The Republican majority in the House of Representatives is moving ahead with a repeal vote of the Affordable Care Act (ACA), which is set to take place on January 12, 2011. The conventional wisdom is that this is a waste of time because it would take 60 votes in the Senate to repeal the ACA and two-thirds of the House and Senate to override the inevitable Presidential veto.
I disagree. It is good news that we will revisit health care reform. I have written consistently that the ACA was a good step, in large part because it was a step. The law that was passed has the chance to begin to address health care costs if implemented, and substantially expands coverage, but we know that we will have to do more in the future to get a handle on health care costs. And we must do more soon because our long term deficit problem is fundamentally a health care cost problem.
One of the benefits of passing the ACA is that it has put the health care system in play, making further changes to health care inevitable. There are certainly policy options that would improve the ACA, and if the Republicans used their new found majority in the House to push some of these options like capping the tax exclusion of employer paid health insurance premiums to slow health care cost inflation, they would deserve credit.
Here are some thoughts I have about what a compromise between Democrats and Republicans could look like. If Republicans are inexorably opposed to an individual mandate now, then lets produce true universal coverage and do away with the need for one. I would trade true universal catastrophic coverage for scaled back insurance benefits and no individual mandate in a second.
The Republicans promised in the election that they would repeal the ACA. Fair enough, have the show vote. But, after that, they owe it to the country to provide clarity in the direction they would take the nation on health care reform. They have to shift from defense to offense. There is no evidence they have an offense.
Now is their chance to prove me wrong: they control the House of Representatives, and all the committees. They need to move beyond slogans and sound bites and write a bill. If it is so simple to address costs and 50 Million uninsured persons, the bill will be short and everyone can read it and get to know it well. Then have hearings on their bill. Mark it in a committee(s). Have the CBO score the bill. Let the country talk about it, and how it compares to the ACA. Debate the best way forward. And then put it to a vote in the full House of Representatives. The Republicans not only owe specificity to the country, they owe it to themselves if they want to be taken seriously on matters of health policy.