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The "Compassion Without Compulsion" Obamacare Fix

The opinions expressed by columnists are their own and do not necessarily represent the views of

Last night I received an e-mail from President Obama about his health law. He said “the law is working. Already nearly 365,000 people across the country have picked private plans through the Marketplace.”

Sorry, Mr. President, but a mere 365,000 people signing up on the federal health exchange, when almost 50 million are uninsured, proves the law is not working. Even the 365,000 number is phony. Only a quarter of them took the final step and paid, the difference between window-shopping and actually getting insured.

Compare that with over 5 million victims of Obamacare who have had their plans cancelled, as well as two hundred thousand people with pre-existing conditions who will lose their coverage in state high-risk pools when the pools close in the coming weeks because of Obamacare. These people don’t have to be sold on the idea of having health insurance. They had it and desperately want to stay insured.

But the malfunctioning website – plus premium sticker shock – plus the realization that most exchange plans don’t allow access to specialists, academic hospitals, and expensive medications people with health problems need -- have deterred these people from signing up.

Last week, the administration announced rules that bully insurers to retroactively cover people who pay late or only partially pay their premium. Insurers were warned that if they don’t cooperate they could be barred from the exchange next year.

This is just the latest of many illegal changes the president made to the law to try to make it workable. Obamacare barely resembles the Affordable Care Act passed in 2010.

The federal government has spent over $6 billion on federal and state exchanges, including over $600 million for the dysfunctional federal website. Money for computers, community organizations, navigators, and slick ads, not bandages and bedside care, what a waste! The tale is wagging the dog. It’s time to abolish the exchanges.

The votes are lacking to repeal Obamacare, but the votes are there to fix it for the near term and prevent more people from losing their coverage. Democrats running for office in 2014 would love to wake up and find the dysfunctional website, failing exchanges, and controversial navigators gone.

Here’s a roadmap for a “compassion without compulsion” compromise that Congress should enact right after the holiday recess.

· Keep the provision that allows adult children to stay on a parent’s plan until age 26. It’s a cost- hiker but popular.

· Keep the Medicaid expansion—where the neediest are helped. States have the option to expand or not.

· Provide block grants to states to expand high-risk pools. That will rescue 200,000 about to lose coverage and 1.8 million who were on wait lists. Cost: $11,000 per person or $22 billion a year.

· Bring back temporary federal subsidies to help the unemployed pay for COBRA premiums until they regain on-the job coverage. As many as half of those who are uninsured because they got laid off regain on-the-job coverage within a year, according to the Congressional Budget Office. Cost: $2 billion a year, based on past experience.

· Pay for the high risk pools and COBRA subsidies with the $26 billion in 2014 currently budgeted for exchange subsidies. The current law gives subsidies to households earning more than $92,000. Redirect that money to those who need it.

· Eliminate the “Washington knows best” requirement that all health plans have to cover “essential benefits.” That caused plans in the individual market to be cancelled and it’s pushing up premiums. Don’t force the fifty year old woman to pay for maternity care.

· Eliminate the employer mandate (already postponed) to save the 40 hour work week.

· Eliminate the individual mandate. There’s no need to force young, healthy people to sign up for health plans at exorbitant rates to subsidize the sick. The fully-funded high risk pools will take care of that job.

Eventually Republicans may have the votes for our brand of health reform: medical liability reform, across state lines insurance sales, and health savings accounts, all cost-reducing strategies.

Now what’s needed is a compassionate compromise to stop the damage to patients and to the U.S. Constitution.

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