Judging by exit polls, the single most effective midterm issue for Democrats was health care — in particular, the argument, made by Democratic candidates across the country, that Republicans were out to eliminate the Affordable Care Act’s regulations governing pre-existing conditions.
So when a Texas judge ruled in December that the entirety of the health law was unconstitutional, he ensured that this issue, and this argument, would remain front and center heading into the 2020 election.
Legally speaking, the ruling is weak, and the case may be tossed in the appeals process. But if it travels all the way to the Supreme Court, it would effectively guarantee that health care remains politically potent throughout the presidential campaign. You can expect the Democrats’ cast-of-thousands presidential field to all swear to protect Obamacare’s pre-existing conditions rules — and President Trump to demonstrate his usual command of the finer points of health care policy in response.
The ruling thus represents a challenge for Republicans — but also an opportunity. At least in theory, it could force the party to finally figure out, or at least start figuring out, exactly what it stands for when it comes to health care policy.
The empty mantra of “repeal and replace” — which was all but buried by the midterms — was never a stand-in for an actual shared vision for the governance of health care in the United States. At the moment, the party seems confused about what, exactly, American health care policy should look like.
That confusion extends beyond Obamacare to Medicare (which President Trump has ruled off limits) and Medicaid (which the repeal bills tried and failed to restructure), as well as to the tax deduction for employer-sponsored insurance around which health care policy has contorted for so many decades.
It’s not that there’s a shortage of ideas: Conservative think tanks have health policy white papers to spare, and have for years. All the way back in 2012, for example, you could find the right-of-center health policy scholars James Capretta and Robert E. Moffit outlining principles for an Obamacare replacement in the journal National Affairs. Their plan called for limiting the tax break employers get for offering health coverage, converting existing public coverage programs to premium support (essentially a subsidy) while promoting competition among private plans, protecting people who maintain continuous coverage from spikes in premiums, and allowing states more flexibility to opt in and out of national health care initiatives.
The Cato Institute’s Michael Cannon has long called for the creation of large Health Savings Accounts that would significantly increase the amount of money individuals could put into tax-free accounts for medical expenses, including health insurance, potentially giving millions of people an optional exit from employer-sponsored insurance.
What connects these ideas is that they are not merely bullet-pointed lists of policy tweaks; they are frameworks for thinking more broadly about what federal health policy can, and perhaps should, be.
That sort of thinking — about both general principles and the specific policy components necessary to make them a reality — is exactly what the Republican Party lacks, and what it desperately needs.
It’s true that some Republican lawmakers have cobbled together proposals of varying degrees of specificity over the year: During his 2016 campaign for the Republican presidential nomination, Senator Marco Rubio of Florida sketched out a mostly forgotten health care plan that would have set up a broad-based system of refundable tax credits intended to subsidize the purchase of insurance in hopes of helping people buy coverage. And during the 2017 Obamacare repeal effort, Senators Lindsey Graham and Bill Cassidy offered a plan to give states far more flexibility, eliminating many of Obamacare's provisions at the national level while essentially turning the program into a block grant to the states.
But these efforts have tended to be cursory and short-lived, with tiny or nonexistent constituencies. Few conservative lawmakers talk about them today, and it’s unclear whether many Republicans in Congress today even grasp the basics.
Which is why, for all these ideas, if you ask Republican politicians what they stand for when it comes to health policy, you are likely to hear slogans like “patient centered” and “preserving the doctor-patient relationship” and possibly something about how Democrats want to “socialize Medicare” — as if the nation’s largest government health program is not already an essentially socialist enterprise.
So it’s possible to imagine that at least some in the party will try to resolve, or at least start acknowledging, some of these questions.
More likely, given the state of the G.O.P. under Trump, who is no one’s idea of a wonk, is that Republicans will simply decline to pursue the issue with any force, and the shabbiness of the party’s current non-position will become even more glaring. Indeed, just this month, Mr. Trump continued to predict Obamacare’s demise, saying he believed that “it’s going to be terminated,” possibly as a result of the Texas case, and that in the aftermath, “a deal will be made for good health care in this country.” What sort of deal? I suspect that even (perhaps especially) the president doesn’t know.
That sort of glibness, in turn, is likely to give already-ascendant Democratic ideas a boost. The party’s enthusiasm for Medicare for All has flourished recently in part because it exists in a vacuum, with little if any substantive competition from the right. There are serious practical and political impediments to making a transition to single payer, from the enormous increase in federal spending and the tax increases it would almost certainly entail to the disruption that would be caused by the elimination of current private health insurance coverage for millions of Americans.
Yet by failing to make even a halfhearted case for an alternative, Republicans are helping to clear the path for their opponents. When the options presented are single-payer or “I don’t know,” it’s not surprising that many Americans would gravitate toward the former.
In the meantime, the Texas case will ensure that the Republicans’ waffling and uncertainty on policy basics, like legal requirements regarding pre-existing conditions, remain in the spotlight. The red state attorneys general who brought the case may have imagined it was a clever way to highlight Obamacare’s flaws, but instead it shined a spotlight on their own.
Peter Suderman is features editor at Reason.
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【匪】【初】【也】【没】【想】【到】【这】【个】【少】【年】【会】【出】【现】。 【还】【在】【她】【骂】【人】【的】【时】【候】【出】【现】。 【这】【是】【什】【么】【意】【思】？ 【【主】【人】，【可】【能】【是】【他】【已】【经】【关】【注】【你】【了】，【你】【要】【不】【要】【再】【加】【个】【好】【友】【试】【试】？【可】【能】【会】【同】【意】【呢】？】【胖】【太】【出】【来】【说】。 “【难】【不】【成】【他】【是】【个】【物】【质】【少】【年】？”【匪】【初】【刚】【说】【完】【就】【觉】【得】【不】【可】【能】。 【虽】【然】【他】【是】【私】【生】【子】【不】【怎】【么】【招】【人】【待】【见】。 【但】【身】【为】【家】【中】【唯】【一】【儿】【子】，【瞧】【着】
【第】【四】【百】【八】【十】【三】【章】：【行】【动】【会】【议】 【沈】【天】【从】【冯】【叔】【的】【办】【公】【室】【走】【出】【来】【的】【时】【候】【已】【经】【时】【间】【已】【经】【接】【近】【午】【时】【了】，【说】【实】【话】，【听】【到】【冯】【叔】【说】【完】【那】【一】【段】【往】【事】【的】【时】【候】，【沈】【天】【整】【个】【精】【神】【都】【处】【于】【懵】【逼】【状】【态】。 【如】【果】【真】【的】【如】【他】【所】【说】，【那】【么】【这】【次】【远】【征】【注】【定】【失】【败】。 【因】【为】【除】【了】【他】【天】【然】【的】【排】【斥】【性】【以】【外】，【在】【上】【层】【会】【有】【守】【卫】…… 【这】【个】【是】【李】【无】【义】【没】【有】【跟】【自】【己】【说】【过】【的】
【那】【辆】【飞】【往】【美】【国】【的】【飞】【机】【啊】，【她】【还】【是】【没】【能】【够】【上】，【那】【张】【被】【握】【在】【手】【心】【的】【机】【票】【啊】，【皱】【巴】【巴】【的】，【洛】【依】【对】【自】【己】【说】，【这】【一】【次】，【办】【不】【成】【大】【事】【就】【不】【要】【回】【家】。 【从】【机】【场】【走】【出】【来】【的】【洛】【依】【也】【不】【再】【是】【以】【前】【的】【女】【学】【生】，【她】【的】【目】【光】【里】【充】【满】【了】【黑】【暗】。【拥】【有】【无】【邪】【美】【貌】【的】【她】，【只】【要】【愿】【意】，【很】【快】【洛】【依】【便】【依】【附】【上】【一】【位】【权】【贵】，【凭】【借】【她】【的】【美】【貌】【和】【智】【慧】，【很】【快】【那】【波】【曾】【经】【对】【她】【穷】福彩快乐10分开奖结果【虽】【然】【从】【外】【观】【看】【不】【出】【骨】【头】【的】【损】【伤】，【但】【伤】【筋】【动】【骨】【一】【百】【天】，【现】【在】【怎】【么】【都】【不】【可】【能】【恢】【复】【完】【好】【无】【损】【的】【状】【态】。 【而】【他】【却】【用】【这】【双】【伤】【痕】【累】【累】【的】【手】【为】【她】【洗】【衣】【做】【饭】，【忙】【来】【忙】【去】。 【何】【若】【梦】【心】【里】【酸】【涩】【不】【已】，【内】【疚】【自】【责】【的】【不】【行】。 【决】【定】【好】【要】【开】【开】【心】【心】【的】，【可】【看】【到】【他】【的】【伤】，【她】【怎】【么】【能】【开】【心】【的】【起】【来】。 【她】【仔】【仔】【细】【细】【的】【看】【着】【他】【手】【上】【的】【每】【一】【处】【伤】【痕】，【突】
【渊】【然】【听】【着】【他】【们】【的】【话】，【望】【着】【灵】【雨】【单】【薄】【的】【身】【影】，【为】【什】【么】……【他】【每】【一】【次】【都】【赶】【不】【上】？【明】【明】【他】【已】【经】【说】【服】【了】【天】【帝】，【却】【还】【是】【来】【晚】【了】【一】【步】，【为】【什】【么】【会】【这】【样】？ …… “【让】【灵】【雨】【跟】【你】【们】【走】？”【渊】【然】【压】【抑】【着】【怒】【火】【看】【向】【青】【栩】，“【你】【也】【好】【意】【思】【说】【出】【口】？” 【青】【栩】【心】【里】【也】【没】【底】，【不】【住】【地】【打】【鼓】，【但】【还】【是】【鼓】【起】【勇】【气】【说】【道】：“【灵】【雨】【是】【青】【门】【宗】【人】，【跟】【我】【们】
【即】【便】【是】【死】【亡】【主】【宰】【布】【下】【的】【屏】【障】，【也】【不】【可】【能】【阻】【挡】【天】【地】【意】【志】【的】【降】【临】。 【看】【到】【被】【取】【出】【了】【神】【格】【的】【中】【位】【神】，【真】【的】【成】【功】【将】【风】【之】【元】【素】【玄】【奥】【领】【悟】【到】【大】【成】，【并】【且】【获】【得】【了】【天】【地】【意】【志】【的】【承】【认】，【死】【亡】【主】【宰】【平】【静】【的】【面】【容】【上】，【也】【终】【于】【露】【出】【一】【丝】【微】【笑】： “【选】【择】【体】【外】【成】【神】。” 【中】【年】【男】【子】【自】【然】【是】【按】【照】【死】【亡】【主】【宰】【的】【要】【求】，【选】【择】【了】【灵】【魂】【两】【分】。 【天】【地】【意】【志】
【在】【所】【有】【人】【期】【待】【的】【目】【光】【中】，【蚊】【道】【人】【与】【天】【冥】【至】【尊】【终】【于】【还】【是】【碰】【撞】【到】【了】【一】【起】。 【他】【们】【一】【个】【是】【血】【海】【凶】【地】【孕】【育】【而】【出】【的】【绝】【世】【妖】【魔】。 【而】【另】【一】【人】【更】【是】【一】【方】【大】【世】【界】【的】【主】【宰】。 【皆】【是】【实】【力】【强】【横】，【手】【段】【逆】【天】【之】【辈】。 【如】【今】【交】【手】，【所】【爆】【发】【出】【来】【的】【战】【力】，【使】【得】【所】【有】【人】，【都】【是】【不】【由】【的】【心】【惊】【胆】【颤】。 【只】【见】【那】【蚊】【道】【人】，【周】【身】【被】【血】【雾】【包】【裹】。 【一】【双】