Last Friday’s vote in the House to defund Obamacare in the continuing resolution was heroic, but it failed to meet the test of a successful military commander going into battle: Choose the “killing ground” and timing that favors your success, and make sure you have superior numbers (votes) and firepower (public support) to achieve victory.
The House continuing resolution will go to the Senate where, inevitably, Obamacare funding will be restored, and the measure will be sent to conference or returned to the House. What is the exit strategy for Republicans that can produce victory, short of shutting down the government, which may snatch defeat from the jaws of victory for 2014?
A successful strategy involves two distinct steps: First, the House should revise the resolution to focus defunding and Obamacare amendments on politically vulnerable, highly unpopular features of Obamacare, forcing the Senate to vote on whether to restore such gruesome elements of Obamacare. These would include:
• Defunding any role of the Internal Revenue Service in administering Obamacare or gathering medical and other data on citizens.
• Eliminating the exemption from Obamacare for members of Congress and their staffs illegally authorized by the Obama administration, which a recent poll by Independent Women’s Voice showed is opposed by more than 90 percent of voters.
• Eliminating funding ($15 million) for the Independent Payment Advisory Board, which has the power under Obamacare to cut Medicare benefits further without congressional approval.
• Eliminate Obamacare’s political-crony funding ($67 million) for La Raza, Organizing for America, Planned Parenthood, and other Obama Democrat partisan groups to serve as “navigators” to promote Obamacare to the public.
• Delay the individual mandate for one year, as Mr. Obama did (but illegally) with the employer mandate for his corporate cronies.
Forcing the Senate to take public votes on the record on the politically unpopular side of these issues will greatly aid Republicans in achieving what is necessary to really stop Obamacare — retaking the Senate majority in 2014. That would also restore our nation’s finances to “regular order,” which means funding by appropriations bills, not continuing resolutions that make the government vulnerable to shutdown.
Second, aggressive public education by congressional Republicans about the Republican-conservative alternatives to Obamacare would further aid Obamacare’s repeal, and restoration of Republican-majority Senate control next year. Reps. Tom Price of Georgia and Phil Roe of Tennessee have bills that would expand the current tax benefits for employer health insurance to everyone. Both would greatly improve incentives over current law, encouraging purchase of health insurance, but not only up to reasonable limits in costs.
This would cut the “umbilical cord” between employment and health care. Most Americans no longer remain with a single employer for a lifetime, so linking health care to employment no longer makes sense. Republican alternatives, recognizing this, accommodate health insurance “portability.”
Moreover, with health savings accounts diminishing “third-party payers,” consumers will pay directly for the “tires, batteries and lube jobs” of health care, and become “cost conscious” consumers, buying health insurance as we do car insurance, for catastrophic events with a deductible. Deposits in health savings accounts not spent on health care could be withdrawn tax-free without penalty, which would greatly strengthen incentives not to waste money on health care when not necessary. The poor could also choose these accounts for their Medicaid coverage.
Replacing Obamacare, the proposals by Mr. Price and Mr. Roe would also eliminate more than $1 trillion in Obamacare tax increases over 10 years, cutting the now current capital-gains tax by 16 percent. Repealing the individual mandate would constitute another “tax cut,” freeing families to choose their own health insurance rather than having Health and Human Services Secretary Kathleen Sebelius impose her choice on them. Repealing the employer mandate would end employer incentives to create part-time jobs to avoid the costs of Obamacare. By repealing and replacing Obamacare, both bills would also eliminate all of the outrageous Obamacare provisions mentioned above.
Mr. Roe’s proposal would also address pre-existing conditions by making health insurance guaranteed issue for anyone with continuous coverage, which is feasible and workable on that condition. It would also provide federal funding to help states set up high-risk pools, which would cover the uninsured who became too sick to buy new coverage in the market, which Mr. Price’s bill supports as well.
Both plans would capture the public imagination as far superior to Obamacare by providing for a universal health insurance tax credit of roughly $2,500 per person, available to everyone, including the poor. This can earn a Congressional Budget Office score of universal coverage, unlike Obamacare, which shortchanges its most ardent supporters by leaving 30 million uninsured 10 years after full implementation. Moreover, the credit would provide equal health-insurance tax benefits for everyone.
Finally, the poor would benefit greatly, with a savings of $1 trillion to $2 trillion over 10 years, if both plans block-grant Medicaid to the states, where the poor would be far better served for less.
The public would overwhelmingly support such Republican health care alternatives as vastly preferable to Obamacare. What a resounding reversal that would be in the public’s appraisal of President Obama and his legacy.
Lew Uhler is president of the National Tax Limitation Committee and Peter Ferrara is a senior fellow at the National Center for Policy Analysis.