Republicans are down the line opposed to the individual mandate, but there’s an internal debate about what to do if the Court also overturns the main insurance regulations. A sizable cargo cult within the GOP wants to preserve some Affordable Care Act provisions and favors passing stand-alone bills reinstating them if necessary. The idea circulating is that the Republican Party should consider a “keep the good stuff” approach.
In other words, one of the first Republican moves amid an historic constitutional ruling and thunderclap political victory would be the remarkable feat of protecting the entitlement they’ve now spent years castigating and promising to repeal in toto. Concessions on this scale make zero political sense—never mind the economics, which are much worse.
The supposedly popular planks are mandates requiring insurers to cover people with pre-existing conditions at below-market prices and allowing parents to keep their adult children on their health plans until age 26. The third is closing the Medicare drug benefit “donut hole,” which asks seniors to contribute to their prescriptions above a certain level (with protections for catastrophic costs).
So despite claiming that more consumer cost-sharing will promote health-care cost containment—for instance by choosing generics over name brands to avoid running over the donut hole limit—the GOP would gut it in Medicare. Tiered formularies and copay scales are routine in the private sector. . . .
An orderly unwinding of ObamaCare was always going to be difficult. But based on its disarray and confusion so far, the GOP may be making it harder.