Republicans’ struggle to repeal and replace Obamacare demonstrates that they desperately need a goal for health care reform. That goal should be universal coverage.
The Affordable Care Act is in bad shape, with premiums increasing at an alarming rate, insurers leaving the exchanges, and a new administration much less willing to prop it up. We aren’t in a “death spiral,” but some action will be needed — especially given the progress made in the Senate yesterday. No matter how often President Trump says he’s “not going to own” any problems, the public will disagree. He’s in the White House. Republicans control the Congress. They are the governing party.
(Related: AEI: Replace Group Health Tax Deduction)
Unfortunately, Republicans don’t seem to know what they want to achieve, other than being able to say that they repealed Obamacare. This clearly isn’t enough to pass good, sound legislation.
What they should address is a crucial failure of the ACA: For all the talk about universal coverage, some 29 million Americans remain uninsured, according to the most recent Census data. Conservatives should argue that they can do better, with the goal of getting the number to zero.
Why? Each of us is in the market for medical care, whether we have insurance coverage or not: We all face the risk of acquiring a devastating disease, or of suffering a terrible accident. Those who don’t have insurance against that risk create the possibility that the cost of their medical care will be passed on to the rest of society in the form of higher premiums or higher taxes. Conservatives, who value personal responsibility, should be the first to argue that individuals should be covered by health insurance. And in a nation as wealthy as ours, a medical emergency should not leave anyone broke. We should have a safety net so that no one falls too far. Universal coverage advances both personal responsibility and social assistance for those who need it. Conservatism is consonant with this objective.