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Horowitz: Do the Right Thing - Fix Obamacare

Tuesday, August 01, 2017


"You can always count on Americans to do the right thing - after they've tried everything else,” said Winston Churchill. By casting the deciding vote to stop the so-called skinny repeal of Obamacare from clearing the US Senate last week, Senator John McCain(R-AZ) has given his fellow Republicans and the President one more chance to prove Churchill right, even on the vexing and divisive issue of health care. Simply put, it is time for a politically smart and substantively correct reset, abandoning the failed effort to repeal and replace and setting the achievable goal of reforming and repairing Obamacare.

Senator McCain, in the statement he released after his pivotal vote, pointed the way: “We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation's governors, and produce a bill that finally delivers affordable health care for the American people. We must do the hard work our citizens expect of us and deserve."

Predictably, so far, President Trump is not heeding McCain’s wise advice, threatening to compound his own political difficulties by withdrawing subsidies for the individual health insurance markets, which would ensure that he owns the resulting steep premium increases and market chaos. “Letting Obamacare fail” as the President often pronounces would not only be irresponsible given the harm it would cause so many Americans; it would inflict major political damage on the President and Republican members of Congress. You can count on most Americans not appreciating President Trump brazenly playing political games with people’s ability to access quality health care—which is sometimes a matter of life and death.

There is a better way, if President Trump is willing to fundamentally change course, and fulfill his campaign promise that everyone would be insured and have access to great health care. It means building a completely different legislative coalition that includes Democrats, along with moderate Republicans and pragmatic conservatives around incremental legislation to fix Obamacare.

This is an achievable goal policy wise that can be accomplished by minimizing risks for health insurance companies through a reinsurance fund and increasing—not lowering-- government subsidies. Taken together, these measures will stabilize the health insurance market and put the brakes on big premium increases. This can be combined with experimenting with allowing health insurance to be bought across state lines and permitting small businesses to join large health care purchasing pools to give them more leverage in the market.

This is a politically smart move for the President as a majority of Americans now approve of Obamacare, while less than 1-in-5 approve of so-called “Trumpcare or Ryancare.”  Underlying these results, as I argued in a recent column, is the fact than 6-in-10 Americans say the government should be responsible for ensuring health care coverage for all Americans, as opposed to less than 4-in -10 who say this should not be the government’s responsibility, according to a recent Pew Poll. This reflects a marked increase in the percentage of Americans who now believe that providing health insurance is an affirmative duty of the government.

If President Trump cannot be convinced to change course, it is time for Senators and House members in both parties to take matters into their own hands. There is a bi-partisan majority that can be assembled for repairing and reforming Obamacare. But it will take courageous leaders from both sides of the aisle; principled legislators devoted to a compromise that serves the best interests of the nation and whom are willing to defy the loudest voices in their respective bases to get it done. 

Let’s hope either President Trump and/ or a critical mass of legislators step-up and prove that Churchill is still right. For many Americans, their access to quality and affordable health care depends on it.


Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates.


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