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December 17, 2025

The GOP’s ObamaCare Opportunity

The party isn’t responsible for the law’s myriad flaws or exorbitant cost overruns, but it can do a lot to fix the system with market-oriented reform.

ObamaCare needs to be taken off life support. Whether it’s fraud, higher costs, or a socialization of the system that never should have happened in the first place, it’s a massive mess that needs to go away for good. Republicans have a chance to do that, but they have fumbled the ball before and are only now inching toward a possible touchdown that could keep them in the game.

House Speaker Mike Johnson has suggested a better alternative to the Democrat proposal to extend pandemic-era ObamaCare subsidies: expanding insurance options for employers and workers. The Left hates it for the obvious reason that it takes some control away from the government and puts the decision back into the market’s hands. “This so-called plan is the height of irresponsibility,” howled House Minority Leader Hakeem Jeffries. Call me crazy, but I’m not sure how it’s “irresponsible” to give people more healthcare insurance options at a lower cost to taxpayers.

The Wall Street Journal expounds on the plan, “The GOP bill would make it easier for small businesses to escape the ObamaCare regulatory morass. The bill would expand so-called association health plans that let small employers unite to sponsor group health plans. These plans would reduce premiums by expanding risk pools and give small employers more leverage with insurers.” The plans wouldn’t have to adhere to many costly ObamaCare rules, though they still couldn’t charge more for workers with pre-existing health conditions.

While this is a good start, a better approach, proffered by National Review’s editors, may be to use the existing funds to directly subsidize those individuals who wouldn’t be able to get insurance in a pure free market. They could then be removed from the regular insurance pool, allowing the market to offer more affordable insurance to everyone else.

“In a free market,” National Review explained, “individuals would have the choice to purchase much cheaper insurance that, while less comprehensive, would still protect them against financial ruin in the event of an unexpected medical event. Insurers could be more innovative — for instance, offering incentives for enrollees to lose weight, exercise, or quit smoking, just as safe drivers get lower car insurance rates.”

The GOP bill is also offering the option of health reimbursement arrangements. These would let employers make tax-free payments for employees to buy their own health insurance instead of sponsoring a group plan. Employees would be allowed to buy their own insurance with pretax dollars, reducing their costs. This would be helpful for small businesses, but they should go further by removing restrictions on health savings accounts so that people could open them to cover out-of-pocket costs regardless of whether they have health insurance, and use them to pay insurance premiums. This would benefit the self-employed, giving them the same tax advantage as those getting their insurance through a traditional employer.

Cassidy, the chair of the Senate Health, Education, Labor, and Pensions Committee, expressed his support for redirecting money from the tax credits into health savings accounts paired with bronze or catastrophic plans on the ACA marketplace. That measure failed in the upper chamber earlier this week, but Cassidy remains optimistic that a deal can be reached before the New Year, declaring, “Let’s just take care of the affordability issue for the enrollee in [the ACA], and do it for the out-of-pocket as well as the premium.” The question is: can a deal be reached without extending subsidies? The House will not vote on extending the enhanced subsidies after a deal fell through on Tuesday night. Only 7% of the country is even enrolled in ObamaCare, meaning that the national impact should be minimal.

The reason politicians have a hard time solving the healthcare crisis is that they’re not supposed to be involved in it in the first place.

Just like you can’t make a blanket education system that works for every individual without a decrease in excellence, the same holds true for healthcare. If you allow the government to make blanket healthcare policies, you end up with the horrible healthcare you find in Canada and the UK. Not to mention that a relatively small healthy portion of the population should not have to pay ever-escalating premiums for more comprehensive insurance than they need to offset the cost of covering older and sicker enrollees.

As the Washington Examiner’s Tiana Lowe Doescher points out, “Obamacare effectively doubles what young individual consumers paid for health insurance so that older and unhealthier people pay less for healthcare. Prices are no longer responsive to demand or risk, making the market for health insurance no longer a market or one for insurance against a risk.”

We don’t need to just go back to the pre-ObamaCare healthcare system; we need to restore consumer choice and rationality to the broader healthcare market. If we don’t want to continue to shovel taxpayer dollars to the insurance conglomerate by the trillion-dollar load, it is imperative to break up the iron triangle of government, “insurance” companies, and hospitals.

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