JLF Head John Hood wrote recently on “What Comes After Obamacare.” The key point:
There is a profound lack of realism on both sides. Obamacare defenders think Americans are about to fall in love with the program. Obamacare opponents think Americans are about to rise up to demand its immediate repeal. In reality, most people get their health insurance from self-insured plans, large-group plans, or government plans such as Medicare and Medicaid. They don’t yet see a direct link between Obamacare’s flaws and their own financial and medical circumstances.
Here’s what I believe to be the most realistic path forward after the flaws of Obamacare become undeniable and inescapable – and after more sensible people are elected to federal office in Washington.
First, deregulate the exchanges to make them resemble, and compete with, private insurance exchanges already cropping up in the market. Second, preserve federal tax credits for individual purchase of health plans or services, but make them simpler and universal. Third, create viable high-risk pools to subsidize those with expensive preexisting conditions in the most rational way. Fourth, remove all remaining tax and regulatory barriers to the growth of consumer-driven health plans, which really are reducing health care costs. Finally, use a premium support model to reform Medicare and to transfer able-bodied Medicaid recipients into truly private exchange plans.
The process won’t be revolutionary or dramatic. It will occur gradually, assuming that Washington and the states accommodate it. The Left won’t get its preferred outcome — the collapse of private insurance and the adoption of Medicare/Medicaid for all. But for everyone else, it’ll do.