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The Conservative Compromise Plan to Fix Obamacare Is Neither a Compromise Nor a Fix

WASHINGTON, D.C. - OCTOBER 18: (AFP-OUT) Sen. Orrin Hatch (R-UT), Chairman of the Senate Finance Committee, listens to U.S. President Donald Trump speak during a meeting  with members of the Senate Finance Committee and his economic team October 18, 2017 at the White House in Washington, D.C. (Photo by Chris Kleponis-Pool/Getty Images)
Thanks Orrin.
Pool/Getty Images

Last week, Senators Lamar Alexander of Tennessee and Patty Murray of Washington unveiled a bipartisan deal designed to stabilize Obamacare’s marketplaces, which have been thrown into tumult by President Trump’s decision to cut off certain key payments to insurers. Shortly thereafter, they announced that their bill had 24 co-sponsors, including 12 Republicans, suggesting it could win the 60 votes necessary to pass the chamber.

Some congressional right wingers, however, seem to feel that Murray and Alexander’s compromise doesn’t offer them enough in the bargain. So now, Axios reports, two Republicans are offering their own, “more conservative alternative.” The proposal, from Utah Sen. Orrin Hatch and House Ways and Means Chair/Texas Rep. Kevin Brady, is a bit of a head scratcher. Framed as a compromise to fix Obamacare, it is in fact neither a compromise nor a fix.

Alexander-Murray proposed a fairly straightforward trade. Republicans agreed to fund critical subsidies to insurers that keep Obamacare’s markets functioning as intended, and which Trump has halted. In return, Democrats offered to loosen the restrictions on how states could tweak the Affordable Care Act’s rules within their borders, potentially leaving room for states like Iowa to change up their insurance markets.

Hatch-Brady is not that kind of a bargain. It would fund the subsidy payments. But in return, it would also suspend Obamacare’s individual mandate requiring Americans to buy health insurance for five years, waive the employer mandate for two years, introduce new abortion-related restrictions on the subsidy money, and expand health savings accounts.

The key item in this laundry list of conservative demands is the individual mandate, which most health care policy wonks still consider fairly essential to making Obamacare work, since it keeps at least some young, healthy Americans in the market. Eliminating the mandate while restoring the insurer subsidies would be rather pointless—it would simply mean replacing one destabilizing Obamacare emergency with another. Which makes Hatch-Brady not much more than another half-baked partial repeal bill.

Obviously, there is no way Democrats will vote for such a thing, which at the moment means it probably can’t pass Congress. This raises the question of what exactly the bill is for. It’s possible House conservatives will merely use it as a starting point for their demands while negotiating with the Senate, and that they’ll be willing to drop the nonsense about the individual mandate if it means they can claim victory on something like the employer mandate. Or, it’s possible Hatch and Brady really want to derail a potential bipartisan compromise by peeling off Republican votes with a dead-on-arrival alternative. If so, the party will be falling back into its old habit of dealing with health care by embracing un-passable messaging bills.

Unfortunately for them, those tend to work better when your party’s own president isn’t causing a debacle someone needs to clean up.

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