Senator Ron Johnson (R., Wisc.) has a plan in case the Supreme Court strikes down the Obama administration’s illegal subsidies for insurance plans in 37 states. He has gotten 31 of his Senate Republicans to join him in sponsoring his bill. He deserves credit on both points: Republicans will need to present a united front in the event the Court rules that way. But we fear that the Senate Republicans are setting their sights too low.
The Obamacare law authorized subsidies to offset the price of health-insurance plans offered on health exchanges established by the states. Most states refused to establish exchanges, surprising the administration, which decided to hand out subsidies in all the states. If the Court rules that it has to stop doing that, several million people will find their insurance bills rising, or their policies canceled.
The impulse to prevent another government-induced disruption to people’s health-insurance arrangements is a laudable one. So is the desire to reduce Obamacare’s regulatory burden. Even the desire to punt on the legislative debate over health care until 2017 makes some sense: It would force a reopening of health-care policy under, let’s hope, a better president. So if the bill passed, we would end the Obama presidency having dismantled part of Obamacare and with the prospect of replacing much or all of it in the near future.
The bill is also a disappointment in another way: It immediately moves Republicans into negotiation mode when they ought to be presenting their own health-care ideas.
A better starting point would be to offer the states a choice: If they do not want to participate in Obamacare, they can opt into a new system in which their residents can still get subsidies but they get out of almost all of the law’s regulations. And they should also have the option of letting most of their Medicaid money be cashed out so that recipients can purchase insurance in the regular market. Instead of just weakening Obamacare, as worthy a goal as that is, Republicans should allow red states to build a different and better model for health-care policy alongside that law’s blue-state model. That approach truly would help to set the stage for Obamacare’s replacement under a new president.
If, that is, it were enacted, which it probably would not be. But Republicans could then negotiate down to something resembling Johnson’s bill. They would have a better chance of getting that kind of deal if they initially asked for more, and they would have done more to advance the case for a less centralized system. We know that politics is the art of the possible. But it should also be the art of making good things possible.