Despite the chaos and disappointment which defined the health care debate in Washington this summer, there is still both an opportunity and obligation to get some big and serious things done for the American people this year.
While tackling tax reform, regulatory reform, entitlement reform and many other challenges are critical to ensuring American prosperity for future generations, health care reform must remain at the top of Congress’ to-do-list this fall.
In voting for sweeping change last November, the chief issue driving many voters was the repeal of Obamacare, a policy monstrosity railroaded through Congress by Democrats in 2010. In the years following, health care premiums have skyrocketed; insurers have left the marketplace and the number of choices has decreased; federal spending is inequitable among the states; employers have been forced to cut hours for workers because of new regulations; and Americans have suffered higher taxes and dropped coverage.
Despite years of promises, Republicans failed at multiple attempts this summer to pass reform through Congress. But this fight doesn’t need to be over. There is still a chance to remedy our imperiled health care system, and it begins with repealing Obamacare and shifting power back to the states.
Senators Lindsey Graham (R – SC), Bill Cassidy (R – LA) and Dean Heller (R – NV) have proposed commonsense legislation that would block-grant funds – based on a fair distribution system – back to states and allow them the flexibility to craft their own market-based proposals, designed to meet their own unique needs, capacity and populations.
The last seven years have served as a painful example of the drawbacks and failures of relying on an inflexible, ill-designed national solution to the complex set of challenges that plague our health care system.
In Florida, we sought a waiver from the U.S. United States Department of Health and Human Services in 2005 to completely overhaul how our state implemented the federal Medicaid program. In doing so, we lowered costs, increased choices and improved quality. Just a few years later, the reforms we implemented were proven to work so well, the legislature, with bipartisan support, expanded them statewide.
Our founders established the bedrock constitutional principle of limiting the power of the federal government. Florida is one of many states to have proven the wisdom of this principle and the power of states to innovate when it comes to health care.
The block grant-approach featured in the Graham-Cassidy-Heller proposal would also be bolstered by funding for states to reform their insurance markets and ready for coming systemic changes, including help to boost participation by both consumers and insurers. Additionally, it includes many of the best revisions in the Senate Republican "Better Care Reconciliation Act." It repeals Obamacare’s individual and employer mandates and subsidies; allows for the expansion of Health Savings Accounts; enables states to reform their Medicaid programs; and eliminates more than $235 billion in taxes.
The legislation isn’t perfect, nor is it the only thoughtful conservative proposal that has been offered by Congressional Republicans in the years since Obamacare was signed into law. But it does represent one of the best hopes Republicans have for salvaging health care reform this year. Democrats should also give this bill thoughtful consideration as it recognizes that states may choose different paths to achieve their goals and will protect the autonomy of both red and blue states. We can all concede that the challenges California and New York face are much different than challenges faced by, say, Montana, Kentucky or New Hampshire.
The Graham-Cassidy-Heller plan is also a much better solution than the proposal recently offered by Governors John Hickenlooper and John Kasich, which unfortunately keeps most of Obamacare intact, including Medicaid expansion and the individual mandate.
Going even further than the Graham-Cassidy-Heller proposal does currently, Congress should also consider allowing for blending of funds and similar block grants for federal programs like the Children's Health Insurance Program, Temporary Assistance for Needy Families, public health funding and Medicaid so that states can create connectivity between these programs. The more flexibility states have, the more innovative and efficient the results will be.
One of the most predictable flaws of Obamacare was that it put enormous power in the hands of a few people in Washington. Now, as a new administration implements its policies, supporters of Obamacare are crying foul and criticizing the administration. Why? The administration is merely pulling the very levers put into law by Obamacare. This is the fundamental argument for why it is dangerous to concentrate so much power in the hands of so few people, and why the founders of our great nation believed these powers rightly belonged with the states.
With Congress back in Washington this month, members have no shortage of serious decisions to make, including votes to raise the debt ceiling, avoid a government shutdown, reform our tax code and accelerate aid for Texans in the wake of devastating Hurricanes Harvey and Irma. These challenges shouldn’t become an excuse for not delivering on the Republican Party’s biggest promise to voters last November.
However well-intentioned it may have been, it is time for a bipartisan recognition that Obamacare has failed. Republicans in Congress were elected on a platform to repeal and replace this failed policy, and voters throughout the nation are hoping they keep their word.
Jeb Bush served as the 43rd Governor of Florida and ran for the 2016 Republican presidential nomination.
Alan Levine served as a senior advisor and health secretary in the administrations of both Governor Bush and former Louisiana Governor Bobby Jindal. He is currently the president and chief executive officer of Mountain States Health Alliance.