By Steve Levy
The present federal government shutdown was, to many, obviously prompted by Senate Minority Leader Chuck Schumer’s need to show he’s willing to fight Donald Trump so he could mitigate a potential primary from AOC.
Yet, the Democrats have couched the shutdown they initiated around extending Obamacare subsidies enacted during COVID. They have concocted the story that Republicans in the One Big Beautiful Bill had eliminated Obamacare subsidies. To the contrary: Republicans retained the original pre-pandemic subsidies, but simply allowed the temporary additional COVID subsidies to expire as originally intended.
The Democrats are presently winning the public relations war, as polls show an overwhelming majority approve extending the healthcare subsidies. However, it’s doubtful that most polled were aware that the subsidies are referring only to the temporary additional funding that was authorized during the pandemic.
Nevertheless, while Republicans remain steadfast against funding healthcare for illegal aliens, they may be willing to foster compromise regarding the Obamacare reimbursements.
This can actually be a positive development since it would provide the GOP with opportunities to finally incorporate some commonsense initiatives into Obamacare that they failed to achieve in the past.
We all remember how Trump’s efforts to eliminate Obamacare ended with a dramatic thumbs down by John McCain on the House floor.
The problem for Trump and the Republicans is that they never really had a cohesive healthcare alternative they could easily describe to the public.
It is certainly true that Obamacare was extraordinarily costly, inefficient and unsustainable. But the 48 million people who were then uninsured, didn’t really care about the nuances — they just saw the Democrats trying to get them insured while Republicans were either dithering or simply fighting every Democratic plan offered. So the question was: Where’s the Republican plan?
Republicans received a justifiable reputation as being uninterested in the plight of these tens of millions of uninsured Americans.
Consequently, Democrats got credit for their plan, notwithstanding the fact that it was unsustainable and based on the lies that you could keep your doctor and experience a $2,500 drop in premiums. In actuality, premiums increased from an average of $13,000 to $24,000 since its inception.
There have been numerous Republican ideas to improve the system to make it less costly while expanding coverage. However, the rollouts have been disjointed, never receiving the momentum they deserved.
So, if the Democrats want to preserve not only the original Obamacare subsidy, but all additional subsidies, Republicans must ensure they don’t cave to this negotiating maneuver unless they get the reforms necessary to improve our healthcare system while making it more affordable.
Some of the proposals, as noted in my book, Solutions to America’s Problems, can include the following:
- Modify the McCarren Ferguson Act to enhance the ability to obtain insurance across state lines.
- Expand hospice care to help avoid the terminally ill being hooked up to remarkably expensive and ineffective procedures in the last six months of life. A study concluded that 5% of patients account for 50% of total medical costs. Another showed that one-third of that cost occurs in the last month of life.
- Dramatically increase the doctor/patient ratio to mirror other industrialized countries. (The US ratio is 2.6 doctors for every 1,000 compared to 4 to 5 for every 1,000 in many European nations.)
- Implement tort reform. Obama’s first move setting up his program was to bar any conversation about lawsuit reform.
Exorbitant insurance rates aren’t just a result of medical malpractice cases, but more significantly, the enormous amount of unnecessary testing via defensive medicine. (An analysis found that 92% of private sector physicians admitted practicing defensive medicine, compared to 48% of government physicians.)
- Create high-risk or reinsurance pools that spread the cost for the uninsured amongst all taxpayers and not just those paying premiums. In Alaska, 500 chronically ill patients were making it unaffordable for the rest of the population. They faced 40% premium hikes in 2017, before the implementation of a pool kept it down to single digits.
- Allow consumers to customize their plans as they can with an auto policy, so they aren’t forced to pay for unneeded coverage.
- Expand President Trump‘s efforts to lower prescription costs by ending our subsidy for Europe on research and development, eliminating the middleman in prescription purchases, requiring greater billing transparency and opening negotiations with Medicare.
These items need to be packaged into one big beautiful healthcare bill and properly pitched to the public that these reforms will be necessary to keep Obamacare sustainable.
Republicans had warned that the ACA was anything but affordable and would lead to skyrocketing health costs for premium and taxpayers. They were proven right.
The answer cannot be to simply continue increasing the subsidies on an annual basis to keep Obamacare afloat. At some point, the entire system will collapse.
There’s an opportunity now to impose efficiencies, since the Democrats are eager to give the appearance of wanting to negotiate. Call their bluff.
Steve Levy is President of Common Sense Strategies, a political consulting firm. He served as Suffolk County Executive, as a NYS Assemblyman, and host of “The Steve Levy Radio Show.” He is the author of “Solutions to America’s Problems” and “Bias in the Media.” www.SteveLevy.info, Twitter @SteveLevyNY, steve@commonsensestrategies.com