July 27, 2017


Moving Past Obamacare May Include Embracing Some of Its Conservative Roots (Stephanie Akin, 7/25/17, Roll Call)

Some political theorists and economists -- including conservatives -- suggest that one of the biggest mistakes may be the reluctance by Republicans to acknowledge that significant parts of President Barack Obama's signature law were based on conservative principles.

And that reluctance, they say, kept GOP lawmakers from participating in a process that could have improved the bill and incorporated more of their ideas. It has now left Republicans without a foundation for a viable alternative. [...]

Ornstein said former Sen. Max Baucus of Montana and other Senate Democrats who were tasked in 2009 with coming up with the outlines for what would become the 2010 health care law wanted to avoid the backlash that had met first lady Hillary Clinton when she tried -- and failed -- to tackle health care almost two decades before. So they made a point of starting with a GOP template, working initially with high-powered Senate Republicans Charles E. Grassley of Iowa, Michael B. Enzi of Wyoming and Olympia J. Snowe of Maine.

The group turned to a plan Republicans had devised as a response to Clinton, according to an account Ornstein wrote in a 2015 article for The Atlantic. 

The plan was built around an individual mandate and exchanges with private insurers. It was derived, in part, from ideas espoused by the conservative Heritage Foundation -- though other scholars had been writing about the concepts for decades.

The individual mandate is a provision of the law that imposes a penalty on people who do not sign up for insurance. Getting healthier Americans, often younger people, to sign up reduced their financial risk if they suffered a catastrophic illness or injury. But at the same time, their participation helped to cover the costs of their unhealthy and older counterparts.

The Supreme Court upheld the constitutionality of the mandate in 2012.

Paul E. Starr, a Princeton sociologist who has written extensively about health care policy, pointed out that more than 20 Republican senators sponsored a health insurance bill with an individual mandate in 1993. Democrats initially opposed the idea and did not include it in the Clinton health care plan that year.

But they were convinced to reconsider, based on the success of Republican Gov. Mitt Romney's 2006 health care overhaul in the Massachusetts, which was the first to introduce an insurance exchange buttressed by an individual mandate.

Posted by at July 27, 2017 7:06 PM