Offered as a correction to this morning’s Headline item. Initially, the Hill reported that Cantor wanted to retain ObamaCare’s framework for preexisting conditions. Not so, as they now note in a postscript to the article: He wants to repeal the whole thing, then replace it with a GOP bill that will have its own, different preexisting conditions provision — but no individual mandate.
How that’s going to work in practice, I have no idea.
Cantor stressed that while he supports full repeal of the current law, Republicans share some of the same goals as Democrats, although they propose different ways of achieving them.
“We too don’t want to accept any insurance company’s denial of someone and coverage for that person because he or she may have pre-existing condition,” Cantor said, addressing a young woman in the audience who noted that she had a pre-existing health condition.
“And likewise we want to make sure that someone of your age has the ability to access affordable care, whether it’s under your parents plan or elsewhere,” Cantor added.
If you’re serious about covering people with preexisting conditions, you’re going to have to subsidize them one way or another. Either you do it by forcing everyone to buy insurance and use the larger premium pool to cover the costs of care for those who are sick, or you bite the bullet and treat this as what it is — welfare for the infirm, a.k.a. Medicare — and let the state pay for them, which means tax hikes to cover the cost. Both options are heresy for Republicans. In fact, so important is the mandate to paying for preexisting conditions coverage in ObamaCare that some think if the former is struck down in court, the latter will have to be tossed out with it. Ace is right that Cantor’s reassurances will make it easier politically to repeal O-Care if the opportunity arises, but what happens if the opportunity does arise and then suddenly the GOP can’t figure out a way to square the cost circle? Are we going to cut other programs to offset the costs for covering preexisting conditions? If so, which ones? He’s making some mighty expensive promises here.
Update: Philip Klein’s underwhelmed by those mighty expensive promises:
Overall, the GOP plan was not very ambitious and is not a true free market alternative. It does allow Americans to purchase insurance accross state lines, but it doesn’t remove one of the biggest barriers to the creation of a free market for health care, which is a tax code that discriminates against those who purchase insurance on their own instead of through an employer. Nor does it include any significant changes to Medicare and Medicaid.
While stopping short of forcing insurers to cover those with pre-existing conditions, the plan would force states to set up “qualifying” federally-subsidized high risk pools or reinsurance programs. It would also make dependents out of everybody through the age of 25, so younger Americans can stay on their parents policies longer. Under ObamaCare, the age is 26.
By all means, the first order of business for conservatives is finding a way to repeal ObamaCare. But winning the health care debate in the long-run will require much bolder solutions than Republican leadership has embraced thus far.
Update: John McCormack of the Standard reminds me of this Capretta/Miller piece from earlier this year about how high-risk pools for those with preexisting conditions might work.