I don’t understand health care policy, which is why I rarely write about it. But libertarian writer Peter Suderman does understand it, so when he writes this about the AHCA, I pay attention. Excerpts:
I have been a critic of Obamacare since it became law, but the Republican alternative is worse in nearly every way.
The American Health Care Act, which was narrowly passed in the House last week, would worsen Obamacare’s problems rather than fix them. Coverage would be disrupted for millions almost immediately, according to a Congressional Budget Office analysis of a previous iteration of the legislation.
The bill would end Obamacare’s individual mandate, already too weak as a policy mechanism, and impose a fee on those who go without coverage and want to re-enter the insurance market — creating an incentive for relatively healthy people to remain uncovered. As a result, the instability that already exists in Obamacare’s exchanges as insurers scale back around the country would only be increased.
It’s unclear what health policy problem this bill would solve. Even for an opponent of Obamacare, it is difficult to understand why House Republicans chose this path to revamping the nation’s health care system.
It’s difficult to understand, that is, if you think they were passing a health care bill. It makes more sense when you realize that isn’t what they were doing at all. They were passing a tax cut — one intended to pave the way for more tax cuts.
The flaws of the bill, then, can be understood as a symptom of the flaws of the Republican Party, which has for decades maintained a myopic focus on tax cuts at the expense of nearly all else. Too often, it is a party of people who seem to confuse governing with cutting taxes.
Suderman deftly explains how this works. Here’s the core principle: “Tax cuts are the one thing every Republican agrees on.” Suderman says there are good reasons to cut taxes and to reform the tax code, but tying it all in with health care policy is courting a major disaster.
It’s like the Republican Party can’t help itself. The prime directive of vulgar Reaganism (“Tax cuts and increased military spending are the answers to every question”) is the thing that cannot be killed.