June 20, 2018

ObamaCare Repeal Back From the Dead?

Maybe. Either way, changes are coming to ObamaCare in the form of association health plans.

There are rumblings that health care reform is fixing to reemerge in Congress thanks to a months-long venture by the Health Policy Consensus Group. This conservative coalition is composed of The Heritage Foundation, American Enterprise Institute, Galen Institute and Manhattan Institute, among others.

“The conservatives’ proposal would drive control of health care almost entirely to the states, reversing the ACA’s [Affordable Care Act’s] federal mandates that seek to provide basic minimum benefits and consumer protections, which Republicans argue limit people’s choice,” The Wall Street Journal reports. “Under the conservative plan, states would receive ACA money in the form of block grants to help low-income consumers buy coverage. Health savings accounts, which let people set aside tax-free money for medical expenses, would be expanded. Insurers could give discounts to people who are young or maintain continuous coverage.”

The Journal adds: “The block grants would be the backbone of the conservative plan. Half of the grant funding would go toward supporting the purchase of private health coverage, and half toward helping low-income Americans get coverage, although the two categories would likely overlap. The grants would ban states from using the money to fund abortions, according to the draft proposal. Medicaid expansion would also be repealed, and people on Medicaid would be able to buy private insurance coverage.”

The caveat, of course, is succinctly laid out by the Journal: “Republican leaders have said they have no appetite for another push to repeal the ACA before the November midterm elections unless such a bill clearly has the votes to pass. Republicans faced a series of obstacles — including internal division and unified Democratic opposition — as their effort to repeal the ACA collapsed last year. There is little evidence those dynamics in Congress have changed.”

As David Thornton points out at The Resurgent, “The midterm elections may seal the fate of the repeal effort. If Republicans lose their majority in either the House or the Senate, any serious effort to repeal the ACA would be doomed. At that point, the best that Republicans could hope for would be a bipartisan effort to fix the worst problems of the law.”

Fortunately, even if this new ObamaCare repeal endeavor falters, there are ObamaCare changes afloat. The Wall Street Journal editorial board this week revealed that “the Labor Department rolled out a final rule on AHPs,” or association health plans. The editors explain: “The point is to allow more small businesses to join forces to offer health insurance, using economies of scale to reduce costs and diversify risk. This is how corporations and unions manage health insurance in the large group market, either by paying an outside issuer or self-insuring.”

It’s not a perfect solution, but it’s progress. “For once,” the Journal writes, “the test of a health-care policy will depend less on government dictates than on the choices of millions of Americans.”

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