Ted Cruz and Mike Lee Have an Rx

“Cruz is right that we should allow plans with non-compliant benefits,” says Goodman Institute founder John Goodman, the author of Patient Power. “In fact, we should allow plans that scale back benefits enough so that they cost no more than the tax credit. That way, people could be insured without paying any additional premium.”

But, Goodman warns, “if some plans can offer skimpier benefits, you can’t allow people to choose those plans while healthy and then switch to the more generous plan after they get sick. People have to pay the full actuarial cost of any such change.”

.. In a sense, this concept is the medical equivalent of school choice: Democrats and the Left want to keep everyone in both collapsing government systems. If people escape rotten government schools and actually learn something on private campuses, Democrats and their socialist model look bad, and those employed in it might lose their iron rice bowls.

The Simplicity of a Health Deal

The GOP must realize protection for pre-existing conditions is here to stay.

Will the most conservative members of Congress accept that the politics of health care have changed?
.. Will they acknowledge that any reform must include continued protections for pre-existing medical conditions?
.. two camps of defectors from the Senate’s reform bill. One consists of Republican moderates— Rob Portman, Dean Heller, Susan Collins, Lisa Murkowski —who claim the bill is too mean to poor and sick people.
.. With the stakes this high, the Senate leadership will gladly shuffle some money toward opioid treatment, rural health-care providers or Medicaid. So getting the “moderates” on board is simple and transactional. They name a price, they get pork, they vote yes.
.. Sens. Ron Johnson, Mike Lee, Rand Paul and Ted Cruz have been clear from the start that any bill must lower premiums, which involves getting rid of costly ObamaCare mandates. And there is no question that among the most expensive mandates are those designed to protect individuals with pre-existing conditions—in particular “community rating,” which requires insurers to charge the same prices regardless of health status.

The House Freedom Caucus was so intent on getting rid of community rating that it nearly derailed the bill. Only after the conference added an amendment allowing states to apply for waivers from community rating did the most conservative members finally came on board.

..every American remembers two particular provisions of the law—pre-existing conditions and coverage for children up to 26. These policies are simple and sound good. And they have become over the years a new standard in most people’s minds.
..Conservatives will argue their side just needs to do a better job explaining how these mandates drive up costs for everyone, or lower the quality of care.
..conservatives face a choice. They can work with their colleagues to minimize the costs of the mandates (there are innovative ways to do this) and build in different free-market reforms to lower premiums.

McConnell’s Calculation May Be That He Still Wins by Losing

When it comes to managing Republicans’ best interests, Senator Mitch McConnell of Kentucky, the majority leader, rarely loses. So it is possible that Mr. McConnell views the potential failure of a hastily written health care bill as an eventual boon.

.. As Democrats immediately took to the Senate floor to excoriate the bill and the secretive process in which it was put together, few Republicans, even those involved in crafting it, came to defend it.

.. Four others went further. Senators

  1. Ted Cruz of Texas,
  2. Ron Johnson of Wisconsin,
  3. Mike Lee of Utah and
  4. Rand Paul of Kentucky

all said they would not vote for the bill as currently proposed.

.. Mr. McConnell and many of his aides are also eager to get to the business of changing the tax code, which they view as less difficult than health care, and have been working with the White House behind the scenes to get that effort started. For Mr. McConnell, cutting taxes is a much higher priority than health care

The Senate Takes Up Health Care Reform

The Senate will take up health care reform after a revised version of the American Health Care Act (AHCA) passed through the House last Thursday.

Senator Roy Blunt (R-MO), a member of Senate leadership, said that the Senate will wait for a new CBO score before preceding to a vote.

.. Mick Mulvaney, head of the Office of Management and Budget, said, “The bill that passed out of the House is most likely not going to be the bill that is put in front of the president.”

Members of the working group include Sens.

  1. Mitch McConnell,
  2. Bob Portman (R-OH),
  3. John Corynyn (R-TX),
  4. John Thune (R-SD),
  5. Mike Enzi (R-WY),
  6. Orrin Hatch (R-UT),
  7. Lamar Alexander (R-TN),
  8. Tom Cotton (R-AR),
  9. Cory Gardner (R-CO),
  10. Ted Cruz (R-TX),
  11. John Barrasso (R-WY), and
  12. Pat Toomey (R-PA).

.. The Senate working group does not feature two of the bill’s biggest critics, Senators Susan Collins (R-ME) and Bill Cassidy (R-LA).

.. The two senators joined a separate group of Republicans studying potential health care solutions including Sens.

  1. Shelley Moore Capito (R-WV),
  2. Johnny Isakson (R-GA), and
  3. Mike Rounds (R-SD)
  4. Susan Collins (R-ME)
  5. Bill Cassidy (R-LA)

.. Senators Cassidy and Collins released a separate Obamacare repeal bill, The Patient Freedom Act.

States have three options under the Cassidy-Collins plan:

  1. Retain the Affordable Care Act, allowing individuals and small businesses able to purchase insurance on state exchanges and low-income residents can receive federal subsidies to cover the cost of the program. States that expanded Medicaid can continue to provide increased Medicaid coverage.
  2. States can receive most of the federal funding, including Medicaid expansion and subsidies to create tax-free Health Savings Accounts for low-income citizens. Low-income residents can use the HSAs to purchase insurance and pay for health care.
  3. Allow states to create an alternative solution without federal assistance. States would retain the power to design and regulate insurance markets without federal intervention.

.. Senators Rand Paul (R-KY), Mike Lee (R-UT), and Ted Cruz (R-TX) were the strongest opponents of the American Health Care Act. Senator Paul crafted his own conservative plan for repealing Obamacare and worked with the Freedom Caucus to push for an even more conservative Obamacare repeal bill. The Freedom Caucus endorsed Sen. Paul’s plan.