Path One is to do something different – to acknowledge the failures of Obamacare, which are massive, and then do a very un-Washington thing and honor commitments made to fully repeal it (which have been numerous), and actually roll back a federal mistake. Then, make a fresh start, with two simple steps. First, freeze Medicaid enrollment immediately and send Medicaid dollars to States with zero strings attached to allow them to innovate and be more effective. Second, increase portability and decrease costs through increased competition, by equalizing the tax treatment between employers and individuals.
If we choose this path, we will, in essence, be saying: Let competitive markets and the States clean up the mess Washington created. Drive down costs through unfettered competition, and increase the number of doctors competing for our business. Cost is the problem. Coverage will naturally increase if costs are lowered and will provide far better health-care options for far more Americans.
Path Two would be business-as-usual, in which we listen to Washington insiders tell us how they are going to construct a health-care system for us. That path is what we were given this week by Donald Trump and the House Republican leadership. That bill, as has been widely observed, is ObamaCare 2.0 – in which the subsidies, regulations, and Medicaid expansion of ObamaCare have been “replaced” with . . . subsidies, regulations, and Medicaid expansion.