January, 2017
Washington -- Congress and the country are tied up in knots over what to do with Obamacare, or the Affordable Care Act (ACA). It either needs fixes to help people pay premiums (Democrats' position), or it needs to be repealed and replaced (Republicans' position).
There is great confusion about the underlying issues. An Uber driver in Washington expressed his frustration well when he said he was all in favor of doing away with Obamacare, which he didn't like, but the politicians should be warned to keep their hands off his ACA policy, with which he was very happy.
Not to laugh–he was on to something. Names and appearances are all-important. Obamacare is actually a version of Romneycare in Massachusetts, which in turn was modeled after the health insurance proposal of the Heritage Foundation in 1990. The Heritage Foundation is a right-of-center think tank, perhaps most famous for its policy input into the first Reagan Administration.
The Heritage proposal is well worth reading, and not just to establish paternity. Note the lengthy discussion about the exclusion from taxation of employer contributions for medical insurance and care, and how it distorts health care markets and drives up costs. In 2016, this is by far the largest tax expenditure in the federal government, at $216 billion in 2016. It is a concern across the ideological spectrum.
How about this for a solution: trim back the huge, counterproductive tax expenditure, use the revenues to fix the Obamacare problems, and call it HeritageCare. Coverage is continuous, no one dies in the streets, tax-policy is reformed, and both sides can claim victory.
The vehicle would be Budget Reconciliation, with appropriate instructions to the revenue committees. Of course there would be howls of protest from corporation and unions alike, but now is the time to act. Never let a crisis go to waste.
