Time to Go For the Kill -- The IRS scandal means House Republicans can defund Obamacare for good.

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Subject: Time to Go For the Kill -- The IRS scandal means House
Republicans can defund Obamacare for good.
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By Peter Ferrara on 5.22.13 @ 6:09AM

The IRS scandal means House Republicans can defund Obamacare for good.

The IRS scandal provides Republicans and conservatives with the
opportunity to repeal and replace Obamacare now. The House Republican
majority should refuse to fund the expansion of the IRS necessary to
manage Obamacare. Without that funding, and hiring thousands of
additional agents, the IRS cannot even begin to manage Obamacare.

President Obama may throw a fit. He may refuse to sign funding bills to
keep the federal government open. No matter. Let him close his
government down if he wants. Nobody wants the IRS playing political
games with their health care and health records, like it did with the
constitutional rights to freedom of speech and Equal Protection of Tea
Party and conservative organizations. Contribute to the Republican
Party? Attend a Tea Party protest? Good luck getting your Obamacare
health insurance tax credit application approved. Good luck finding a
doctor the government will pay to do that operation your kid needs.

Obama can flail away all he wants. The public will now back the
Republicans in this fight, just as it did in the sequester battle. But
won�t the public feel that the Republicans would be irresponsible to
just refuse to fund Obamacare, leaving the health system in chaos?

That is why the Republicans need to back up their IRS Obamacare
chokehold with legislation proposing free market, Patient Power health
care reforms to replace Obamacare. (A comprehensive, free-market health
reform plan to replace Obamacare has already been proposed by John
Goodman and myself in our NCPA paper, �Health Care for All Without the
Affordable Care Act.�)

Going for the Jugular of Obamacare
President Obama sold Obamacare to the 40% of the nation that supports it
on the grounds that it would provide universal health insurance. But the
Congressional Budget Office (CBO) scores the legislation as still
leaving 30 million uninsured 10 years after full implementation.

It will be much worse than even that, however. In fact, for the reasons
I explain below, it is quite possible there will be more people
uninsured after Obamacare goes into effect than before. That is the
exposed jugular of Obamacare. Those who�ve been supporting it have done
so because they believe in universal health care. If Obamacare is going
to make the problem worse rather than better, for all of its costs, then
public support for replacing it with a better plan will explode. As I
will also explain, the free market, Patient Power plan that Republicans
should now advance would assure universal health care for all, with no
individual mandate, and no employer mandate, at a cost savings of at
least $2 trillion over the next 10 years, as compared to current law.

The employer mandate under Obamacare doesn�t just require employers to
provide health insurance to their employees. Employers must provide the
health insurance that HHS Secretary Kathleen Sebelius specifies that
they must buy, to satisfy the employer mandate requirement. That will
include, of course, every politically correct benefit and coverage,
which will make the required insurance very expensive, in the range of
$15,000 to $20,000 for a family plan. But under Obamacare, employers can
just pay a fine of $3,000 per employee, and forego the much higher cost
of the mandated health insurance altogether. Even many employers who
currently provide health insurance will see this as a better deal, and
terminate coverage, especially since they will no longer be free to
choose their own coverage. Kathleen Sebelius will be choosing it
instead, forcing the costs of their current coverage up.

This is why even the Washington Establishment CBO reported in February
that �in 2019, an estimated 12 million people who would have had an
offer of employment-based coverage under prior law will lose their offer
under current law.� CBO estimated that the number losing their
employer-provided health insurance could rise as high as 20 million.

But that is surely an underestimate as well. As the response of dropping
employer coverage grows, competitive pressure for more and more
employers to do so and avoid Obamacare�s costs will rise, spreading the
practice further. Former CBO Director Douglas Holtz-Eakin estimated in a
study for the American Action Forum that 42 million workers will lose
their employer-provided coverage under Obamacare. Given the strong
incentives for doing so, it could be two or three times higher.

Other employer practices for avoiding the costs of Obamacare will
further increase the number of uninsured. The employer mandate only
applies to full-time workers, defined as those working more than 30
hours a week. But already we see a marked trend in the labor market of
millions of workers suffering cutbacks to 29 hours a week, another
practice that may well accelerate as more employers do it, and it
consequently becomes more accepted in labor markets. The employer
mandate also does not require any coverage for dependents of their
workers. So expect to see many more uninsured as employers drop their
family coverage. Employers will not even pay any employer mandate
penalty for these practices.

We will see dramatic steps to avoid the costs of Obamacare in the
individual health insurance market as well. The penalty for failing to
comply with the individual mandate is only $2,000, so the savings for
avoiding the costly Obamacare health insurance will be even greater.
Moreover, even this penalty is not enforceable under Obamacare. When an
amendment to remove the power of the IRS to garnish wages or seize
assets to enforce the penalty was put to a vote, Congress did not want
to go on record authorizing such measures. So we can expect millions
more in the individual health insurance market to become uninsured as
well.

In addition, everybody will know that under Obamacare�s guaranteed issue
regulation, insurers must accept everyone who applies for coverage no
matter how sick and costly they have become. Moreover, under Obamacare�s
community rating regulation, insurers cannot charge those sick
applicants any more than they charge others. So everyone can just wait
until they get sick with a costly illness to get coverage, at no extra
cost, meaning millions more uninsured.

Of course, that will drive up the cost of health insurance even more,
just as it would for fire insurance if homeowners could wait until their
homes caught on fire to call for coverage, at no extra charge. That is
why health insurance experts are estimating that Obamacare will double
and triple premiums for many workers and small businesses, particularly
for coverage for young and healthy workers. That will cause millions
more to drop coverage, the lower cost young and healthy in particular. A
market survey conducted for American Action Forum found that 17 percent
would drop coverage if premiums rose just 10 percent, 35 percent would
drop coverage if premiums rose 20%, and 45% would drop coverage if
premiums rose 30 percent.

Of course, if the low cost young and healthy drop out, that will just
drive up premiums for the remaining sicker even more. That will mean
still more healthy people dropping their coverage. The resulting
financial death spiral would quite likely drive some insurers out of
business altogether, meaning still more uninsured. This all could quite
possibly mean more uninsured under Obamacare than before.

Universal Health Care Without Obamacare
But the NCPA study referenced above shows how health care for all can be
assured, with no individual mandate, no employer mandate, and a savings
of at least $2 trillion as compared to Obamacare.

To assure health care for the poor uninsured, Medicaid would be reformed
with block grants sending the federal funding to the states, just as was
done for the old Aid to Families with Dependent Children (AFDC) program
in 1996. Those AFDC block grants reduced the cost of that program by 50%
from where it would have been otherwise under prior trends. CBO has
scored Medicaid block grant legislation already drafted and introduced
by Congressman Todd Rokita (R-IN), as designed by the Carleson Center
for Welfare Reform, as by itself saving $2 trillion over the next 10
years.

States could provide the poor with health insurance vouchers to buy the
private health insurance of their choice in the market, where
competition would drive down costs. The poor could use those vouchers to
choose Health Savings Accounts, with proven, market incentives to drive
health costs down further. When the Bush Administration granted Rhode
Island a waiver allowing the state the same flexibility as with block
grants, the state signed the poor up with managed care institutions
ensuring their access to health care.

Such reform would greatly benefit the poor, because Medicaid so badly
underpays doctors and hospitals that the poor on the program face grave
difficulties finding timely, essential care. They are documented in
studies to suffer worse health outcomes as a result, including premature
death. But with private, market health insurance, they would enjoy the
same health care as the middle class, because they would have the same
health insurance as the middle class. The Rhode Island reforms were
documented to improve health care access for the poor over Medicaid as
well.

To assure health care for the sick uninsured who have become too costly
to buy health insurance for the first time in a private, competitive
market, states would receive federal assistance to set up High Risk
pools. Those who could not buy insurance in the private market because
they were already too ill would go to the High Risk pool to get
coverage. They would be charged premiums based on ability to pay, with
state subsidies covering remaining costs. Such High Risk pools have been
established in 30 states, and have worked well at quite modest costs,
because few people actually become too sick to buy private health
insurance in the market.

These High Risk pools would also provide the solution for pre-existing
conditions as well, because those who could not get private coverage for
those conditions could go the High Risk pool.

The law has long provided that those with health insurance cannot be cut
off from such insurance after they become sick. Indeed, that is
prohibited under common law fraud. That prohibition was federalized
under the Kennedy-Kassebaum legislation of 1996. If the law needs to be
updated to close any loopholes, it should be.

The NCPA-healthcare-for-all-without-Obamacare plan also provides for a
Consumer Choice Tax Credit that would expand the same tax benefits of
employer-provided health coverage to everyone. Everyone would be
eligible for a refundable tax credit of $2,500 to $3,000, which would go
to employers that provided health coverage as well as to individuals who
obtained health coverage on their own. This would replace both the
Obamacare health insurance tax credits, and the current employer health
insurance tax benefits, at an additional savings of a trillion dollars
or more over 10 years. The NCPA plan even provides that for those who
fail to use this tax credit to buy health insurance, the subsidy per
person would go to the local government where they reside to be used for
indigent care.

Consequently, everyone would be assured of health care when they need
it. Those who already have coverage would be assured they could keep it.
Those who were too poor to buy health insurance would receive assistance
to buy it. Those uninsured who became too sick to buy health insurance
for the first time in the market would be able to get essential coverage
from the High Risk pools. That provides a solution for pre-existing
conditions that cannot be covered in the private market as well.

Additional provisions in the federal legislation for this NCPA plan can
provide for the interstate sale of health insurance, creating a
national, competitive market that can further drive health costs down.
It can provide for medical malpractice reform as well, for a complete
health cost strategy. And the hundreds of bureaucracies created for
Obamacare can also be abolished, for further savings.

Unlike Obamacare, this truly American health reform plan greatly expands
Patient Power and choice, providing better health care, while reducing
costs through market competition, incentives, and choice.

--
Nick Gillispie describes the Obama-era media as "more prone to
being lapdogs than watchdogs." That has a nice ring to it, but it seems
to us the metaphor is a little off. The pro-Obama media are acting like
watchdogs--but watchdogs whose master is Obama rather than the public.