The Omnibus Spending Bill was one huge mistake but it appears another is coming. Republicans promised over and over again that they simply would repeal Obamacare. However, reports indicate  they will introduce another bill this week which also will replace Obamacare with new rules, containing contain many of the faulty provisions of the present system.  They claim they will not allow coverage of preexisting conditions but a review of the plan shows that change is cosmetic only. The gimmick is that the bill will allow states to get a waiver from such coverage; but they must set up a high risk pool, which practically is economically unsound. The details are here. The Republicans may may be saved from their stupidity by the Democrats who have vowed to block the Republican bill by delaying tactics . More stupidity – all the Democrats have to do is sit back and vote NO on the Republican bill. When it passes, the Democrats can lament that their better plan has been destroyed and the Republican plan is problem-laden.  By doing nothing, they get out from under the terrible mess they created with Obamacare and saddle Republicans with the mess.  A Democrat Win-Win! Why are both sides being stupid? Because their goal is not an intelligent system for the country. Their goal is their own self interest; Each party wants to claim credit for giving voters “free stuff” and no politician wants to be charged with taking away a “freebie.”  After all, it costs them nothing;  the taxpayers pick up the bill. More evidence that we need Term Limits. [Archive Issue 24, section 10.] Time to remember economist Thomas Sowell’s words of wisdom:
No one will really understand politics until they understand that politicians are not trying to solve our problems.  They are trying to solve their own problems — of which getting elected and re-elected are No. 1 and No. 2.  Whatever is No. 3 is far behind.  [Emphasis added]
How did we get to this sorry state of affairs? Let’s review the history Politicians Ignore  Common Sense  More Thomas Sowell:It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it.  Michael Ramirez’ sardonic “explanation”:   How Obamacare Became Law In 2008, a key point in Obama’s  campaign was so-called Healthcare Reform. In 2009, Obama pushed for a bill dubbed Obamacare. 60 votes in the Senate were required for its passage.  It received exactly those 60 votes. No Republicans voted for it. Every Democrat voted for it. It would not have passed were it not for 2 blatant lies. President Obama repeatedly told the voters: We will keep this promise to the American people: if you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period.
The act purported to continue existing plans under a grandfather process if insurance companies followed certain rules and regulations which proved unworkable. Insurance companies had to cover benefits that many people did not want or need and led to a rise in premiums which people could not pay and so lost their plan. When they lost their plan they usually lost their doctor as well. [Emphasis added.]  The Republican Position on Obamacare  2016 Last year, the Republicans passed a bill which repealed Obamacare and cut federal funding for Planned Parenthood.  Obama vetoed it, as the Republicans knew he would.  Paul Ryan commented: But here’s the thing. The idea that Obamacare is the law of the land for good is a myth. This law will collapse under its own weight, or it will be repealed. Because all those rules and procedures Senate Democrats have used to block us from doing this? That’s all history,… We have now shown that there is a clear path to repealing Obamacare without 60 votes in the Senate. So, next year, if we’re sending this bill to a Republican President, it will get signed into law. [Emphasis added.] Next year is now and we have a Republican President and a Republican Senate and a Republican House.   Here is a recent version of the bill Paul Ryan promised: Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted. Keep that promise. Pass this bill. Republicans’ first legislative crack at Obamacare a/k/a the Affordable Care Act  Not President  Trump’s finest hour. He sided with Paul Ryan in sending a bill not simply to repeal the act but to replace it. Ryan was forced to withdraw it when it became evident the votes were not there to pass it. The withdrawn bill was ill-conceived and ignored opportunities to enhance market competition and reduce premium costs.  Inexplicably, the President backed Ryan’s effort  and deprecated the Freedom Caucus, a congressional caucus of conservatives in the United States House of Representatives, formed in 2015. Most members were  strong supporters of President Trump but opposed the Ryan bill.  The President was threatening people who supported him and aligning himself  with “No Trumper” RINOs.  That was wrong. He eventually walked that position back. The Ryan bill was not good. It was dubbed Obamacare-lite and that description was accurate. And it was not only conservatives who objected to the Ryan bill. Rep. Charlie Dent of Pennsylvania, a moderate GOP member:I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals… We have an important opportunity to enact reforms that will result in real healthcare transformation — bringing down costs and improving health outcomes. This legislation misses the mark. A main point in the refusal to support the Ryan bill was that bill’s inclusion of the Obamacare requirement compelling insurers to cover people with preexisting conditions. As noted, the new bill expected to be introduced this week includes many of the Obamacare goodies. 
 1. DO NOT INSURE PREVIOUS EXISTING CONDITIONS  The most egregious error in the failed bill was the preservation of Obamacare’s mandate that preexisting conditions must be covered. People can refuse to pay premiums for insurance coverage for years. Then, when a catastrophic illness like cancer strikes them, they can obtain coverage simply by paying a 30% higher premium for just one year. Who wouldn’t go for that deal? It drives up costs which must be paid for by higher premiums for responsible taxpayers. It rewards the grasshopper at the expense of the ant.  Aesop got that; but the GOP did not.
How does this make sense?  Give the entitlement generation yet another entitlement? Are we nuts? What happened to the idea that responsibility is a good thing?  This is just another “goodie” ordained by our selfish Senators to get votes at our expense. 
 Obamacare is in a “death spiral.” Aetna CEO Mark Bertolini so characterized it after Humana, another major health insurance provider, announced it would withdraw from the Obamacare exchange program in 2018.The Aetna executive predicted that even more companies will back out of the government-run marketplaces in the coming weeks, leaving several areas across the U.S. with no insurers to provide Obamacare coverage. Costs keep rising. Among his other misrepresentations, President Obama promised families a $2,500 reduction in premiums. Instead, in the individual market, premiums have increased an average of 105 % since the law took effect and premiums  increased in employer sponsored plans. E.g., the Kaiser Family Foundation reported  family premiums  increased an average of $4,372 from 2010 to 2016. Deductibles have risen as well. Another Obama promise was an increase in choice of insurers, but of the 23 nonprofit health insurers created through the law’s Consumer Operated and Oriented Plan  Program, 17 have collapsed and one changed status to for-profit. Taxpayers loaned more than $2 billion to these companies that will never be repaid. This year, 70 percent of U.S. counties have only one or two insurers offering coverage and the situation is worsening as more insurers leave the exchange. Taxes have been increased $800 billion, including taxes on health insurers, medical devices, and prescription drug manufacturers. Medicaid has expanded, embracing anyone earning less than 138 percent of the federal poverty level. The Congressional Budget Office expects Obamacare to add $1 trillion worth of new Medicaid spending over the next decade.  
4. DO NOT REPLACE OBAMACARE and  5. REPEAL OBAMACARE  As noted above, Paul Ryan’s words:… So, next year, if we’re sending this bill to a Republican president, it will get signed into law. [Emphasis added.]  Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted. it.
 Ramirez on it with customary insight:     The government role causes disparities, and tax considerations play a part where they do not belong. . E.g.: …employer-sponsored health insurance gets a huge tax subsidy — premiums paid by the employer and employee alike are tax exempt, and employers have the further option to offer tax-advantaged health savings accounts and flexible spending plans and even to help employees with their contributions.
Paul Hsieh, a physician and co-founder of Freedom and Individual Rights in Medicine, writing in Forbes
I do support the idea of reducing the differential tax treatment between employer-provided health insurance and privately purchased insurance — and eventually eliminating this disparity. This would go a long way towards uncoupling health insurance from employment, a reform we badly need.)  
andthe real cause of rising health costs is not ‘fee for service’ but rather a third-party payer system that encourages wasteful spending….The marketplace or the bureaucrat? Do you want the freedom to spend your own money for your own best medical interest according to your best judgment? Or do you want the government deciding how much can be spent on your health care? 7. ALLOW COMPETITION AMONG HEALTH CARE INSURERS ACROSS STATE LINES   Increasing competition will help with premiums and plans.
 8. ALLOW DOLLAR FOR DOLLAR DEDUCTION FOR HEALTH CARE INSURANCE PREMIUMSand 9. ALLOW DOLLAR FOR DOLLAR DEDUCTION FOR ALL MEDICATIONS, PRESCRIPTION AND NON PRESCRIPTION These are tax considerations which could help immensely. Both these provisions would provide incentives for young people to take care of themselves. At present, while they are enjoying youthful health, there seems to be no downside to putting off insurance premiums or expensive meds. But one thing even youth cannot avoid is the IRS. Young people should embrace these ways to reduce taxable income, with resulting benefit to them and us. 
10. PROVIDE TORT REFORM  Texas has had success imposing limitations on punitive damages The result has been lowered malpractice insurance premiums, which in turn keeps doctors working and patients receiving help. 11. USE NUCLEAR OPTION TO REMOVE 60 VOTE REQUIREMENT FOR LEGISLATIVE MEASURES.
 While Senator Paul wants to repeal Obamacare root and branch, at present he is for a replacement plan offered from the outset. would hope he could be persuaded to implement his ideas when we see what needs to fixed after we are out from under the program foisted upon us by the Democrats. That will put things in the proper context: Republicans cleaning up Obama’s mess.   


Facts are stubborn things…Don’t be afraid to see what you see. …No government ever voluntarily reduces itself in size…Professional politicians like to talk about the value of experience in government. Nuts! The only experience you gain in politics is how to be political. … .Millions of individuals making their own decisions in the marketplace will always allocate resources better than any centralized government planning process… 

– Ronald Reagan

Dick Coleman

Richard M. Coleman served as National Co-Chair, Lawyers for Reagan-Bush ’84 and really does miss RR. A graduate of Georgetown University and Harvard Law School, Dick is a Fellow of the American College of Trial Lawyers, and a past president of the Los Angeles County Bar Association and of the National Caucus of Metropolitan Bar Leaders. A professor on the faculty of Pepperdine University’s Straus Institute for Dispute Resolution for 17 years, he received Pepperdine’s Excellence in Teaching Award. He has hosted TV forums on legal and financial topics and written and spoken extensively on political issues.

© Richard M. Coleman 2018