The Affordable Care Act (ACA), commonly known as Obamacare, was passed in March 2010 without a single Republican vote in the House or Senate. The legislation was controversial because it required all American households to purchase medical insurance. The individual mandate provision was challenged in federal court, and Supreme Court Chief Justice John Roberts led a 5-4 majority in ruling that the mandate was in fact a tax and therefore was constitutional.
The ACA contains thousands of pages of complex regulations, which members of Congress did not have time to study and debate before voting on the measure. Speaker Nancy Pelosi famously made the statement, “You will have to vote for it to find out what is in it.” Since passage, thousands of pages of new regulations were added by the Obama Administration Secretary of Health and Human Services.
President Donald Trump and Republican members of Congress campaigned in 2016 on the promise that it would repeal and replace Obamacare. They cited the rising medical insurance premiums and deductibles since the law was implemented as the imperative to replace it. The legislation to repeal and replace the ACA was rolled out by Republican Speaker Paul Ryan and labeled the American Health Care Act (AHCA).
RYANCARE CRASHES AND BURNS
Conservatives quickly designated the AHCA as “RyanCare” and blasted it for not allowing consumers to purchase medical insurance policies across state lines or including other free-market provisions, which would bring down premium costs. Opposition by Rep. Mark Sanford and other members of the conservative Republican Freedom Caucus led to Ryan withdrawing the bill without a vote.
The Congressional Budget Office scored the AHCA, and the results were not what Trump or Congressional Republicans had promised during the campaign. The projection was that it would cause premiums in the individual insurance market to rise 15-20 percent in 2018 and 2019. Sanford observed, “What people want to see is a drop in their premiums and greater choices in the way in which they can buy insurance. If the Republicans’ reform plan does not do those things, I think a lot of people will be upset.”
THE SANFORD ALTERNATIVE
Sanford and the House conservatives felt like they were not included by the House leadership in the development of the AHCA, so he offered an alternative — the Obamacare Replacement Act (HR-1072). Modeled after similar legislation sponsored by Sen. Rand Paul (R-KY), the Sanford plan proposes free-market solutions to bring down the cost of medical insurance.
The Sanford plan allows individuals to deduct the cost of premiums from their taxes, as businesses currently can do. It would allow policies to be purchased across state lines, which would increase competition in the insurance market and lower prices. It would allow professional and trade associations such as realtors and plumbers to form group purchasing plans. The Sanford plan would allow households to put up to $5,000 in pre-tax income into Health Savings Accounts (HSAs) each year and use those HSAs to pay for premiums or any medical expenses.
THE WAY FORWARD
President Trump supported the AHCA, even though it didn’t meet the provisions he outlined during the campaign. While Trump took the time to meet with the members of the House Freedom Caucus on several occasions, he never publically advocated for the group’s principles. When it became apparent that the AHCA would not pass, Trump said he was going to shift his focus to tax reform.
The Secretaries of Health and Human Services (HHS) in the Obama Administration issued about 1,400 mandates and directives within the ACA. Trump HHS Secretary Tom Price, a former Congressman and orthopedic surgeon, has the authority to remove or amend those provisions or add new ones. I would like to see him add a provision to require price disclosure for medical services. I get my blood work for annual physicals at Any Lab Tests Now on Ashley River Road, which publishes all of its prices. I pay $229 for the tests, which would cost more than $600 if I purchased them through my insurance plan. Prices will go down if consumers know what they’re paying.
John Steinberger is the editor-in-chief of LowcountrySource.com. To contact him, email John@LowcountrySource.com.
