Congress ought to be debating proposals to improve Obamacare, rather than pursuing a path that, in the end, will neither defund it nor fix its shortcomings

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Efforts to end Obamacare are doomed; let's fix it instead
By Carl P. Leubsdorf, October 4, 2013

Even some of its strongest supporters concede that President Barack Obama’s Affordable Care Act is an imperfect law, passed in an imperfect way.

“Any time you implement something like this,” longtime Obama confidante David Axelrod said last August on MSNBC’s “Morning Joe” program, “it’s new and there’s no doubt that it’s complicated, there will be changes along — there should be changes along the way.”

But Republicans have chosen to mock the technical glitches accompanying its launching and make repeated doomed efforts to use the measures renewing government funding or extending the legal debt ceiling as vehicles to scuttle or delay it.

These GOP critics have been trying to do the wrong thing. Instead of using Obamacare as a political lever to satisfy their tea party base, they ought to be working with the administration to fix its shortcomings or trying to use their House majority to replace it.

After all, the goal of expanded health insurance is one most Americans share. Indeed, the 2010 Republican mantra implicitly acknowledged that by reiterating over and over that their goal was to “repeal and replace” it.

If so complex a bill had been passed at a time before polarizing partisanship paralyzed the political system, the two parties would have joined in the appropriate congressional committees to draft “technical fixes” improving its operation.

But that requires the cooperation that nowadays seems impossible. The proof: the failed 2009 effort by Senate Finance Committee Democrats to craft a bipartisan health bill with their GOP counterparts, killed by GOP party pressure to stand firm against any bill.

Still, even before this week’s rollout of access to Obamacare, there have been suggestions of ways to improve it. Many, however, came from either fervent supporters or bitter opponents, creating doubts they could attract the broad support needed to pass.

For example, the pro-Obama heads of three major unions urged revision of a provision encouraging small-business employers to avoid providing health insurance by limiting their workers to fewer than 30 hours per week.

They also objected to the fact that nonprofit insurance plans in union contracts won’t get the same federal subsidies as for-profit plans.

Meanwhile, conservative publisher Steve Forbes urged GOP lawmakers to replace Obamacare with a measure allowing participants to choose their benefits, rather than accept mandated ones; preventing use of Medicare money to fund health insurance plans; and expanding tax deductions for insurance premiums.

Rather than trying to defund the law, an idea he called “even more unpopular than the bill itself,” Forbes said Republicans “should take the president up on his taunt that the Republicans have no alternative.”

Even former President Bill Clinton, who sought to spur Obamacare participation in a strongly pro-administration speech last month, took the occasion to call for bipartisan federal and state cooperation to fix some of its flaws.

Noting the provision requiring large employers to provide health insurance for their employees, he added that it doesn’t cover family members who are required to have insurance but are ineligible for federal subsidies to buy it.

“It’s not clear to me that anybody intended this,” Clinton said. “Congress should fix it.”

He also said tax credits to help small businesses afford health insurance for their workers are too small and limited to too few companies.

And he cited problems in states like Texas that took advantage of the Supreme Court ruling that they don’t have to provide expanded Medicaid coverage, designed to benefit millions of low-income Americans.

Republican Sen. Roy Blunt of Missouri was right Tuesday when he said the heavily partisan way the bill was initially passed has made it harder to fix, and that this was everybody’s fault.

Still, Congress ought to be debating proposals to improve Obamacare, rather than pursuing a path that, in the end, will neither defund it nor fix its shortcomings.
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