Although Republicans have talked incessantly about repealing Obamacare since the day it became the law of the land, they were for Republican versions of it before they were against it. They are for Republican versions of it right now. And they wholeheartedly support government intervention into the health-care and health-insurance industries that are even worse.
In the recent Supreme Court case of King v. Burwell, the Court once again upheld a legal challenge to Obamacare (the Patient Protection and Affordable Care Act). At issue this time was whether federal subsidies were available for purchasing health insurance under both federally run and state-run health-insurance exchanges. The Court ruled that they were, even though the letter of the Obamacare law says only that subsidies are available to those “enrolled in through an Exchange established by the State.”
Previous to that, in the Supreme Court case of National Federation of Independent Business v. Sebelius (2012), the Court upheld the Obamacare “individual mandate” to buy health insurance as a constitutional exercise of the power of Congress to “lay and collect taxes” even though the congressional mandate that individuals purchase health insurance was to be enforced by a penalty. This, the dissenting opinion made clear, was an unconstitutional attempt by Congress to regulate beyond its power under the Commerce Clause. And reclassifying the individual mandate as a tax rather than a penalty in order to sustain its constitutionality “is not to interpret the statute but to rewrite it.”
In both cases, Chief Justice John Roberts (a George W. Bush appointee) provided the swing vote in favor of Obamacare.
On strict party-line votes, both the House and Senate have voted countless numbers of times to repeal Obamacare since the Republicans regained control of the House in the 2010 midterm elections and the Senate in the 2014 midterm elections. But, of course, it is a meaningless exercise because Barack Obama would never in a million terms as president sign into a law a bill to repeal his signature piece of legislation and eponymous health-care law. It is good political theater for the Republicans, though.
Republican presidential candidates Rick Santorum, Carly Fiorina, Marco Rubio, Rand Paul, and Ted Cruz, as well as Republican candidates for other offices, have signed the Obamacare Repeal Pledge, a project of Independent Women’s Voice and American Majority Action. The “presidential version” of the repeal pledge reads,
I pledge, if elected, to sign all bills which seek to REPEAL the health care bill, HR 3590, signed into law on March 23, 2010.
To that end, I would now and will for the duration of my presidency, promote and sign all measures leading to its defunding, deauthorization, and repeal.
I shall do so whether those measures are taken for the whole of the bill or those component parts that impose mandates, restrict patient and doctor choice and access, violate individual freedom and privacy, reduce healthy competition, increase costs, or raise taxes.
Although Republicans claim to belong to the party of the Constitution, federalism, limited government, less-intrusive government, less-government regulation, and the free market, they have always envisioned a role for the federal government in health care.
In 1974, Richard Nixon proposed that every employer be required to offer all full-time employees the Comprehensive Health Insurance Plan (CHIP). It included temporary federal subsidies to employers to help them cover their share of the cost.
In 1986, Ronald Reagan signed into law a bill that was passed with the help of the Republican-controlled Senate called the Emergency Medical Treatment and Active Labor Act (EMTALA). It requires any hospital that participates in Medicare (virtually every hospital) to provide emergency care to anyone who needs it, regardless of his lack of insurance, immigration status, or ability to pay.
In 1989, the Heritage Foundation, a conservative think tank, issued a monograph entitled “A National Health System for America.” It reads like a conservative version of Obamacare, with an individual mandate, government subsidies to purchase insurance, and a penalty for failing to be insured.
In 1993, the Republican alternative to Bill Clinton’s health-reform bill appeared: the Health Equity and Access Reform Today Act (HEART). The legislation proposed health-insurance vouchers for low-income individuals as well as employer and individual mandates.
In 1997, the Republican-controlled Congress created the State Children’s Health Insurance Program (SCHIP), a partnership between federal and state governments that provides federally funded health insurance to children in families with incomes too high to qualify for Medicaid.
But even while Republicans talk out of the right side of their mouth about repealing Obamacare, they talk out of the left side of their mouth about making health care accessible for everyone regardless of pre-existing conditions or past illnesses, eliminating annual and lifetime spending caps, expanding state high-risk pools, and reducing the cost of health-insurance coverage.
Walker’s goal is a more affordable and more efficient system that will not add to the deficit. He wants to replace the existing system of tax credits under Obamacare with a system based on an individual’s age instead of income. Tax credits would be available to anyone without employer-based health-insurance coverage. Under the Walker plan, “the federal government would provide funds to states to help provide coverage to those with pre-existing medical conditions who still do not have insurance coverage and who couldn’t afford it before ObamaCare.”
Rubio pledges to “reform insurance regulations to lower costs, encourage innovation, and protect the vulnerable.” Americans with pre-existing conditions should have access to “federally-supported, actuarially-sound and state-based high risk pools.” Rubio wants to work with Congress to “create an advanceable, refundable tax credit that all Americans can use to purchase health insurance,” the value of which should increase every year.
Why are Republicans so upset about Obamacare? Not only have they supported and do they support Republican versions of it, they support two federal programs that are even worse: Medicare and Medicaid.
Medicare is government-funded health care for Americans 65 years old and older and for those who are permanently disabled, have end-stage renal disease, or have ALS (Lou Gehrig’s disease). Medicaid is government-funded health care for poor Americans of any age and people with certain disabilities.
Aside from its many tax increases, the main problems with Obamacare are its mandates. The individual mandate dictates that every American not covered by Medicaid, Medicare, or private health insurance must purchase health insurance or pay a penalty come tax time. The employer mandate dictates that all employers with 50 or more full-time or full-time-equivalent employees must offer them “affordable” health insurance that provides “minimum value” or pay an annual tax penalty.
Medicare and Medicaid are pure socialized medicine. Yet conservative Republicans — not RINOs, liberal Republicans, or moderate Republicans — are some of the biggest supporters of those programs. In fact, in 2003, when the Republicans had a majority in both houses of Congress under a Republican president, they introduced and passed the Medicare Prescription Drug, Improvement, and Modernization Act — the largest expansion of Medicare since it was instituted as part of Lyndon Johnson’s Great Society.
It is libertarians who are not only upset about Obamacare, but have the real solution to the health-care and health-insurance woes that plague this country.
First, repeal every word of the Obamacare legislation and replace it with nothing.
Second, repeal all laws, mandates, and regulations relating to health insurance.
Third, repeal all laws, mandates, and regulations relating to health care.
Fourth, repeal all laws, mandates, and regulations relating to medicine.
Fifth, abolish Medicare, Medicaid, SCHIP, and the Department of Health and Human Services.
Sixth, abolish the DEA and FDA and end the War on Drugs.
In other words, get the government completely out of health care and institute medical freedom.