For ObamaCare replacement to succeed, GOP can’t overpromise

Following a difficult recess in which the organized Left turned out to townhalls in an appeal to keep President Obama’s healthcare law intact, lawmakers are currently debating the best way to fix America’s broken healthcare system. As they consider their policy options, lawmakers should keep in mind the mistakes that led to Obamacare’s failures, and seek to implement new policies that will avoid a similar disaster.

The first mistake of Obamacare was attempting to restructure and regulate a massive portion of the economy through an immense single piece of legislation.  Many lawmakers who voted to pass the lengthy bill did not even know or understand what was in it, evidenced most pointedly by then-Speaker of the House Nancy Pelosi’s now-infamous comment that “We have to pass the bill so that you can find out what is in it.”

{mosads}Not only is this approach unwieldy, but it also all but guarantees that there will be poorly-considered policies contained in the legislation.

As the Brookings Institution’s Stuart Butler recently pointed out, all too often, “a law altering one part (of the health care system) triggers unanticipated changes elsewhere.” Because of this, lawmakers should be given an opportunity to understand precisely what a given bill is intended to do, and should seek to weigh the inherent cost/benefit trade-offs in the proposed policies.  

To do this, Congress first needs to be able to thoroughly consider and debate any proposal.  The give-and-take of the legislative process established by the Founders is designed to air out difficulties with policies and, ideally, develop stronger ones.  

One of the major causes for the problems with Obamacare was that it was rammed through by a Democrat-controlled Congress, with little or no input (nor a single vote) from the then-minority Republicans.  

Second, Congress needs to be able to deal with any unintended consequences of a particular policy with minimal disruption of the broader system.  As Obamacare has shown, comprehensive legislation makes it difficult to fix problematic policies without risking destabilization of other parts of the system.

Hence, a targeted, step-by-step approach to health care reform is preferable to a massive “ObamaCare-lite” replacement bill, which is likely to succumb to the same failures as Obamacare.  Smaller, more focused bills will allow for more debate, and more clarity around what the policies are likely to accomplish.  And, a more focused approach will allow individual pieces to be addressed without risking the collapse of the broader health care system.

But the problems with Obamacare go beyond the process by which it was passed, or a mere bungling of particular policies.

A new constellation of technocratic solutions crammed into a different massive bill is not likely to succeed where Obamacare failed.  The problems lie in the fundamental unsoundness of its fiscal foundation.  As former Senator Phil Gramm recently wrote in “The Wall Street Journal,” “ObamaCare’s problems are not just the result of poor government engineering. They are the result of the financial physics of massive government overpromising.”

A more targeted approach can also help reign in this kind of overpromising by ensuring that policies are feasible and are likely to effectively address the problems they aim to solve.

Thanks to a new set of policy solutions recently outlined by Freedom Partners, there are actions that Congress can and should take to address the access and affordability issues that Obamacare clumsily sought to alleviate, including re-establishing high-risk pools for those with pre-existing conditions, restoring the power of states to address the needs of their populations, expanding health savings accounts, and removing currently-existing barriers to the supply of medical services.  

Congress should continue its hard work in repealing Obamacare using budget reconciliation. But once it does, it is imperative that lawmakers seek replacement measures be passed in a deliberate manner, wary of the unintended consequences that so often accompany changes in health care policy, and responsive to the needs of real Americans whose lives are impacted by these changes.

Shaun Rieley is a policy analyst with Americans for Prosperity.

The views of contributors are their own and not the views of The Hill.