Progressives are understandably breathing a sigh of relief following the Senate’s failure to repeal Obamacare and replace it with legislation that would have scaled back health-insurance coverage. But they shouldn’t be too comfortable in their victory — it’s temporary.
President Donald Trump has threatened not to support the Affordable Care Act. If the Trump administration decides not to make critical payments to insurers, or stops enforcing the tax penalty for people who don’t buy insurance, the law could be in serious trouble. And even if the administration continues to support Obamacare’s success, progressives should be clear that the law still needs improvements to ensure that premiums don’t continue to increase at an unsustainable rate, and that households in all parts of the country continue to have access to insurance through the individual market.
(Related: 6 ACA Individual Mandate Replacement Ideas)
What’s needed to move forward? Republicans and Democrats working together.
A major problem with the Affordable Care Act is the way it was passed: on a party-line vote, without support from a single Republican. This made the law vulnerable and created uncertainty about its future among market participants. The unsuccessful GOP repeal-and-replace efforts have been just as divisive. For a policy change of this magnitude to be lasting and stable, it should have at least some bipartisan support.
President Barack Obama’s lasting health care legacy is winning the fight over whether universal coverage is the right goal. Mr. Obama was correct that it is, and as I’ve argued recently, conservatives should agree. But what is needed to get us there in best way? Let me outline a few corollary goals.
Universal coverage should be pursued in a way that is affordable, both to households and to the government, and that helps lower the trajectory of health care costs overall. It should lead to higher-quality medical care, to make being insured attractive to households, and should encourage innovation, productivity and technological progress in the health care sector. It should encourage young and healthy people to be covered in order to balance the risk pool facing insurers, making it attractive for insurers to offer insurance. It should ensure that even the hard-to-cover are insured.
To achieve these goals, both conservatives and progressives are going to have to give ideological ground.