Republicans own Obamacare, and they should fix it

Iowans are in big trouble if politicians adopt the philosophy of Jeff Kaufmann, chairman of the Republican Party of Iowa. 

He issued a statement this month in response to reports about Iowa’s “stopgap” plan — a proposal from the state insurance commissioner to stabilize the private health insurance market for Iowans who buy coverage on their own. The plan needs federal approval to move forward, but President Donald Trump told a top human-services administrator in August to reject it, according to the Washington Post.

Iowa officials say they haven't heard that their proposal is dead, and Gov. Kim Reynolds has asked to speak with Trump about it.

Kaufmann summed up his vast wisdom on the issue in this nugget e-mailed to media: “Democrats created Obamacare. Democrats own Obamacare. Obamacare is failing Iowans, collapsing right before our eyes, and no matter how much they try to deflect blame, they own this abysmal failure. Period.” 

That's not only an unhelpful cop-out, it's untrue when it comes to the stopgap proposal. A Republican administration in Washington has essentially ignored a request from Iowa's Republican insurance commissioner, Doug Ommen. That has nothing to do with Democrats.

Granted, the Affordable Care Act is not perfect. Interestingly, its biggest flaw is a provision long championed by Republicans: relying on private insurers, instead of government programs, to cover Americans. Conservatives are big fans of everything private, including health insurance.

Obamacare created exchanges for people to purchase private plans and provided subsidies to help pay for those plans. As many predicted, this is not sustainable.

When insurance companies don’t turn a profit, they flee the exchanges. That is what several have done. Iowa now has only one carrier, Medica, planning to offer policies under the Affordable Care Act for 2018. If that carrier exits the market, where would 72,000 Iowans turn for coverage? They need an answer quickly; the enrollment period begins Nov. 1. 

Congress could easily and fundamentally solve the problem by amending Obamacare to create a “public option” for insurance. If private companies do not participate in exchanges, people can buy into a government-run plan. This safety net would guarantee everyone has access to coverage.

Congress should create this public option now. The alternative is leaving states to beg or bribe insurers to participate and remain in exchanges. Or, in Ommen’s case, ask the federal government for permission to redirect federal money to buffer insurers from the financial strain of the sickest customers.

Despite Kaufmann’s lame blame attempt, Republicans do, in fact, own Obamacare. 

The majority party holds essentially all the power in Washington. It has failed to pass bills to fund, fix or even repeal the law. And when a Republican state official offering a plan supported by a Republican governor and U.S. senators cannot even proceed with his idea because a Republican administration in Washington is dismissing him, the majority party owns that action, too.

Though Trump has said he would “let Obamacare fail,” his administration has bent over backwards to ensure the law fails the American people. The U.S. Department of Health and Human Services has worked hard to suppress the number of people signing up for health coverage, which will further destabilize state insurance markets. 

The agency slashed funding to groups that help consumers find coverage and announced the website used to obtain coverage would be down for maintenance several days during a now shortened open enrollment period. And it has so far dismissed or ignored Iowa's attempt to try to help itself. 

The Washington Post, citing anonymous sources, reported President Trump learned about Iowa’s plan in a Wall Street Journal article. He tried to reach Tom Price, his Health and Human Services secretary who has since resigned over a travel scandal. Price was in Asia. So Trump called the administrator of the Centers for Medicare and Medicaid, and told her to reject the plan.

On Thursday, Trump signed an executive order in an attempt to manipulate how the health reform law works. The order, among other changes, instructs federal agencies to rewrite rules for "association" health plans and widen employers' ability to use pretax dollars to help workers pay for any medical expense.

Such personal attention and dedication to the law demonstrate how Washington Republicans have actively taken ownership of Obamacare. It is their responsibility. And they will be held accountable if it fails the American people.