On health care, congressional Republicans should listen to Donald Trump. The president-elect may not be chock-full of ideas about health-care policy, but he has the right political instincts. He has said that Obamacare should be replaced, that its beneficiaries should not simply be stripped of coverage, and that people with pre-existing conditions should be protected. It is possible and desirable to devise legislation that meets these objectives. Trump has also warned congressional Republicans to be careful — and he is right about that, too, because their current course does not look likely to accomplish the repeal of Obamacare or its replacement by something better….
The core of a conservative replacement of Obamacare — a replacement that is simultaneously a repeal — would be the end of the federal government’s role as chief regulator of health insurance and the restoration of the states to that position. Simplify the tax credits, pare them back if possible, and allow them to be used for any insurance policy that meets these two conditions: The policy meets the approval of state regulators, and people who maintain coverage can continue to buy such coverage at the same price if they get sick. People would have much more freedom to buy the coverage that meets their specifications rather than those of Washington regulators; they would have the means to buy basic coverage; and they would have the incentive to do it as well (since maintaining coverage would protect them in the event they got sick).The mandate to buy insurance — a mandate that came into existence in order to counter the side effects of Obamacare’s onerous regulations — should simultaneously be abolished. And most people on Medicaid should be given the option to cash out their benefits and buy insurance on the regular, private market.Too many congressional Republicans think that conservatives will take a quick but phony win on health care. We disagree. A real win is worth the time and effort.