October, 2017
Washington -- It was totally predictable that Congress would founder on repealing and replacing the Affordable Care Act, in part because the ACA was the conservative, Republican health care plan in the first place. (See the earlier post in this space at the beginning of the year: Call It HeritageCare.)
A lot of grief could have been avoided had the ACA been fixed with revenues from cuts to tax expenditures for employer-provided medical care. Beyond that, Republicans should have jumped at the chance to remove the widely-acknowledged, distorting hand of government from the employer-provided health care markets. They didn't. So much for any coherent Republican approach to governing.
There is another chance to do this, through the upcoming tax bill. Rather than cutting tax deductions for payments to state and local governments, cut them for employer-provided medical care. The revenues could be used for lowering the corporate tax rate in a trade-off, of course, but they could also be used to fix the ACA.
One of the nearly-forgotten advantages of the budget reconciliation process is that it provides a way to cross committee jurisdictions. The cost of the bipartisan ACA fixes that might be coming out of the Senate Committee on Health, Education, Labor, and Pensions could be covered by cuts to tax expenditures advanced by the Senate Committee on Finance.
Not holding my breath.
