President Trump has perfected the art of antagonizing his opponents with provocative tweets. He demonstrated this skill recently in declaring that the tax reform act, by repealing the Obamacare mandate, had effectively repealed Obamacare.
This generated a number of stories from left-leaning pundits pointing out that there's a lot more to Obamacare than the mandate. Sarah Kliff, writing for Vox.com, noted that many Republican voters believed the president and hoped that would bring an end to efforts to undo the rest of Obamacare.
But many Republicans in Congress seem intent on continuing to fight for repeal of the controversial law. A skeptical report in The Hill noted that the GOP had tried and failed to accomplish that goal in 2017. In their view, "nothing significant has changed since then that would now make the path easier. In fact, the obstacles appear even greater now that Democrat Doug Jones has been elected to the Senate from Alabama."
It's true that there is more to Obamacare than the mandate. It's also true that, in a purely political sense, there's little reason to believe that Republicans will be able to repeal Obamacare in 2018.
But the repeal of the Obamacare mandate fundamentally changes the political dynamics in the real world far from Washington, DC.
Last year, an estimated 15 million Americans would have dropped out of Obamacare if they could. Now they can. Another 6.5 million paid a fine rather than sign up for coverage. This means that more than 20 million people directly benefit from the repeal of the mandate.
Most of these people would prefer to buy insurance that meets their needs, but the Obamacare mandate did more than say that people had to buy insurance. It said they had to buy a very comprehensive and expensive set of benefits. Especially for young people, it was often far more insurance than they needed and far more costly than they could afford.
The reality is that there is no one-size-fits-all solution to health insurance. Different people have different needs and preferences.
This reality will create a demand for a variety of insurance options to meet a variety of needs. Some people will prefer more comprehensive coverage and higher premiums. Others will opt for less coverage and lower premiums. All will be covered against catastrophic events but day-to-day coverage will vary.
Sooner or later, Congress will begin offering ideas to meet this demand. One proposal introduced last year would allow insurance companies to offer a variety of options so long as they offered at least one plan with the full Obamacare coverage. Once those plans are available, they will find plenty of eager buyers.
As younger Americans consider the alternatives, they will certainly take advantage of the fact that we live in an era of rapid technological innovation. Self-monitoring of their own health is leading millions to make better lifestyle choices. The ability to conduct EKG's on your smartphone is already here and soon people will be taking x-rays on the mobile devices.
Whether or not these innovations technically repeal all of Obamacare is really beside the point. They will accomplish something far more important -- bringing down the cost of health care while improving the health of the nation.