Health Care is Not Complicated to Fix

The temporary and partial federal government shutdown began on October 1 after Congress failed to pass an appropriations bill to fund the government through the end of November. The main issue between Democrats and Republicans that precipitated the shutdown was health care.

Democrats want to roll back certain provisions included in President Trump’s One Big Beautiful Bill Act (OBBBA), a budget reconciliation bill signed into law on the Fourth of July that includes several provisions related to Medicaid. The OBBBA institutes federal work requirements for able-bodied Medicaid recipients, requires Medicaid recipients making above the federal poverty line to pay more fees to receive certain care, tightens Medicaid eligibility requirements, and eliminates Medicaid coverage of certain procedures.

Democrats also want an extension of the Affordable Care Act (ACA)—otherwise known as Obamacare — enhanced premium tax credits that are set to expire at the end of the year. Although premium tax credits have been part of the ACA since it was enacted in 2010, in 2022, as part of the Inflation Reduction Act (IRA), Congress extended for three more years the enhanced premium tax credits that were instituted under the American Rescue Plan Act of 2021. The enhanced credits increase the amount of government subsidies available to help certain Americans afford health insurance purchased on the misnamed government “marketplace.”

According to an IRS “Fact Sheet”:

The Premium Tax Credit is a refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Health Insurance Marketplace, also known as the Exchange. The size of your Premium Tax Credit is based on a sliding scale. Those who have a lower income get a larger credit to help cover the cost of their insurance. When you enroll in Marketplace insurance, you can choose to have the Marketplace compute an estimated credit that is paid to your insurance company to lower what you pay for your monthly premiums (advance payments of the Premium Tax Credit, or APTC). Or, you can choose to get all of the benefit of the credit when you file your tax return for the year. If you choose to have advance payments of the Premium Tax Credit made on your behalf, you will reconcile the amount paid in advance with the actual credit you compute when you file your tax return for the year.

If the extra subsidies expire, many Americans will see their health insurance premiums substantially increase. More than 24 million Americans currently have ACA health insurance.

House Speaker Mike Johnson (R-La) said that “House Majority Leader Steve Scalise (R-La.) is working with the chairs of three House committees to compile a Republican health care plan.” That would be Ways and Means Chair Jason Smith (R-Mo.), Energy and Commerce Chair Brett Guthrie (R-Ky.), and Education and Workforce Chair Tim Walberg (R-Mich.).

“Republicans have been working on a fix for health care, we’ve been doing this for years,” said Johnson. “The expiring Obamacare subsidy at the end of the year is a serious problem,” said Johnson. “If you look at it objectively, you know that it is subsidizing bad policy. We’re throwing good money at a bad, broken system, and so it needs real reforms.” But Johnson also said that it is not appropriate to address the subsidies on a simple stopgap government funding measure “because it’s very complicated to fix.”

I’ve got news for Speaker Johnson: The subsidies are not complicated to fix because health care is not complicated to fix. And it won’t take years to develop a plan.

Speaker Johnson then has the audacity to say that “we know we’re going to have to arm wrestle with Democrats” because “many of them are avowed to get us to a single-payer system.” “They do love socialism, my friends,” said Johnson of the Democrats.

I’ve got more news for Speaker Johnson: We already have socialized medicine in America. It is called Medicare — a program that Republicans greatly expanded with their Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Republican Party platform of 2024 states that President Trump “has made absolutely clear that he will not cut one penny from Medicare” and that Republicans will “protect” Medicare.

The Constitution nowhere authorizes the federal government to have anything to do with health care or health insurance. This means not only no Obamacare subsidies but also no Obamacare, no Medicaid, no Medicare, no Children’s Health Insurance Program (CHIP), no Centers for Disease Control and Prevention (CDC), no National Institutes of Health (NIH), no Food and Drug Administration (FDA), no Surgeon General, and no Department of Health and Human Services.

What is so complicated about that?

No American is entitled to health care or health insurance at the expense of any other American. No American should be forced to pay for or subsidize the health care or health insurance of any other American. Health care and health insurance are services that can and should be provided on the free market just like other services. That is how you fix health care.

Originally published at the Future of Freedom Foundation and reposted here with permission.

Tags: Affordable Care Act, Congress, Healthcare, Obamacare, Shutdown