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Editorial: Obamacare Hasn't Worked

On November 2, 2010, 63 Republican congressional candidates and six Republican senatorial candidates won seats thanks to the Tea Party wave, instigated by the passage of the deeply partisan Affordable Healthcare Act (ACA). These newly-elected politicians promised to the voters that they would work around the clock to repeal the ACA, which was very unpopular with the voters.

Over seven years after Barack Obama signed the ACA into law on March 23, 2010 and nearly seven years since the Republicans took the House, the act is still the law of the land. The Republicans in the House voted to repeal the ACA 54 times, as of 2014, and Republican senators triggered a government shutdown over the ACA funding in 2013. Regardless of all of these efforts, American people are still paying disastrous premiums for healthcare because of the regulatory language embedded into the ACA and the taxpayers are footing for waste, fraud, and abuse within the newly-created healthcare bureaucracy.

On May 4, 2017, Speaker Paul Ryan (R-Wisconsin), who was under pressure from President Donald Trump, showed his prowess when he mustered together enough votes to pass the American Healthcare Act (AHCA) onto the Senate. This Republican replacement bill for Obamacare cut Medicaid funding, established an alternative form of the mandate, expanded tax credits for healthcare purchasers, and more. Voter consensus is widely against the act, with support barely in the double digits, and Trump himself called it "mean."

President Donald Trump and Senate Majority Leader Mitch McConnell

Once the House passed the AHCA repeal, the Republicans in the Senate got to work on amending the House's bill so that they could come to a consensus bill that would bring together hard-righters like Ted Cruz (R-Texas) with moderates like Susan Collins (R-Maine). Titled "Better Care Reconciliation Act of 2017," their proposal incorporated many tenets of the House Republicans' bill and added the repeal of a 3.8% tax on investment income.

Majority Leader Mitch McConnell (R-Kentucky) seeks a vote on the Senate proposal in July, but it is so deeply unpopular with the public and among members of his caucus that it will be an uphill climb to get 50 Senate backers.

The fact of the matter is that the American people were promised a repeal and a replacement of the ACA, not just a modification of the failed act with expanded tax breaks for the wealthy. I do believe in trickle-down economics, but the objective with the replacement should not be to incorporate tax reform. Instead, it should be an exercise in rejecting the regulatory state that Obamacare created and in encouraging the free market.

I have a proposal for the Republicans: ditch the unpopular aspects of the AHCA and simply give the people a choice when it comes to their healthcare. Remove the regulations that block people from buying less comprehensive plans, which would be more than sufficient for young people, and establish only a simple rule: insurers cannot deny someone with pre-existing conditions.

The key word is "deny." Insurers should be allowed to charge those with pre-existing conditions more for their plan, as they would be much more comprehensive. To paraphrase Senator Jeff Flake (R-Arizona), if the government wants to subsidize the healthcare of those with pre-existing conditions along with the poor and the elderly, they should do it through direct subsidies rather than through rising premiums for all.

Additionally, along with allowing for less-comphrensive plans, the Republicans should permit people to purchase their plans across state lines. This competition would bring down the cost of coverage in a demonstration of the effectiveness of the free market.

The AHCA does have two fundamentally sound principles: the alternative form of the mandate and the tax credits for those who buy insurance. The mandate, as established by the ACA, is a violation of the "search and seizure" clause of the 4th Amendment. The Republican alternative, which establishes a 30% buy-in premium for someone buying a plan after not having coverage, is acceptable. For the critics, consider an analogy: should one be allowed to buy fire insurance when their house is on fire? Just the same, the tax credits -- an alternative form of subsidies -- would incentivize the purchase of health insurance more than the fines associated with the mandate ever did.

The greatest part of a plan that is centered around the free market is that it would drastically reduce the role of government in our affairs and it would allow for the consumer to find cheaper coverage. Regardless, there is one reasonable concern with such a concept: what about the people who are genuinely unable to pay for coverage, regardless of how cheap the free market makes it? The Republicans in the House and Senate answer that the tax credits will subsidize the poor, but for the people who don't take home enough to pay taxes, these credits would be unhelpful. The better option is to maintain the current level of Medicaid enrollment, while cutting the waste, fraud, and abuse so that it is actually sustainable.

If Medicaid enrollment levels are not slashed and there aren't tax breaks for the wealthy, there would great public consensus for the Republican plan to need to repeal Obamacare. While the approval ratings for the ACA are rising, this doesn't serve as indication of public support for the 2010 act -- it serves as a demonstration against the AHCA.

The Republicans in the Congress are doing a great disservice to the American people by stalling the repeal of Obamacare in the interests of partisanship. We elected them to accomplish positive change, and it is a disappointment that they have not completed their most crucial duty.