meet the purposes of ObamaCare) can somehow be reversed at this point. It can’t be.
What can be done is Congress creating a new option in the form of a national health insurance charter under which insurers could design new low-cost policies free of mandated benefits imposed by ObamaCare and the 50 states that many of those losing their individual policies today surely would find attractive.
What’s the first thing the new nationally chartered insurers would do? Rush out cheap, high-deductible policies, allaying some of the resentment that the ObamaCare mandate provokes among the young, healthy and footloose affluent.
These folks could buy the minimalist coverage that (for various reasons) makes sense for them. They wouldn’t be forced to buy excessive coverage they don’t need to subsidize the old and sick.
If this idea sounds familiar, it was proposed right here three years ago, after the 2010 elections in which Democrats lost the House due to public disquiet over ObamaCare.
Because such a move could be sold as expanding the options under ObamaCare and lessening the burden of an unpopular mandate, it always had potential to draw Democratic support. That’s doubly true now that Democrats are saddled with President Obama’s promise that anybody who liked their existing insurance can keep it. Mr. Obama’s promise is not literally keepable but the national charter would be the next best thing, letting millions find policies that are a good deal for them in their particular circumstances.
And, yes, this would also blow up the disingenuous financial engine of ObamaCare. This is a feature not a bug.
The ObamaCare exchanges would devolve into refuges for those who are medically uninsurable. But this seems increasingly likely to happen anyway. Having assumed the job of subsidizing the people, the federal government should do so honestly and openly and efficiently.
ObamaCare is dead on the vine. It becomes clearer by the day the only way insurers can make the Obama benefits package work at a monthly premium affordable by healthy people who don’t qualify for subsidies is with massive deductibles and copays. ObamaCare’s individual mandate, as philosophically odious as some find it, would survive. An admirable principle buried in ObamaCare—that subsidies should be reserved for the needy—would also survive.
What wouldn’t survive is the Democratic scheme to force everyone, regardless of age and actuarial risk, to buy a gold-plated package of benefits that will stimulate a wasteful race to spend more resources on health care. And, down the road, by reforming ObamaCare, much else could be reformed, including Medicare and the ill-begotten and destructive link between employment and health care.
This outcome will shock liberals who have single-payer sugar plums dancing in their head right now. Let’s leave them with one thought.
The government-run systems you so admire in other countries mostly came about long ago. They came about to expand access to medical care at a time when medical care couldn’t do all that much for people. We live in a different age. America, let’s face it, would be embarking on a single-payer system not to expand access—though that slogan would be used—but to deny and limit care in order to control runaway spending.
Liberals, you think you want to go there but you don’t.