It’s as if Democrats didn’t even bother reading the GOP bill before attacking it.
After the House voted last week to repeal and replace ObamaCare, Democrats quickly launched a barrage of false attacks. Minority Leader Nancy Pelosi asserted that the bill would “gut” protections for patients with pre-existing conditions. Never one to shy away from melodrama, she added: “This is deadly. This is deadly.”
Apparently the GOP proposal is the second health-care bill Mrs. Pelosi didn’t read. The legislation makes clear: “Nothing in this Act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”
On Fox News Sunday, the MIT economist Jonathan Gruber came from a different angle, alleging it was dangerous to grant states waivers from some ObamaCare requirements. He suggested insurers could now “literally say, just because the genes you were born with, you’re going to pay more for health insurance.”
Apparently Mr. Gruber is also averse to reading. States may seek waivers from some ObamaCare provisions, but the law explicitly prohibits waivers on pre-existing-condition protections. To receive a waiver insurers must prove it would lower or stabilize premiums, increase coverage, or expand the choice of health plans.
People in waiver states who never had insurance or let their policies lapse would be guaranteed coverage, but to keep them from gaming the system, insurers could take their health into account when determining premiums. After one year, premiums would drop to the standard rate. This rare occurrence is a long way from Mr. Gruber’s charge that people would pay “many, many multiples more.”
The bill also includes $8 billion over five years to help states with waivers set up high-risk pools to cover people with expensive illnesses. Mr. Gruber dismissed this as “trivial.” Yet the Kaiser Family Foundation found in 2011—before ObamaCare kicked in—that 35 states had high-risk pools covering 226,000 people with $2.6 billion in claims. Some $1.4 billion was covered by the premiums these patients paid, and the states had to toss in only $1.2 billion. That’s $400 million less than would be available each year under the GOP bill. Even the New York Times reported that if states tapped all the bill’s available money for high-risk pools, it would total $138 billion. And who thinks 35 states will seek waivers?
This hardly exhausts Democratic complaints. Rep. Richard Neal (D., Mass.) said last weekthat Republicans had voted to impose an “age tax,” because the bill would allow premiums for older ObamaCare policyholders to be five times those of younger people. (Now insurers can charge older people only three times as much.) Yet the older age group’s health expenses are, on average, nearly five times as high. Today everyone under 50 on ObamaCare is paying higher premiums to subsidize the policies of those above 50.
So in reality, Republicans are repealing the “age tax” Democrats placed on the younger 80% of ObamaCare policyholders to subsidize the older 20%. This despite that older ObamaCare policyholders are in their prime earning years and likely have higher incomes, greater wealth and lower child-rearing expenses.
There is also Mr. Gruber’s startling claim that the Republican bill will cause 24 million people to lose their insurance. How can 24 million people lose ObamaCare coverage when only 11 million people bought the policies? The claim is a distortion of the Congressional Budget Office’s estimate that abolishing ObamaCare’s individual mandate would lead 24 million people to forgo purchasing insurance in the future. Freed of ObamaCare’s penalty—a 3% tax on their income—people may decide to do something else with their money.
The CBO is notoriously bad at estimating the benefits, such as lower prices, that come from a consumer-driven system. The Republican bill would enable more competition, expand health savings accounts and promote inexpensive catastrophic coverage.
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Mr. Gruber was similarly misleading in claiming “the House bill cuts Medicaid by $880 billion over the next 10 years,” hinting the program would wither away. Federal Medicaid spending this fiscal year is $389 billion. Under the GOP bill, it will be $469 billion in fiscal year 2027. The bill restrains future Medicaid growth. It doesn’t reduce spending.
From his academic bubble, Mr. Gruber said last year that ObamaCare is “working as designed” and “there’s no sense in which it needs to be fixed.” Yet since its passage, Americans have lost plans and doctors and watched as their premiums and deductibles skyrocketed.
Republicans can win the health-care battle by doing two things well: First, reminding voters of ObamaCare’s many broken promises. Second, and more important, offering a practical explanation of how their plan will improve health care. It helps that Republicans have reality on their side.