Louisiana Governor Shows GOP’s Obamacare Replacement Is Full of Holes

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In an opinion piece published by Fox News on Monday, Louisiana’s Republican governor, Bobby Jindal, argued that the Affordable Care Act can still be repealed. He acknowledged that “those in the elite salons of Washington” believe that the healthcare law cannot be repealed.

“The conventional wisdom on the cocktail circuit contends that once you mandate health insurance for millions, you cannot unmandate it,” Jindal wrote. “This theoretical belief has become accepted in Washington as a dogmatic article of faith. And the Obamacrats and most of the press believe that repeating this mantra often enough will make it so.”

As many lawmakers have pointed out, never before in the history of the United States has a major entitlement program been repealed.

Republican lawmakers have attempted nearly 50 times to repeal, defund, or mitigate the impact of the law. But with 8 million potential voters enrolled for coverage through the exchanges, the party’s repeal efforts have been complicated. In the months since Obamacare enrollment began, political commentators have focused on the GOP’s need to change its healthcare rhetoric from repealing Obamacare to replacing the reform law.

In his Fox News piece, Jindal asked why a “country that won two world wars and put a man on the moon” cannot repeal a “disastrous public policy” even if it would be difficult to unravel. Said Louisiana governor, “the idea that ObamaCare cannot be repealed defies both logic and real world justification, on multiple levels.”

Enrollment numbers, which the Obama administration has called a success, have a different meaning for Jindal. Health policy experts have cautioned against reading too much into the numbers, but that is not Jindal’s concern. “The fact that the federal government has by force of law and under pain of taxation forced millions to sign up does not constitute ‘success’ or ‘progress,’” he wrote. “In fact, I bet the administration could have raised their enrollment totals even higher if friendly IRS agents had paid personal visits to all Americans ‘encouraging’ them to enroll.”

Obamacare’s real progress comes in the form of rising health care premiums, increasing health care costs, and the cancellation of non-compliant health care policies, according to Jindal. All three of those changes directly contrast with what the president promised when campaigning for the law. The president said that people “who liked their plan could keep their plan” and that health care premiums would decrease on average by $2,500 per year, wrote Jindal.

Obama also pledged that healthcare reform would bend down the curve of health care spending. “To pass ObamaCare in the first place, the American people were sold a bill of goods that would make even P.T. Barnum blush,” the Louisiana governor said.

Of course, Jindal is not pushing for repeal without offering a solution for the American healthcare crisis. Jindal has endorsed a replacement healthcare reform called the America Next health plan. The Louisiana governor believes it will address what he sees as the top concern of Americans: rising healthcare costs.

In place of Obamacare, Jindal proposed a plan that includes an “innovative” $100 billion grant program that would act as an incentive for the nation’s “laboratories of democracy” — otherwise known as the 50 U.S. states and Washington D.C. — to develop their own reforms and solutions to slow the increasing healthcare costs. States’ eligibility for grants would be tied to their ability to lower insurance premiums for their citizens.

Other reforms would be implemented, as well: tax equity between employer and individually purchased health plans, medical lawsuit reform, wellness incentives, and new incentives for health savings accounts. Citing a Congressional Budget Office analysis of a similar state-based reform, Jindal claimed that the plan would lower premiums on the individual health insurance market by $5,000 per year when compared to current projections.

Jindal is also in favor of a protecting “the safety net for the most vulnerable” Americans. “As someone whose mother arrived on these shores pregnant with me, I’m well aware of the plight of Americans with pre-existing conditions. I was one — from birth,” wrote the governor. He argues that states can offer insurance access for Americans with pre-existing conditions through a high-risk pool through reinsurance or through “some other mechanism.”

Currently, insurance customer with pre-existing conditions purchase insurance through the exchanges along with all other customers, a feature of the reform that has caused healthier Americans to see slightly higher premiums than they would have in the old individual market. Of course, the Affordable Care Act included provisions to help insurers manage the risk they now incur because the reform prevents them from denying coverage or charging higher premiums to sicker patients: risk adjustment, reinsurance, and risk corridors.

As evidence of the viability of the plan, Jindal argued that conservative governors have already launched important reforms, from the Hoosier State’s Healthy Indiana Plan to Rhode Island’s innovative Medicaid waiver to Louisiana’s Bayou Health program. “These reforms have lowered costs — in some cases dramatically — improved the quality of care, and received widespread public support,” Jindal wrote in Fox News.

The Healthy Indiana Plan, signed into law by Gov. Mitch Daniels in 2007, provided more than 100,000 uninsured Indiana workers with health coverage by helping its beneficiaries purchase a private policy with a subsidy from the state. Rhode Island obtained a special waiver from the federal government in early 2009, allowing for some additional latitude in its Medicaid program. Bayou Health transformed Louisiana’s Medicaid program into a managed-care system in hopes of achieving better health outcomes.

Jindal merely gave a rough sketch of his improved take on healthcare reform in his piece for Fox News, but if Obamacare has proved anything, it is that the structure and mechanics behind the ideas are key to the success of any reform of the healthcare system. What Jindal did accomplish in his argument is communicating how far the GOP is from finding a strong alternative to the health care reform.

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