The shutdown may be over, but life doesn’t get any easier for Republicans. While Senate Minority Leader Chuck Schumer (D-N.Y.) may be the target of his base’s disgust for reopening the government, his party did manage to redirect the conversation to an issue that the GOP has struggled for years to address: health care.
Before the ink on Obamacare was even dry, conservatives made it their mission to topple the law — a goal that they came within a whisper of achieving, but 15 years later, still haven’t. Now, with the GOP’s dire predictions about the misnamed Affordable Care Act coming true and costs spiraling out of control, Speaker Mike Johnson (R-La.) and Senate Majority Leader John Thune (R-S.D.) have little choice but to tackle what will almost certainly be a wildly complicated problem. Fortunately for them, though, it won’t be on Democrats’ terms.
By refusing to play Schumer’s games and refusing his absurd demands to keep propping up their doomed program with trillions of taxpayer dollars, Republican leaders have managed to expose the most important truth of all: Obamacare is a failure — just as they insisted it would be. The only way Joe Biden’s party managed to keep it afloat was to shovel enough money into the system to mask the spiking costs and keep the voters from turning on them. But their COVID-era subsidy system is about to come crumbling down, ripping the band-aid off the uncomfortable reality that these sky-high prices are the result of their incredibly flawed law.
As National Review’s editors explain, “From its implementation in 2014, enrollees were subject to dramatic annual premium increases, and the program struggled to sign up younger Americans, driving costs even higher and forcing many large insurers out of the individual market. Republicans were unsuccessful in replacing the program in Trump’s first term with something better,” they lament, “and so when Democrats retook power, they used the emergency of Covid as an excuse to funnel more subsidies to insurance companies. The temporary measure did not fix any of the underlying problems with Obamacare.” If anything, it just hid the impending disaster under a pile of taxpayer dollars.
“What was supposed to be a temporary measure during the pandemic was extended again in 2022 through this year,” the editors note. And let’s not forget, they point out, the subsidies were supposed to stop “when enrollees are at 400 percent of the federal poverty level. The 2021 actions removed that cap and also increased the amount of the subsidy that enrollees who were previously eligible received” — more than doubling the number of people on Obamacare marketplace plans. And although it was Schumer’s party that decided to sunset these credits in 2025 — something a handful of brave Democrats have tried to remind people — they thought they could use the shutdown to squeeze Republicans into extending them.
It’s all combined to create the perfect storm for everyday Americans, who are staring down premiums that are double what they were paying last time around. In part, that’s the sticker shock from the disappearing credits, but it’s also the result of unchecked insurance companies that have been ratcheting up prices for years. “The purpose of Obamacare, according to Democrats, was supposed to be making health care more affordable for everyone and subsidizing it for people with lower incomes. Over a decade later, Obamacare keeps raising costs for health insurance,” NRO’s editors shake their heads, “and Democrats now insist that everyone, regardless of income, should be eligible for larger subsidies than Obama signed.” Of course, “One group that is very happy about this state of affairs is health insurance companies, who are the recipients of the subsidies. ‘About half of all health care spending and the majority of health insurer revenue now comes directly from the government,’ according to analysis from the Paragon Health Institute.”
Unfortunately for both parties, the situation is a ticking time bomb. Open enrollment for Obamacare is already underway, and people who expect coverage in January have to sign up by December 15. That gives Johnson and Thune, who are already under water on appropriations bills and other backlogged business, less than a month (thanks to Thanksgiving) to try to dig the country out of this mess.
As for Obamacare, Dr. Andy Harris (R-Md.) points out, most people had come to understand the ugly truth about Obamacare before subsidies. “We were promised that if you like your doctor, you can keep your doctor. That’s obviously not true. If you like your insurance company, you keep your insurance company. That’s obviously not true.” Now, the premiums are astronomical. And frankly, he stressed, “The only reason anybody is on it is because the federal government, after COVID, subsidized 95% of the average premium. That’s ridiculous.”
As far as Harris is concerned, “We have to return the power over your health care to you. So that means price transparency. That means health savings accounts (HSAs). That means getting the providers to accept the lowest that they’ve negotiated with some of the big insurance companies to level the playing field between the insurance companies and the average person,” he told Family Research Council President Tony Perkins on Saturday’s “This Week on Capitol Hill.”
The result would be a “seismic shift,” Perkins agreed, where “health care decisions and funding [could be] taken away from government bureaucrats and big insurance companies and placed into the hands of the people with a direct relationship with their doctors.” That should be the goal, Harris nodded.
Over in the Senate, Bill Cassidy (R-La.) is taking the HSA idea and running with it. Under a plan he’s mulling, the government would take the money Democrats want to spend in extending the subsidies ($23 billion in 2026) and use it to create the health savings accounts. “HSAs,” The Washington Times underscores, “are tax-exempt accounts paired with high-deductible health insurance plans. The consumer can use money from the account for co-pays and deductibles, prescription drug costs and other out-of-pocket health expenses.”
“Who [wouldn’t] want to spend 100% of the dollars on the patient choosing the health care she wants, as opposed to 100% going to insurance companies and only 80% being spent on health care?” he told reporters Monday. “As a conservative, I love it. But I think it’s got a lot of appeal to people who are left-of-center, too.” Cassidy plans to unpack the concept more in a hearing this week.
That’s more than okay with House conservatives like Harris. “The fact of the matter is that right now, most people don’t have any control over [their health care]. It’s controlled by insurers who decide whether or not you’re going to get health care, whether or not you qualify for surgery, whether or not you qualify for some drugs. [It’s] crazy. That decision should be in the hands of the individuals,” he emphasized, “not the government, not the insurance companies. And we could expand this well beyond Obamacare. … What we can do is we can take some of those subsidies, those huge subsidies we’ve been paying to insurance companies, give the lion’s share of that [to] someone with an HSA, and then have them go out and buy their care if they want.”
Asked how quickly Congress could move on this, Harris was realistic. “Look, we can’t do a comprehensive overhaul of Obamacare before December 31st, but we could start down that path, and we could start making inroads. And then if we have to, we can revisit it after the first of the year. The Democrats want to extend these ridiculous Biden bonuses, these COVID-era enhancements for three years now.” The doctor paused before floating the idea of a temporary fix first. “Maybe we just extend some of them partially for six months while we negotiate all the rest of this. But in the end, there is going to be a negotiation on the high cost of health care premiums for the Americans who aren’t on Obamacare. That’s going to be part of this discussion.”
So will the loopholes for highly controversial “coverage” on abortion and gender transition procedures, which were never addressed. “The Affordable Care Act, the subsidies that we’ve been talking about,” Perkins broached, “they do not have the Hyde protections that prevent taxpayer money from being spent on abortion or transgender surgeries. Is that a part of the conversation?” Harris replied that it “absolutely is.” “With Mike Johnson as speaker of the House, he is not going to bring a bill to the floor that does not include Hyde protections,” Harris reiterated. The majority of Americanswould certainly appreciate that after years of watching helplessly as their dollars flow to the killing of innocent unborn children.
As always for Johnson, the to-do list is long and the road is rocky. But, as he told Perkins this past weekend, “Sometimes it’s an advantage to be underestimated, you know? I don’t know why they continue to do that. You and I both know the answer here is [that] God is doing this. We pray for these things. We work hard.” He smiled when he said, “I get accused of over- spiritualizing everything,” but, he added quickly, “I don’t think you can. I mean, we’re trying to do the right thing, and God honors that. And I expect that’s going to happen in the days ahead because we’re going to continue that same course.”
Topics:Congress, Health Care, Federal Spending, Federal Government, Obamacare
Suzanne Bowdey serves as editorial director and senior writer at The Washington Stand.
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