Despite support to repeal Obamacare, replacing is the challenge

For Republicans, it all seemed so easy.

By controlling the White House, Senate and House for the first time since 2006, they finally had the muscle this year to scrap the 2010 health law known as Obamacare and substitute a more market-oriented system.

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But during the past few months it became increasingly obvious – as former House Speaker John Boehner of West Chester Twp. predicted in February – that congressional Republicans would never agree on a new health bill to replace Obamacare, the law they love to hate.

“The simple rhetoric of the campaign has become a difficult reality,” said former Republican congressman David Hobson of Springfield. “It’s like the old story of the dog running after the bus. The bus stops and the dog doesn’t know what to do.”

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Senate Majority Leader Mitch McConnell, R-Ky., acknowledged that reality Tuesday when he pulled a Republican version replacing Obamacare because he could not win enough votes from his own party. And few believe his 11th-hour plan of trying to simply scrap the 2010 law has any real chance of gaining Senate approval.

Instead, Washington once again missed a chance to devise a health-care system which would control escalating costs of individual insurance policies while simultaneously extending government or private insurance to all Americans.

And while some Republicans are relieved that they may have put the divisive issue behind them, the reality is Congress eventually will have to repair the individual insurance marketplaces established by Obamacare while controlling future costs of Medicaid, the joint federal and state program which provides health care for low-income Americans.

For Republicans such as Sen. Rob Portman of Ohio, the political damage is uncertain. In 2015 when Portman and other Republicans knew that President Barack Obama would veto their bill, they easily passed a repeal of Obamacare. The 2015 vote was aimed at pacifying conservatives who abhorred Obamacare for imposing new taxes and mandates on the insurance market.

Those conservatives, many of whom voted for President Donald Trump, are almost certainly going to be enraged at congressional Republicans.

An analysis by the non-partisan Congressional Budget Office showed the GOP bill would have increased the number of uninsured Americans by 22 million in 2026 while scaling back an expansion of Medicaid which allowed Gov. John Kasich of Ohio to provide health coverage to more than 700,000 low-income people.

Efforts in the past to expand insurance to all Americans while controlling costs have foundered because of partisanship and the search for an elusive utopia. Both political parties have their fingerprints on the weapons that killed health care revisions throughout the past 60 years.

With that in mind, Kasich and 10 other governors from both parties Tuesday urged a bipartisan approach, declaring “the best next step is for both parties to come together and do what we can all agree on: Fix our unstable insurance markets.”

Obamacare cut the number of people without health coverage by 40 percent through federally subsidized private plans sold through the marketplaces, known as exchanges, and expanding Medicaid eligibility.

The drawback was not enough young people entered the federally subsidized individual markets, which drove up costs of premiums and led many insurance companies to drop out of the exchanges.

The CBO projected that Medicaid spending would spiral out of control, from $385 billion this year to $655 billion by 2027. The CBO concludes that by 2027, federal spending on Medicaid, Medicare and Social Security will be $3.6 trillion out of a total federal budget of $6.6 trillion. Without restraining spending on those programs, it will require massive tax increases to balance the budget.


Do you support repeal of Obamacare or not? What do you want to see in any potential replacement plan? Do you think they should just leave it alone?

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