Now that Florida’s Judge Roger Vinson has ruled that the individual mandate in the new health care law renders the entire law unconstitutional, Republicans need to present their own suggestions for reform.
Judge Vinson’s opinion tied at 2-2 the score on challenges to President Barack Obama’s signature health-care initiative. Two district courts have upheld it, and two have found Congress exceeded its constitutional authority when it required individuals to buy health insurance, starting in 2014.
These cases will eventually go to the Supreme Court, which could toss out the new law during Obama’s presidency.
If this happens, Republicans need to fill the void, without the massive restructuring and federal sweep that characterized Obamacare.
Three committees in the House of Representatives — Energy and Commerce, Budget and Ways and Means — are working on an alternative health care proposal. How should it be structured?
Grace-Marie Turner, president of the Galen Institute, advises Republicans to take a step-by-step approach to reform. “The American people don’t want a huge overhaul law that tries to do too much all at once — whether it comes from Democrats or Republicans,” she told me.
Turner believes that in the short term, programs and spending should focus on getting rid of policies and regulations that are driving up costs. “Over the longer term, Republicans’ main job is to reset the incentives that are causing so many distortions in the health sector today,” she said.
One model system is the Federal Employees Health Benefits Program, which offers a variety of plans to federal government employees, including members of Congress. Every year, federal employees, depending on location, can choose from about 20 to 30 plans offered by a wide range of health insurance companies.
Possibilities include bare-bones, relatively inexpensive catastrophic health coverage, where people can pay for routine care out of pocket or out of a health savings account; health maintenance organizations, where all care is covered but limited to certain providers; or a more expensive fee-for-service plan, where more services are covered and the annual deductible is lower.
Under Obamacare, plans must include dental and vision care for children, mental health and substance abuse services, no copayments for routine care, and coverage of adult children up to age 26 on parents’ plans. Companies have to insure anyone who applies, regardless of medical history, with no dollar cap on lifetime coverage.
In other words, the government not only tells people they must have health insurance, but it also specifies unusually broad coverage by today’s standards.
Many of the plans available to federal employees would be disallowed under the 2010 Act, because they would fail to satisfy the law’s criteria for coverage. Oddly enough, this is not mentioned on the FEHB website. Information about the new law focuses on how to add “children” up to age 26. (www.opm.gov/insure/health/aca/)
The Department of Health and Human Services has granted over 700 Obamacare waivers to companies that offer less expensive plans with lower benefits. The department has been accused of favoring Democratic campaign contributors by granting to waivers to unions including the Service Employees International Union, the American Federation of Teachers and the United Food and Commercial Workers Union.
Even if no favoritism is involved, the need for waivers shows that it’s difficult for companies and consumers to comply with Obamacare’s provisions. More generous required benefits mean higher premiums, which causes hardship for enrollees.
Breaking down barriers to national competition in insurance is another small step that would enhance competition and give consumers more choices, just as consumers are allowed to buy goods and services from companies in other states.
Judge Vinson has ruled. Now Republicans need to take small steps up to the plate.
Examiner columnist Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute.