- - Monday, December 5, 2016


With their vow to repeal and replace Obamacare, President-elect Donald Trump and the Republicans have ventured onto thin ice. The dismal fate of the Democrats who preceded them onto the ice, and breaking through it, is a cautionary tale about the consequences of not keeping promises. Come Inauguration Day, the nation’s new leadership had best hustle past the health care hazards lest they take an icy bath, too.

Mr. Trump’s choice of a physician, Dr. Tom Price, to run the U.S. Department of Health and Human Services, is a promising beginning. It’s the common-sense approach to government that Americans expected when they elected the billionaire businessman to the presidency. An orthopedic surgeon and a Georgia congressman, Dr. Price combines knowledge of the healing arts with an experienced perspective on what’s wrong in Washington.

An Obamacare makeover is just what the doctor ordered. Dr. Price’s longstanding replacement legislation, the Empowering Patients First Act, can be the initial blueprint. It calls for ending Obamacare as a government mandate and substitutes an array of private insurance plans. Buyers can buy one that best suits them. Forcing Americans to buy a policy that some can’t afford and others don’t want — or pay a penalty — is fundamentally wrong. To trick the public into buying into socialized medicine demonstrates a fundamental blindness in the party’s governing philosophy.

Obamacare currently requires applicants for federal subsidies to undergo an intrusive process of government verification of financial eligibility. The Price plan would instead provide families with refundable tax credits amounting to $4,000 annually for a couple who files a joint tax return, plus $500 for each dependent, which would help offset the cost of health insurance.

In contrast to President Obama’s broken Obamacare promise that “if you like your health care plan, you can keep it,” a substitute plan would enable the 155 million Americans who are satisfied with their employer-provided insurance to stick with it. Those without that option could join pools that boost their purchasing power in an open marketplace encompassing all 50 states, not just the state where they live.

The greatest challenge to a health care do-over is how to provide affordable insurance for those with pre-existing conditions. Left to the mercy of the free market, their premiums are sky-high now and likely to go higher. Together with the insured pool with low-risk policyholders, they drive up everyone’s costs toward unaffordability. The deal-making president will need his A-game to find a solution Americans can live with.

The new Trump administration must eliminate Obamacare provisions that use taxpayer money to bail out insurance companies in the Obamacare exchanges for their losses. A federal district court has ruled such payments unlawful — without the proper appropriation by Congress, Team Obama has essentially pilfered $5 billion from the Treasury to pay back the insurers. With a congressionally authorized financial bridge back to a competitive business model, companies must resist government tampering in the marketplace in return for sketchy promises of guaranteed sales.

Mr. Trump should not expect much help from Democrats, who vow to resist all efforts to replace Obamacare. This despite the president’s scheme having plunged the party to its lowest ebb in public esteem in generations. The way for Republicans to ensure they don’t follow them is to produce a replacement plan that enables all Americans to choose the health care coverage that is right for them. To get that done Dr. Price and the party must be ready to move with speed before the ice cracks around them, too.

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