In the ongoing debate about health care, the newest conversation revolves around cost-sharing reduction (CSR) subsidies, which cover the cost of deductibles and out-of-pocket expenses for certain individuals.
Now, some lawmakers—Republicans and Democrats alike—are calling on President Donald Trump to outlaw the subsidies, which would accelerate the demise of the Affordable Care Act.
Republicans should take a lesson from Democrats. During President Obama’s battle to enact Obamacare, his chief of staff, Rahm Emanuel, famously said, ‘You never want a serious crisis to go to waste. What I mean by that is an opportunity to do things you could not do before.’ I agree. Eight years later, Americans are in a serious crisis because of Obamacare. And now there’s a huge opportunity to deep-six the law. Republicans should not let it go to waste.
It’s time to pivot after the failure of the American Health Care Act (AHCA), the Obamacare replacement bill that was opposed by conservatives and moderates alike.
Why waste time trying to resurrect AHCA or pass another Obamacare replacement bill? Americans want Obamacare repealed. Republicans should begin by following through with President Trump’s threat. End the unauthorized Obamacare cost-sharing reduction subsidy payments, estimated to be $7 billion in 2016. This one action could sink much of Obamacare.
In fact, Congress sued the Obama administration due to the illegal provision of CSRs to insurers. According to the suit, the CSR subsidies violate the constitutional divisions between the legislative branch and the executive branch. Congress won but the Obama administration appealed. Now, the lawsuit is stalled, and President Trump hasn’t yet dropped the appeal, but could—and should.
The Trump administration could implode the exchanges by refusing to provide cost-sharing subsidies. The ending of subsidies and impending collapse of Obamacare would give states a reason to rise up and tell Congress they are taking back health care and re-establishing their own insurance markets for affordable private coverage without the government exchanges.
Obamacare is nothing more than high-priced Medicaid for the middle class. President Trump and Congress now have a chance to end CSRs and with it the unaffordable disaster called Obamacare.
Without these payments, the subsidy-ridden veil surrounding the true cost of Obamacare will be ripped to shreds. And health plan premiums, loaded with ACA mandates and regulatory requirements, will skyrocket to their actual cost.
The fallout will be immediate. Americans who could never afford Obamacare-priced premiums will refuse to buy coverage. Enrollment will plummet. The healthy will forgo coverage. The sick will pay whatever it takes to keep coverage. Health plans will lose their taxpayer-funded financial cushion and exit the Obamacare exchanges in droves. And the Healthcare.gov exchange, funded by a surcharge on monthly premiums, will implode. This is where crisis and opportunity come together.
It’s up to President Trump, Congress and states to right the Obamacare wrong and restore affordability. According to Brase, a real marketplace exists outside of government-controlled exchanges, and affordable insurance exists outside of managed care corporations.
True insurance exists outside of Obamacare coverage. Mr. Trump should drop the administration’s appeal against the Republican lawsuit and stop CSR payments. Republicans in Congress should refuse to fund CSR subsidies. The impending Continuing Resolution, which appropriates money to keep the federal government funded, should not include CSR subsidies. And Republicans in every statehouse around America should reassert their right to direct health care within their borders and enact laws to make it so. The time, and opportunity, to end Obamacare is now.
Twila Brase is president and co-founder of Citizens’ Council for Health Freedom (CCHF, www.cchfreedom.org), a Minnesota-based national organization dedicated to preserving patient-centered health care and protecting patient and privacy rights.