Why Congress Should Fully Repeal Obamacare through Budget Reconciliation

Since Obamacare was first signed into law in 2010, Republicans promised to repeal it, campaigned in Senate and House races to repeal it, and voted over 60 times to repeal parts or all of President Obama’s failed healthcare law.

Earlier this year, President Obama vetoed an Obamacare repeal bill (H.R. 3762) that Republicans in Congress passed using a filibuster-proof process known as budget reconciliation. This bill included the repeal of Obamacare subsidies, taxes, individual and employer mandates, and Medicaid expansion, but noticeably left out the repeal of insurance market regulations.

But now with President-elect Donald Trump in office come January 20th, who also campaigned to repeal Obamacare, Congress has its best opportunity yet to successfully repeal all of Obamacare.

Unfortunately, some Republican members of Congress are already calling for a partial repeal of Obamacare, citing Senate Parliamentarian obstacles as an excuse. (Legislation changed through budget reconciliation must have a budgetary impact.) Ironically, the Obamacare insurance regulations that some members want to save are one of the main reasons causing rising premiums. A partial repeal of Obamacare would fail to provide relief to individuals experiencing out-of-control costs in premiums and deductibles.

Partial repeal of Obamacare based off the fear that insurance regulations don’t have a budgetary impact doesn’t make sense either. Higher premiums caused by insurance regulation under Obamacare increase taxpayer funded subsidies which directly impact the federal budget. This point is further underscored by the fact that the Obama administration argued that insurance regulations are inseparable from the rest of Obamacare before the Supreme Court in King v. Burwell.

Sadly, the number of Republican excuses to not fully repeal Obamacare through reconciliation seems unending. One member of Congress is considering not voting for the “shell” budget required to set up Obamacare repeal unless it balances. While all conservative and frankly responsible members of Congress should believe in balanced budgets, now is not the time to stall momentum to repeal Obamacare. Especially when Congress already appropriated funding for half of this fiscal year and can fight to balance the budget for fiscal year 2018, which begins in November.

Republicans in Congress are out of excuses. They must act now to fully repeal Obamacare through budget reconciliation and have a bill ready for President-elect Trump to sign soon after inauguration. Once Obamacare is fully repealed, Republicans should pass a series of bills that lower cost, expand choice, and restore the traditional doctor-patient relationship. They can start by implementing the following five polices:

  1. Improve and expand health savings accounts so patients have direct control of their own health care dollars and can pay for all medical services including insurance.
  2. Remove barriers that stop patients from participating in direct primary care arrangements to increase patient choice.
  3. Allow patients to buy health insurance across state lines and enact state-led medical tort reform to increase competition.
  4. Equalize the tax treatment of health insurance to lower run-away health care spending and increase portability.
  5. Transition Medicaid and Medicare into a premium support model and get the federal government out of the practice of price fixing.

It’s time Republicans fulfill their promise to the American people and fully repeal Obamacare as quickly as possible. Time is ticking away.

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