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January 16, 2017

Vice President-elect Mike Pence recently said “Our first order of business is to repeal and replace Obama care.” But doing so will be a perilous enterprise for Republicans!

The [Un]Affordable Healthcare Act passed Congress in 2010 with no Republican support -- passing the Democrat-controlled Senate as part of the budget reconciliation which only required 51 votes. Promises of you can keep your doctor, your health plan, and lower premiums were untrue. Few, if any, congressmen read the 1,990-page bill as evidenced by then Speaker Pelosi commenting, “[You] have to pass the bill so that you can find out what’s in it....”

The bill mandated that most businesses provide subsidized healthcare; with tax penalties to persons refusing to purchase it.  The Supreme Court upheld the law and ruled the mandated penalties were taxes. 

Obamacare failed miserably.  Coverage costs rose by almost 50% through 2016 with another increase of 25%-45% expected this year.   Many insurance companies participating in the exchanges were willing to accept new policies with losses in order to gain future market share and it was done with an expectation that rates would later significantly increase.

Meanwhile millions of policy holders lost their doctors and/or health care plan.  With huge losses incurred by insurers, only one choice for health insurance provider now exists in many states.  Apparently supporters didn’t read or comprehend the impact of the bill.  Existing health insurance programs, though not without issues, had worked for the vast majority of Americans.  The added mandates and taxes only added healthcare coverage for 5% of the population. 

One newscaster characterized it, “because of Obamacare's own internal flaws, it's sort of like a suicidal dying patient . . [Republicans] can make it die faster, but they can't save it.”  

The Act failed because it didn’t include tort law reform; ensure competition and because it didn’t address individual preferences and accountably.

As Congress starts the complicated process of repealing/replacing Obama Care, unity will be required.  Through the reconciliation process the financial parts of Obamacare can be eliminated.  But not so with the mandate that people get health insurance or face tax penalties.  This will impact millions of Americans.  Getting rid of the insurance mandate will take 60 votes in the Senate and it is unlikely Senate Democrats will join to eliminate this requirement.  They’ll then blame Republicans.

The Insurance Mandate chilled growth and employment opportunities as companies moved full time jobs to part time in order to avoid the insurance mandate.  If Congress votes to remove the requirement for small businesses to provide this now extremely expensive benefit, then employees will need to purchase their own; a reality which was created for political gain will also reach into the voting booth. 

The Republicans face an arduous task and may be blamed as they attempt to fix the legislative failure passed by Democrats in 2010. There’s an understanding among key Congressional leaders that a phase-out plan is the best solution but getting bipartisan support for it may be elusive.  

Mark and Bill, and John