A thoughtful article by a Senator

Ben Sasse is a Senator from Nebraska, but not one of the Senators one hears a lot about; I had barely heard of him. But a column he wrote on the online Web site of the National Review, entitled “The Three Republican Camps after King v. Burwell,” is so good that I need to display it.

In the wake of the Supreme Court’s disappointing King v. Burwell decision, many are asking what comes next for those of us who have opposed Obamacare as a disastrous federalization of American health care.

I predict that the Republican party will quickly divide into three camps on health-care politics:

1. There are those who will want to throw in the towel. They will say it is time to move beyond the fight for repeal and admit that Obamacare is here to stay. They will condescendingly shake their heads at us unsophisticated conservatives, claiming that the only constructive path forward now is to make our peace with Obamacare, and to try to make it 12 percent less bad.

2. At the other extreme, there will be those who remind the first camp that no voter sent us to Washington to be slightly more efficient central planners than the Democrats. We are not here to sweep the floor of the Titanic by modestly adjusting Democrats’ unaffordable entitlement expansions. They will insist that we should invest 100 percent of our efforts in repealing Obamacare, and stop there. Even though the president would veto all repeal attempts (presuming such efforts could even clear the Senate), forcing such vetoes is necessary to remind voters where each party stands and thus why the 2016 presidential election is so crucial to America’s future.

3. Finally, there are those who — while remaining committed to full repeal — believe that there is no viable political pathway to repeal without simultaneously outlining our replacement plan. And then actually winning voters to support that vision. This group recognizes that it has a harder messaging job than the other two camps but believes that actually getting rid of Obamacare — rather than just romantically fighting lost causes — requires admitting that you cannot beat something with nothing. I propose that we name these three camps: the Fix-It Caucus; the Repeal-Only Caucus; and the Replacement Caucus.

Actually, I do not know of many Republicans that will join Sen. Sasse's “Fix-It Caucus.” But this is, of course, the direction that the Democrats are trying to push the Republicans to go.

To the Fix-It Caucus, I say: There is no way to sufficiently improve the command-and-control foundations of Obamacare, because it starts with the flawed (and unconstitutional) demand that Americans buy only the full-service insurance-and-redistribution products that Washington’s empowered bureaucrats compel us to buy. If the Beltway class’s Greek-style overspending is ever to be restrained, it will be accomplished only by giving the central planners even more power over rationing access and setting prices for drugs, devices, and procedures. The central planners’ answer to imperfect central planning is always more power for the central planners. Their answer is never more freedom. We ought not go down this road with the Washington-always-knows-best authors of Obamacare.

To the Repeal-Only Caucus, I agree that we should indeed use every available means — including reconciliation — to fully repeal Obamacare. But we must admit something else as well: American health care wasn’t healthy before Obamacare. And thus that even though the public disapproves of Obamacare (by an average of eight percentage points, according to Real Clear Politics), large portions even of Obamacare’s opponents are not persuaded by a repeal-only message. A family’s desire to be able to keep its health insurance when changing jobs or geography (a problem that Obamacare doesn’t make any better, by the way) is perfectly reasonable. We should acknowledge it and advance that cause.

So count me in the third camp.

And I would say the same for myself: “count me in the third camp.”

We must make the 2016 election a referendum on Obamacare vs. an understandable, common-sense, patient-centric alternative. We need a 2016 presidential nominee who can not only prosecute the case against Obamacare, but who will also enthusiastically champion the conservative cause of putting families in control of their own health futures. An exclusively negative set of talking points is a path to a dead end, both on Obamacare and in the 2016 presidential election.

Democrats have long held an advantage over Republicans on health care, mostly due to a perceived empathy problem in my party. But Obamacare has been such a train wreck that this Democratic advantage is mostly gone today. Obamacare is not popular. It’s going to be less popular than ever by Election Day 2016.

So here is the good news: The American people might finally be ready to listen to Republican ideas on health care. But they’re not looking for us to only say no to Obamacare — although that remains part of our task. They want us also to be for actual health-care reform that empowers families, expands choices, and comes with an honest budget.

We owe them that much this time.

Let’s remember how we got here: It was not simply that President Obama had a bad idea on health care and Democratic majorities in Congress. Obamacare arrived also because Republicans failed to persuade the public that we could address the avalanche of problems government had already created by decades of interfering with the health-care market. As a result, Obama filled the vacuum while Republicans appeared not to care. We cannot make that mistake again.

Beginning now, presidential contenders must present a constructive vision for health-care reform. It should be a minimum requirement that any candidate worthy of consideration must have a coherent plan for the voters. The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017. If Republicans fail to offer compelling alternatives to Obamacare in the 2016 campaign, we will lose — and we will deserve it.

The only point where I might differ from Sen. Sasse is that he says “The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017,” and I might say that “The primary election for Republicans is mostly about what vision of a replacement for Obamacare …” Obamacare is, I think, the #1 issue on which we need to fight the 2016 campaign.

The danger for Republicans over the next year is that the circular firing squad so dominates the conversation that the media latches on to a “There they go again, Republicans infighting” narrative, and then the third group — the Replacement Caucus — is never heard.

There’s an election here to be won, but there are no shortcuts. We have to do the hard work of making the case one voter at a time. Fixing Obamacare certainly is not the solution. And neither is being the “Party of No.” That will simply turn off the swing voters we need in order to put a conservative in the White House who can repeal and replace Obamacare.

We have an opportunity here, but let there be no more talk of waiting until some future date to produce the Republican health-care alternative. Now is the time.

Your move, 2016’ers.

I like what Sen. Sasse says. I would nearly totally agree with his points. And in particular, the Republicans need to come up with ideas for a better way to do health care.

Incomprehensible!

Yesterday the Supreme Court ruled on King v. Burwell, and all I can say is that, since they are the final arbiter, their decision has to be accepted as law. Apparently, Chief Justice John Roberts has decided that the Court will not decide on the basis of what is actually written in the law, but rather on what the apparent intent of the majority of the members of Congress who voted to pass it was.

Since ruling the other way would have made “Obamacare” unworkable, the Court has kept it alive for now by its ruling. And this means that it certainly will be alive for the remaining year and a half of Barack Obama's term as President, since he will veto any attempt to revise it. Which makes the election of a Republican in next year's election even more important than it would have otherwise been.

This is not the worst decision ever made by the Court — that would probably be Plessy v. Ferguson or Dred Scott v. Sandford — but certainly, I think it is one of the bad ones. But this is a nation of laws, and the Supreme Court is the supreme interpreter of what the laws mean, so for now we have to live with it. And since it is not a Constitutional decision, but only a ruling on the meaning of an Act of Congress, it can eventually be changed by a new act; it doesn't require amending the Constitution, as the Fourteenth Amendment was the only way to counteract the Dred Scott decision.

President Obama has no right to control what cases the Supreme Court considers!

According to a report by The Associated Press,

President Barack Obama says the U.S. Supreme Court probably shouldn't have taken up the latest challenges to his signature health care law.

Obama says there was no reason for the health program to end up in court, maintaining that “it's working.”

The high court is expected to decide soon whether Congress authorized federal subsidy payments regardless of where people live, or only for residents of states that created their own insurance marketplaces.

The decision could have far-reaching implications because millions would lose their insurance if the court said people who enrolled through the federal site couldn't get the subsidies.

Obama says it has been well-documented that Congress never intended to exclude people who went through the federal exchange.

Obama commented Monday in Elmau, Germany, at the conclusion of a summit.

The President seems to feel that any challenge to the way he does business to accomplish his goals is unjustified. Well the news for President Obama is that thuis is a government of laws. The President does not have the power to rewrite a law, just because it is worded in such a way that the President's goals atre not met, in order to make it work the way he wants it to.

Obamacare's failure

A column on the Real Clear Politics site, by Jack Kelly, dated June 7, 2015, entitled “Spare Us From Obamacare,” makes very interesting reading. So I reproduce it here.

The Affordable Care Act isn’t.

Some major health insurers seek eye popping rate increases for 2016 — such as 25 percent in Oregon, 30.4 percent in Maryland, 36.3 percent in Tennessee, 51.6 percent in New Mexico.


Insurance commissioners won’t approve all companies ask for. Rates will rise modestly in some states. But the odds are your premium will cost a lot more next year.

Premiums for non-group policies rose 24.4 percent more last year than they would have without Obamacare, said the National Bureau of Economic Research. Premiums in this market rose more after two years of Obamacare than in the eight years preceding, said eHealth Insurance, a private health exchange.

Despite subsidies for the industry of at least $16 billion, many insurers lose money. Far fewer individuals signed up for Obamacare than expected (and the administration claimed). Those who did are older and sicker.

“Only about 40 percent of those eligible eventually signed up after two full open-enrollments,” insurance expert Robert Laszewski told the Washington Examiner. “Carriers need more like 75 percent.”

Subsidies for insurance companies mask the true cost, said Stephen Parente, director of the Medical Industry Leadership Institute. Unless reauthorized in 2017, premiums for the cheapest plan could rise nearly 100 percent for individuals, 50 percent for families, he said.

That’s on top of sky-high deductibles. The average deductible for the cheapest Obamacare plan is about $5,180 for individuals, $10,500 for families — four times the IRS threshhold for a “high deductible” plan.

The column then cites an example of why Obamacare hardly qualifies as useful insurance:

Patricia Wanderlich, who suffered a brain hemorrhage in 2011, skipped the brain scan she should have every year because her Obamacare policy has a $6,000 deductible.

“To spend thousands of dollars just making sure (her aneurysm) hasn’t grown?” Ms. Wanderlich told The New York Times. “I don’t have that money.”

The column then goes on to cite some interesting statistics:

About 25 percent of non-elderly Americans with private insurance can’t afford to pay a mid-range deductible ($1,200 for individuals, $2,400 for families), The Wall Street Journal said in March.

People with a policy they can’t afford to use are no better off than the uninsured. Which may be why — despite the threat of fines — so few without insurance signed up for Obamacare.

About 75 percent of those who did are subsidized. Subsidies could end for people in 36 states if later this month the Supreme Court rules for plaintiffs in King v. Burwell.

We have, of course, already discussed this case, but the column makes a good reminder of what it entails:

As written, the ACA permits subsidies only for insurance purchased on exchanges “established by the state,” plaintiffs note.

That was a drafting error, politicians told New York Times reporter Robert Pear. Not true.

The words “established by the state” appear nine times in the ACA. No “drafting error” is repeated that often.

And finally, in summary:

Nearly every promise Democrats made has been broken. The average family pays more (some much more) for insurance, not $2,500 less. About 9 million Americans (so far) have learned they couldn’t keep the health plans they had if they wanted. Or some of their doctors.

Federal spending for health didn’t go down. It’s zoomed upward. So have emergency room visits. Overhead costs are exploding.

The Congressional Budget Office estimates that Obamacare will lower full-time employment by 2.3 million in 2021, compared with what might have been without reform.

The ACA has hurt millions more than it’s helped. The worst is yet to come. President Barack Obama delayed or altered (mostly illegally) unpopular provisions at least 50 times. If they’re implemented fully, up to 100 million who get insurance from their employers could have their policies canceled, the American Enterprise Institute has estimated.

As premiums and deductibles rise, and the job-killing employer mandate goes into effect, a “death spiral” — begun because so few healthy people have signed up — will accelerate. If the Supreme Court rules the ACA must be enforced as written, it would be a mercy killing.

Why so many?

There certainly seem to be a lot of Republicans contending for next year's nomination for the Presidency. Some people are expecting as many as twenty to declare, and already there are so many it's hard to keep track. While the polls seem to give the edge to either Scott Walker or Jeb Bush, a lot can happen between now and next year's convention. But why so many? I can't recall there ever being such a large field of contenders.

It's not that hard to figure out. Barack Obama has become one of the most unpopular Presidents in history. While a popular President can anoint a successor (witness the fact that Ronald Reagan was able to pull in enough voters to the Republican side to elect George H. W. Bush, even though Bush was not a very charismatic campaigner), an unpopular President serves to recruit votes to the opposite side. Many people will be voting Republican just to say we need a change from Obama. So a prospective Republican nominee has a good chance to win the Presidency in 2016.

And that's a good thing. It is really necessary to undo the damage that the years of Obama's Presidency have caused — to our economy, to our foreign standing, and in other ways. And certainly Hillary Clinton would not undo that damage; her proposals in the health care area, for example, out-Obama'd Obamacare. (As a candidate, Obama opposed — and Clinton proposed — some features that are the most objectionable in Obamacare, like the mandates.)

Returning to the blogging scene (continued): The Supreme Court cases

Getting back to blogging, there are not a lot of things that can be discussed at the moment, which is part of the reason I have not been active the past few months. There are two pending Supreme Court cases which I think are very important: King v. Burwell, which could throttle Obamacare if it is decided on the plain language of the statute, and Obergefell v. Hodges, which might lead to gay marriage being recognized nationwide. But until June, the Supreme Court is keeping silent on how they will rule. And yet, the Justices have likely made their decisions already, so nothing I say can do much. (Of course, I doubt my blog is being read by any Supreme Court Justices, but one can only hope!). And besides these cases and the 2016 election, which I discussed yesterday, it's hard to come up with a topic to discuss. But I will try.

Two years of inaction?

While President Obama's press conference on Wednesday seemed to be positive — and I said so in my post the next day — I fear that we will not see action to help the American people in the next two years. In the press conference, the President was asked some specific questions, and among them was one about whether he could sign legislation that eliminated the individual mandate. He explicitly answered:

“The individual mandate is a line I can’t cross because the concept, borrowed from Massachusetts, from a law instituted by a former opponent of mine, Mitt Romney, [he] understood that if you’re providing health insurance to people through the private marketplace, then you’ve got to make sure that people can’t game the system and just wait until they get sick before they go try to buy health insurance”

Of course, mentioning Mitt Romney was a gratuitous attempt at phony bipartisanship. Romney signed the Massachusetts law as a compromise with a legislature that was 85% Democratic. And it does appear that at the time he was convinced that it was necessary to prevent gaming the system. He has stated that this is an issue that should be addressed state-by-state, and if he had been elected President he would have signed an authorization for any state to opt out.

By making such statements, Pres. Obama has made it likely that there are important areas that he will not compromise on. And some of these will be necessary to compromise if any business can be done.

The Supreme Court will hear King v. Burwell!

The Supreme Court has decided that they will hear King v. Burwell. When two different appellate courts originally ruled in opposite ways on the language in the Affordable Care Act that says subsidies can only be paid in states that have established their own exchanges, it looked as though the Supreme Court would get to rule on it. But then the court that had ruled against the Administration's interpretation, in Halbig v. Burwell reversed itself in an unusual procedure where the decision of a three-judge panel was overruled by the full court, there was no longer a diversity of appellate court decisions, so the Supreme Court might not have heard the case. However, the Supreme Court announced yesterday that the King v. Burwell case will be taken up.

How anyone can believe that words as specific as “exchange established by a State” can include an exchange established by the Federal Government because a State chooses not to do so escapes me. The original decision in Halbig makes sense; its overruling — and the King decision — was simply an attempt by partisan judges to save the Act no matter what. And the Supreme Court is acting sensibly here, and I compliment the Justices who chose to take up the case.

Will he be willing to compromise?

Yesterday President Barack Obama addressed the nation at a news conference. He said some good things about how he has heard the message of Tuesday's election and how he wants to work with the Republican leaders in Congress to get things done. If he acts as he spoke, good. I wonder, though, whether he will really be able to work with Congressional Republicans. Certainly, he has not shown any willingness to address Republican concerns in the past six years.

One thing that I think was apparent is that Pres. Obama is more willing to work with Senate Republican leader Mitch McConnell — he even referred to sitting down for a drink of Kentucky bourbon with him — than with Speaker of the House John Boehner. He never issued a word of praise for Boehner, and only referred to him in conjunction with McConnell as leaders of the Congress. It has become clear over the years that both Obama and Boehner dislike each other immensely, and McConnell will have the major role of finding something they all can agree on.

But again, the question is how much common ground can they find. The President already ruled out some of the changes to Obamacare that the GOP obviously wants. How much more has he ruled out? We can only wait and see.

Election results -- I'm very happy

When I went to vote yesterday, I was certain that nobody I voted for would win — I'm in such a blue state that I didn't really think Larry Hogan would win the Governorship even in such a Republican year. But at least it looked good for the chances of people in other states voting in new Republican Senators, and I was eagerly awaiting the Senate results.

I woke up today to find that my expectations for the Senate were fully met — it looks like the GOP will have at least 52 Senators, and the three states which are undecided could all go Republican as well, so we might end up with 55. (In Alaska, though 100% of the votes are in, for some reason they haven't called the state, though Dan Sullivan seems to have a clear plurality there. Louisiana had a plurality for the Democrat, Mary Landrieu, but their law calls for a runoff when there is no absolute majority, and Bill Cassidy could still pull it off. Only Virginia seems a close call, with Democrat Mark Warner leading Republican Ed Gillespie, so that seat was likely to end up with the Democrats.) When all is said and done, it looks like a 53- or 54-member Republican caucus. And the President is forced to settle for only those accomplishments in his last two years that he can accomplish by executive order. Unfortunately, he does have the negative power to veto, so Obamacare will not be replaced by a more sensible approach to health care reform in the short term. But his ability to further wreck the economy and hurt the country's direction will be restricted.

But the icing on the cake for me was that Larry Hogan won! I have been conceding that Anthony Brown would be our next Governor whether I wanted him to be or not, so seeing Hogan win was a pleasant surprise. It seems that whenever the Maryland Democrats nominate for the Governorship a sitting Lieutenant Governor after a Governor is term limited, then the Republicans can win. I strongly supported Hogan's bid, but never expected it to be successful. So this has been a happy election result for me.

Thoughts about a candidate: Ben Carson

He is not mentioned in most of the polls I see, but apparently Ben Carson is considering a run for the Presidency. Whether he actually does become a candidate or not, I cannot predict, but I do have some thoughts about him.

First, other than Obamacare, about which he has spoken up loud and clear (even with President Obama in the room!) I don't know where he stands on the issues. It's clear to me that he might make a great Secretary of Health and Human Services in a Republican administration, or perhaps Surgeon General. I'm less sure about what he would be in the Presidency. He has no background in foreign policy, military affairs, or economic policy. Can he lead in those areas? I have no idea.

I'm not excluding him. And it might yet be that once I've heard him campaign I might like him. But right now I have serious questions about his qualification for the office.

A great day for foes of Obamacare

The Court of Appeals for the D. C. Circuit has issued a ruling in the case of Halbig v. Sebelius, which says that the subsidies in the Affordable Care Act (a. k. a. Obamacare) can only apply in states that have created their own exchanges, a clear interpretation of the plain language of the Act, which makes total sense. Meanwhile, the 4th Circuit, in the case of King v. Burwell, has ruled the opposite way. When two appeals courts have issued rulings so sharply in conflict, this guarantees that the Supreme Court will get to settle this. If Halbig is sustained by the Supreme Court, many other parts of the Act will fail to apply in all those states which use the federal exchange. So this could send Obamacare crashing down.

It's a case of bad drafting, because the Congress and President Obama were in such a hurry to force this down the throats of the American people. If they had been willing to work things out, and not dismiss the Republicans' efforts to change the plan, perhaps a clearer bill would have passed, but it might not have met Obama's demand to give health care that covers certain things to everyone whether they want it or not. Of course, that would have been a better bill, though Obama would not have liked it as much. But now he may be left with such a mess that the Act will have to be repealed and the government will start over. And that is good news.

Hobby Lobby, mandates, and the right way to do insurance

The big problem that led to the Burwell v. Hobby Lobby Stores case is the decision by the authors of the so-called Affordable Care Act, a. k. a. “Obamacare,” to rely on compulsion, rather than assistance, to achieve its goal — and, of course, having the wrong goal: universal coverage, rather than coverage for all who want it. Since it mandated employers’ provision of insurance, it had to determine what was required to comply, and having some people set up minimum requirements that conflicted with others’ religious scruples is what caused the conflict that Hobby Lobby was all about.

Now, suppose that the goal was, as I think it should be, coverage for all who want it rather than universal coverage. Then nobody would be penalized with fines, either for failure to provide coverage or for failure to enroll. If a person’s employer did not provide coverage, or the person was unemployed, the government would provide a subsidy that can only be used to purchase health insurance. The amount of this subsidy could be keyed to income, of course. If a person’s employer provided coverage, but this coverage did not include something the government deemed essential, the government would provide a subsidy to enable the person to buy a supplemental policy that would cover those conditions and products that the government deemed essential but the employer-provided insurance policy did not cover. (Thus none of the Hobby Lobby-type conflicts.)

Some raise the argument that with the elimination of limitations on coverage for pre-existing conditions, people will decline to buy insurance until they are sick. There is an easy fix to this, which does not involve fining people. Simply use a rule similar to the one that parts of Medicare have: If you were eligible for insurance but did not choose to buy it, when you do buy it you will be liable for an increased premium.

Can anyone find fault with this way of doing it?

Telling Boehner to pass laws

Yet another person has written a post saying: “Dear Speaker Boehner: Do your job instead.” That was the actual title of a post by Sally Kohn of CNN. Of course, she is described as a “progressive activist, columnist and television commentator.” And so as far as she is concerned, President Obama is just doing his job. She does not see him as violating law after law passed by Congress and the Constitution he was sworn to “preserve, protect, and defend.” She has no problem with his executive orders, which she points out were fewer in number than those of “Theodore Roosevelt, Dwight Eisenhower, Ronald Reagan, and President George W. Bush.” What she does not point out was that their executive orders were in conformity with law and the Constitution. They never issued orders directing that laws duly passed by Congress — such as our immigration laws and even the “Obamacare” law that he considers his pride and joy — not be fully enforced.

And what is most amazing is her directive to John Boehner to “pass laws to help rather than jeering from the sidelines and rooting for America to fail so you can blame it on President Obama.” John Boehner would like to “pass laws to help,” but he knows that anything his House passes will be shot down by the Senate.

Let us give an example. Kohn refers to a jobs bill that did pass the House. She of course derides it by saying,

You assert that you have passed jobs bills that President Obama and the Democratic Senate are ignoring, but frankly the word “jobs” as you use it there is questionable. Your “jobs” bills include legislation to repeal Obamacare, through which 20 million Americans now have health insurance, cut food stamps for poor Americans and reduce government regulations on fracking.

Meanwhile, President Obama proposed an actual jobs bill that would have created construction jobs to modernize our deteriorating roads and airports, provided tax credits for employers that hired returning veterans, extended unemployment benefits, which also spurs spending, and cut payroll taxes for 98% of American businesses. But that jobs bill was killed by Republican opposition in Congress.

Which approach would have actually created jobs? Clearly, Kohn thinks the second. But repealing Obamacare, in fact, would create millions of jobs, simply because employers are not now hiring people due to the onerous burden that Obamacare places on them. Reducing government regulations of fracking would create jobs in the petroleum industry. And on the other hand, extending unemployment benefits encourages people who might look for work not to. Boehner's bill would have created jobs; Obama's would not. All I can say is, Sally Kohn, you don't know what you're talking about.

Kohn wants Boehner to pass bills, but not bills that would actually help the country; she wants Boehner to pass bills like Obamacare — which she has the gall to describe as a good thing! — to hasten the president's destruction of our economy. But then, what can you expect of a “progressive activist, columnist and television commentator”?

The news from Florida… and what it means for Obamacare

Tuesday there was a special election in Florida. A Republican member of the House of Representatives, Bill Young, had died and his seat was being filled, but the district in fact had been trending Democratic. President Barack Obama had won the district twice, as had the most recent Democratic candidate for Governor of Florida, Alex Sink. And this same Alex Sink was the Democratic candidate for the House seat to be filled, so she didn't need to build name recognition. And the Republican candidate, David Jolly, was a former lobbyist (a fact that his opponent used against him) with no history in politics, and who had weathered a divisive primary. So by a lot of lights, Sink was favored to flip this seat and turn it “blue.” This in fact was predicted by such as Sean Trende, even though he considers this a Republican year, and has predicted that the Republicans will take over the Senate.

So what should we conclude? Trende had said before the election was complete that this single election means little, and afterwards has not changed that point of view. But really, given all that was going in Alex Sink's favor, I think one thing is certain: it is poisonous to be associated with “Obamacare.” She was not even there to vote for it, but merely defended it in her campaigning. And David Jolly made attacking “Obamacare” the cornerstone of his campaign. This has to mean something. And certainly in the elections where Democratic incumbents are up for re-election, who actually voted for “Obamacare” in Congress, this will be used against them. I think this Noveber will be a good day for Republicans.

More on health care reform

Democrats have assailed Republicans for wanting to “repeal and replace” the so-called “Patient Protection and Affordable Care Act,” usually known as “Obamacare,” but not having any plan for the replacement: in other words, Republicans are accused of being willing to “repeal” but only giving lip service to “replace.” Well, a couple of weeks ago, I read of a plan by Republican Senators Richard Burr, Tom Coburn, and Orrin Hatch that would replace “Obamacare.” As described in that article (see my January 29, 2014 post entitled “Reforming health care”) the Burr/Coburn/Hatch plan had some flaws, but recently I saw an editorial in The Washington Post that gave a description that differed from the one I saw last month. (The Post did not like the Burr/Coburn/Hatch proposal; it called it “a starting point for a conversation, not a replacement”; but that's another matter — for one, the Post seems to think that mandates are a good idea!) The original article I saw last month said that Burr/Coburn/Hatch would not require insurance companies to cover people with pre-existing conditions, but only grant the companies incentives, while the plan described in the Post editorial would require this coverage; and there was no mention in the earlier posting of replacing the individual mandate by a plan similar to what Medicare Part D has — allowing the insurance companies to charge a higher premium to people eligible for coverage who chose not to buy insurance (which I think is the best way to sove the problem of people signing up only after they become sick), but the Post editorial says that Burr/Coburn/Hatch has such a provision. I don't know whether the first posting was in error, or the Senators involved modified their proposal, but if the Post editorial is correct about those two provisions, Burr/Coburn/Hatch becomes a plan I can support pretty much unreservedly.

It is going to be a major slog trying to get something like Burr/Coburn/Hatch passed, of course. The Senate is still dominated by Democrats, though in November an election is coming up that may — probably will — change that; and President Obama is on track to veto any bill that destroys his “masterpiece.” But this blog will favor the implementation of Burr/Coburn/Hatch or something like it, and you are likely to read more here in the future.

The REAL effect of “Obamacare”

The Congressional Budget Office just came out with a report on the effects that “Obamacare” will have on the economy and on the health insurance status of the American people. As reported by John Podhoretz in the New York Post, it's not so good. On page 111, it says:

As a result of the ACA, between 6 million and 7 million fewer people will have employment-based insurance coverage each year from 2016 through 2024 than would be the case in the absence of the ACA.

That's fewer! So, people may say, “That's not so bad; people will pick up their insurance on the exchanges, and this will lead to more coverage altogether.” But the report also says:

About 31 million nonelderly residents of the United States are likely to be without health insurance in 2024, roughly one out of every nine such residents.

Now note that when President Obama was selling “Obamacare” to the American people in September 2009, he said:

[T]here are now more than 30 million American citizens who cannot get coverage.

So in 2024, we will have approximately the same number of uninsured Americans as we has in 2009! All this tampering with the health insurance of millions of Americans, merely to tread water?

Read Podhoretz's column. It's illuminating.

Reforming health care

Of course, in his State of the Union address, President Obama touted his signature health care plan. And he even pointed to one of its successes: a woman who was uncovered until January 1, and shortly afterward was able to have a serious surgical procedure that was covered because of an “Obamacare”-based policy. He didn't mention its much larger failures: millions of people who had been covered, but lost their coverage because their plans were not in compliance with requirements put in place by “Obamacare” to cover this or that or the other thing. One person that often has been cited is retiring Senator Tom Coburn, of Oklakoma, who is retiring in part because of a cancer he has, and no longer has insurance that covers his cancer specialist — though, a physician himself, he is rich enough to continue to pay this doctor out of his own pocket!

Mentioning Sen. Coburn is particularly apropos, because he is one of three Senators (the others are Orrin Hatch of Utah and Richard Burr of North Carolina) who have come up with a plan they would like to see replace “Obamacare.” There is a column by Avik Roy on Forbes Magazine's site which advocates the Coburn/Burr/Hatch plan as the best alternative to replace “Obamacare,” and, while I'm not certain I approve of all its provisions, it deserves consideration.

I think that the CBH plan does not go far enough in keeping the “Obamacare” ban on denial of insurance for pre-existing conditions, for example — this is one of “Obamacare's” good points — but just because it's not exactly what I would propose would not make me turn it down entirely. However, I think that something like it might be the basis for a Republican alternative.

A big surprise

It does not surprise me that courts are issuing injunctions against enforcement of the “Obamacare” requirement that religious organizations violate their own religious scruples and provide coverage for things that they deem immoral. But that one of the injunctions was issued by Supreme Court Justice Sonia Sotomayor does. For she is an appointee of President Obama, and a known liberal.

It seems that even someone like Justice Sotomayor understands the importance of the First Amendment issue at stake — and that bodes well for people who are raising this issue.

It's crazy!

On the one hand, there are online posts like Lanhee Chen's on the Bloomberg site, entitled “If 2013 Was Hard on Obamacare, Just Wait for 2014,” giving us the news that “Obamacare” is on its way down the tubes, and giving us some hope that this colossal mistake will be repealed soon. On the other hand, there are also posts like Jonathan Cohn's, on the New Republic site, entitled “We Don't Know if Obamacare Is Working Well. But We Know It's Working.” This post seems to imply that things are back on track with it, that we just have to let it work out some rough spots. They can't be looking at the same facts.

I wish I had all the facts. But what I've seen mostly confirms the first position. “Obamacare” is a disaster, and needs to be put out of its misery — quickly. But how to do so, with Obama in the White House? I do have to admit, I don't really know. Until President Obama is replaced by a competent chief executive, like Chris Christie, it looks like “Obamacare” will limp along, with temporary postponements of its worst features. And the United States will limp along too, with nobody knowing what will be the rules in a month. A shame, but too many people were dazzled into electing this total incompetent — people said Sarah Palin was inexperienced in 2008, but she was a seasoned veteran in gevernment executive experience compared with Barack Obama!

All one can do is hope that a Republican Senate will be elected in the coming year to go along with John Boehner's Republican House, and between them, as much of President Obama's agenda as possible will be frustrated.