Repeal and Start Over

By Robert Romano

Now that ObamaCare is the law of the land, and is as unpopular as ever, Congressional Republicans are left with the daunting task of peeling back the layers of the newly-expanded entitlement state left in the wake of the government takeover of health care.

A CBS News poll released last week found an overwhelming majority, 62 percent, of Americans want the GOP to continue their resistance to government-run health care. That includes 66 percent of political Independents, and even 41 percent of Democrats who said that Republicans should continue their opposition. This, as businesses (see: Boston Herald and New Hampshire Union Leader) warn that ObamaCare is a jobs-killer.

With any political mandate, however, the question becomes not whether or not to pursue the public’s agenda, but how. On that count, there appears to be a bit of debate. Should Republicans campaign on repealing the bill entirely, or should they maintain certain provisions?

As reported by Americans for Limited Government Director of Congressional Affairs, Derek Baker, “there has been much discussion and confusion about whether Republicans should pursue a strategy of ‘repeal’ (or ‘repeal and start all over’) versus ‘repeal and replace.’ While this may seem a matter of semantics to the casual observer, there is substance to the debate. At issue is what’s assumed in the repeal and replace mantra: leave the now current law mandate in place to cover preexisting conditions, rather than pursue the piecemeal strategy (once ObamaCare is repealed) that has been championed all year by Republicans of moving incremental bills that improve the healthcare system step-by-step (such as the ability to purchase insurance across state lines).”

The trouble with leaving the mandate in place for insurance companies to cover so-called preexisting conditions is that it accepts the premise of federal control over minimum levels of insurance coverage. As with any coverage expansion mandated by law, this will place upward pressure on the cost of premiums — the very problem health care reform purports to address.

In short, accepting it is tantamount to accepting higher premiums. One of the major reasons premiums have risen to the degree they have is because of the minimum insurance requirements that states already impose upon companies. Coupled with the ban on the interstate purchase of health insurance and thus the lack of a competitive national marketplace, some states have seen premiums rise faster than others.

To be certain, several states already have used what are called “guaranteed issue” and “community rating” rules that cover preexisting conditions. These rules require insurers to accept applicants without regards to factors like health status or age, and not to charge higher premiums as a result.

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