National Review editors assess the latest prospects for Capitol Hill action on health care reform.
Senator Rand Paul, the Kentucky Republican, has one thing right: The latest Republican bill on health care is not a repeal and replacement of Obamacare. Under it, the Affordable Care Act’s taxes, spending, and regulation would mostly remain in place. Of course, previous Republican bills left a lot of Obamacare in place, too. For many months it has been clear that Republicans do not have the votes for a true replacement.
Where Paul is wrong is in opposing the Graham-Cassidy bill on that basis. A true replacement of Obamacare would be better than Graham-Cassidy, but Graham-Cassidy is still much better than Obamacare. It abolishes the individual and employer mandates, caps per capita spending on Medicaid, blocks federal funds from going to insurance plans that cover abortion, and lets interested states attain freedom from some of Obamacare’s regulations. Some of those states could use that freedom to create markets in which people outside of Medicare, Medicaid, and employer-based coverage would finally be enabled to buy cheap, renewable catastrophic-insurance policies.
The senator’s objections to the bill amount to a case for improving it, perhaps in a conference committee after it passes the Senate. They do not amount to a case for voting it down.
