Can we be serious now?
With Sen. John McCain delivering the fatal blow to the Senate’s final-for-now effort to repeal the Affordable Care Act early Friday, perhaps Senate Republicans can now do what Majority Leader Mitch McConnell recently suggested, though in the form of a threat: negotiate with Democrats.
That appears to be what the country wants. It’s what Minority Leader Charles E. Schumer has offered. It’s a way forward – a way to promote health for Americans and for Congress to regain a reputation for sobriety. By taking a clear-eyed approach to the potential solutions for health care and, more specifically, the ACA, it can build support for its prescriptions while showing that it actually can produce legislation of value to the Americans who are – make no mistake – watching them.
It even has a place to begin. Rep. Brian Higgins and several of his Democratic colleagues have unveiled intriguing legislation to allow Americans between the ages of 50 and 64 to buy into Medicare, creating potential benefits for them, their employers and private insurers – and all without damaging Medicare’s balance sheet. He plans to introduce the measure this fall.
That’s one approach. There are others that could work in combination. Congress, as this page has argued previously, also should look to reform how courts handle malpractice lawsuits (though many of these occur in state, not federal, courts) and to lower the price of prescriptions by making use of the government’s purchasing power. Democrats will hate the former and Republicans will cringe at the latter. What can they do? They can compromise.
That is what McCain urged earlier this week when he voted to allow debate on health care to begin, but followed up with a passionate plea for the Senate to return to working as it is meant to. “We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle,” he said.
But to change, members will also have to follow the Arizona Republican’s advice to shut out the crackpots lobbing virtual hand grenades from the outside: “Stop listening to the bombastic loudmouths on the radio, television and internet. To hell with them! They don’t want anything done for the public good.”
That’s the first required step if Congress is to relearn the ropes of compromise. Little can happen until they do. Republicans and Democrats will both have to risk angering their bases. This country works best from the political center, not the fringes.
It’s hard to be optimistic. The best chance of compromise will be in the Senate, where the rules are different and six-year terms offer some protection from political pressure. But even if that happens, the House is a more volatile place, with more members committed to killing the ACA, also known as Obamacare.
After that President Trump would have to be willing to sign the legislation, even though he has promised voters the ACA would be history on “Day One” of his presidency. He wouldn’t be the first politician to declare victory and run, but a lot of unlikely events would have to occur first.
But something has to happen and it shouldn’t be Trump’s half-baked idea of letting the ACA die of its own accord, which will damage the health care of millions of Americans, many of whom voted for Trump. The legislation written by Higgins is as good a place as any to start.
The Medicare Buy-in and Health Care Stabilization Act would allow Americans at least 50 but under the current Medicare age of 65 to buy into the program at a cost far lower than traditional insurance, but high enough to bolster Medicare’s finances. It would be voluntary, but by taking older, often sicker, Americans out of the private market, premiums for younger people could be lower without hurting the bottom lines of private-sector insurers.
It’s not a health care cure-all, but it offers enough temptations to be worth closely examining. It has attracted the interest of many Democrats and even some moderate Republicans, Higgins said.
If Congress is willing now to be serious about health care, examining this idea would be a good way to prove it.