Put Up

Way back in 2010, some of us warned that Obamacare legislation was architecturally flawed, that it wouldn't live up to its political hype, that it would cost much more than projected, that it would lead to higher healthcare costs and insurance policies that "covered" people, but provided them with little if any true health benefits. We were dismissed as uncaring and shortsighted. History has proven otherwise.

Now, as Obamacare moves ever-closer to collapse, it's original creators point a finger at anyone and anything but themselves and suggest that a few small tweaks can fix their masterwork. That's like suggesting that a collapsing house with a disintegrating foundation can be fixed with a coat of bright shiny paint.

Meanwhile, the GOP stumbles toward a solution with a proposed House bill that tried to thread the needle between moderate concerns for fairness and conservative concerns for fiscal responsibility. Not surprisingly, the creators of Obamacare were outraged at any suggestion that "repeal and replace" was on the table, suggesting that a paint brush and a can of paint was all that would be necessary. Now, the Senate has suggested a more palatable approach, still flawed, but far stronger that the House version.

By providing tax credits tied to age and income, the proposed Senate bill provides a means for coverage for low income people in their 50s and 60s. By allowing individual states to tailor medicaid coverage to the unique characteristics of their low income populations and by encouraging health care insurance competition, it has a chance, at least, to lower premiums.

Avik Roy goes into a few details:

Because the Senate bill’s tax credits are robustly means-tested and available to those below the poverty line, the bill is able to repeal Obamacare’s Medicaid expansion while offering higher-quality coverage to individuals who signed up for Medicaid under the expansion.

The reason that Medicaid’s health outcomes are so poor is because the outdated 1965 Medicaid law places a laundry list of constraints on states’ ability to manage their Medicaid programs. As a result, the main tool states have to keep Medicaid costs under control is to pay doctors and hospitals less and less each year for the same care. Hence, many doctors don’t take Medicaid, and Medicaid enrollees struggle to gain access to care ...

[Another] area where the Senate bill does extremely well is in giving states the latitude to come up with new ways to serve their needy populations with better results and lower costs.

We’ve talked already about the new flexibility that states will have with their Medicaid programs. They’ll have even more flexibility to open up their private insurance markets to innovation and competition, through a new set of “Section 1332” waivers in which the validity of the waiver applications will be assumed by the federal government so long as the plan doesn’t increase federal spending.

Furthermore, the bill offers states around $100 billion in stability and innovation grants that states can use to shore up their insurance markets, by providing extra assistance to the needy or the sick.

There are still some areas where the Senate bill can be improved, but characterizing it as "heartless" or "evil" as some Democrats have done is nonsense. An unhinged Senator Elizabeth Warren tweeted: I’ve read the Republican 'health care' bill. This is blood money. They’re paying for tax cuts with American lives. The Dems really do have to get a grip—is Warren actually suggesting that the intent of GOP senators is to kill their fellow citizens? That trying to reduce the enormous expense associated with Obamacare is the equivalent of "blood money." And the Dems wonder why they keep losing elections.

What is "heartless" is to do nothing while Obamacare collapses. What is irresponsible is to snipe from the sidelines while refusing to participate in correcting a healthcare mess of the Dem's own making. The Dems act like a little child who uses crayon on the walls and windows of her room and then throws a tantrum while her parents try to clean up the mess. The parents shrug, recognizing that the child isn't able to act responsibly, but when the child criticizes the cleanup continuously ("you missed a spot, you're not doing what I want ..."), she does become rather irritating.

Any replacement of Obamacare will be a compromise—it will not be perfect. But defending the status quo is unacceptable.

The future of healthcare coverage is in the hands of the GOP. As Avik Roy writes:

... any Republican conservative in the Senate who is thinking of voting “no” on this bill [should be asked]: how many times in your life will you have the opportunity to vote for a bill that fundamentally transforms two entitlement programs? How often will you get to vote for a bill that cuts spending by hundreds of billions of dollars? How often will you get a chance to make a difference for millions of your constituents who are struggling under the weight of rising premiums and exploding deductibles?

As Sen. John Cornyn (R., Tex.) put it on Thursday, “it’s time to put up or shut up.”

The GOP has to "put up" a viable healthcare bill while at the same time the rest of the country has to "put up" with the Dems' whining criticism of their work.