While it’s true this is the first time a Republican controlled congress has effectively voted for an entitlement, it is also the first time since the New Deal that a major entitlement has been reeled back.
Opposition to the ACA (Obamacare) has united and galvanized the center-right coalition in an unprecedented way, and has led to unprecedented political gains in local, state, and federal office for the Republican Party. Republicans hold the majority of governorships, state legislatures, both houses of congress, and the presidency (Democrats still hold sway in the judiciary, especially the lower courts, thanks to the nuclear option enacted by Harry Reid). Every election since the passage of the ACA has seen victories for Republicans.
But, despite all of this, something totally unexpected happened. Despite American’s overwhelming opposition to ACA, certain aspects of the law became normalized, such as the coverage of pre-existing conditions at no extra cost in premiums, children being covered on their parents’ insurance until 26, and the expansion of Medicare and Medicaid. This normalization was further solidified with the language Donald Trump campaigned on, promising “We’re going to have insurance for everybody”, “…there will be no cuts to Social Security, Medicare & Medicaid”, “I am going to take care of everybody” and even recently has touted a clause in AHCA that “guarantees protection” for those with pre-existing conditions. The first step towards understanding why Republicans are pushing its very first independently owned entitlement program is that while they won elections, they lost the narrative. For the first time since the New Deal, the majority of Americans believe centralized, government control can provide a more equitable solution then the free market.
Despite all of this, Republican leadership still had a path towards a full repeal of Obamacare and the re-establishment of free market principles to the health insurance market, backed by amazing innovations that could assist in establishing equity in the market without making it an arm of the government bureaucracy (HSAs, patient/physicians co-ops, creation of an FDIC like entity to recoup insurance company losses for pre-existing condition coverage, etc).
In 2015, congress passed the Restoring Americans’ Healthcare Freedom Act, voted affirmatively by all but seven Republicans in the House and two Republicans in the Senate. While the bill was vetoed by Obama the next year, it would have effectively fully repealed the ACA. If party leadership had put the same language on the floor this year, the bill would have either passed, or a lot of representatives would be explaining to their constituents why they were posturing against Obamacare in 2015 but got cold feet now that there’s a President who would actually sign the bill. Instead, congressional leadership and President Trump let the progressive Republicans off the hook with the AHCA, and they were much more at liberty to resist bold moves establishing free market principles then if they’d been opposing a bill they had already voted for once.
Now, the AHCA has passed the House of Representatives. Key in its passage was language allowing states to file for waivers from certain Obamacare requirements still in effect, which won the support of the House Freedom Caucus, and the creation of high risk pools to help those with pre-existing conditions maintain coverage, which won enough defections from the Tuesday Group to secure passage.
Supporters of free market principles should be frustrated that the AHCA is not a victory matching the rhetoric promised by Republicans in election after election, but should also recognize that it is, nevertheless, a victory. While it’s true this is the first time a Republican controlled congress has effectively voted for an entitlement, it is also the first time since the New Deal that a major entitlement has been reeled back. While many states will continue to labor under many of Obamacare’s provisions, the language of the AHCA will allow some states to wrest free from federal control of health insurance and begin establishing the free market within their borders. The AHCA is a resounding victory for federalism!
Moving forward, we will have a state to state comparison of the effectiveness of approaches and obtain concrete data which can win the support of the American public back towards believing equity can be more easily derived from a free market providing individual choice and quality private options as opposed to the false hopes that central planning and government control can manufacture things only freedom and liberty can provide.
We must, however, wait to see if the Senate can indeed pass the AHCA while maintaining the State waivers and the center-right integrity of the bill. As a reconciliation measure it only needs a simple majority, so the votes are there. But, it will likely face similar theatrics as progressive Republicans square off against liberty/freedom Republicans for the bill’s soul.
Moving forward, we must realize that while the AHCA is not what supporters of free market principles were hoping for, it is still a step in a positive direction and would be much better then leaving the ACA in place. If we make too much of a stink about what was promised, as opposed to the realistic options now in front of us, we may well be stuck with Obamacare for the foreseeable future. And, irregardless of President Trump’s tweets to the contrary, letting Obamacare collapse of its own weaknesses would be disastrous for America and disastrous for the cause of economic freedom. Make no mistake, every step this country is allowed to take towards an Obamacare collapse is a step towards a single payer system.
I myself am frustrated with the language of the AHCA and frustrated with how foolishly party leadership let the opportunity to fight for full repeal slip from their fingers. I’m frustrated that Donald Trump campaigned on full repeal but kept using language that demonstrated his lack of understanding of free market principles and the realities of the health insurance dilemma. I’m frustrated that Paul Ryan has not lived up to the hopes of moving on from Boehner era brinkmanship in placing concerns of Democrats and moderates over the will of voters manifested in election after election. I am frustrated that time and time again, the Democrats seem to manage a free-for-all when they’re in power and Republicans barely manage to hit the brakes.
But, I will not let my frustrations or my resentments dictate my words and actions, nor surrender my common sense in a reckless attempt to constantly find a hill to die on. Neither I, nor the House Freedom Caucus, are abandoning principles in begrudgingly supporting the AHCA. We have stood our ground and won some valuable concessions, and should be wary of walking away from a chance to reel back the damages of the ACA, and at least console ourselves with the realization that while our efforts may not have led to a giant leap for economic freedom and individual liberty, it has, at the least, secured a few firm steps in a better direction and clarified the narrative that the AHCA is not the full repeal promised and has clearly communicated to the people of the United States, and to congressional and executive leadership, that this fight is far from finished.
Remember, if we give up our place at the legislative table as the AHCA goes to the Senate, we only succeed in granting more power to the progressives who most assuredly will take advantage of our absence.
-The Millennial Federalist
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