So basically we're going to try and pass a bill that is barely cosmetic changes to the turd that exists now, so we can stand up on stage for a photo op, grinning, glad handing, and back slapping while telling Americans 'we did something!'
It is far more than cosmetic changes. According to the CBO, it will reduce premiums by 30 percent. That's significant. Also, block-granting the Medicaid expansion frees up billions for tax relief for ordinary Americans.
I understand the conservative opposition - it preserves community rating. But that reflects a sea-change in attitudes - a decade ago the issue of pre-existing conditions wasn't on the radar, but Obama's election and the ACA has changed that. Politically, community rating is here to stay - or, at least, cannot be addressed at this time given the certainty of political attack ads accusing Republicans of abandoning kids in wheelchairs.
The ACA must be addressed in stages, and the Senate bill is a worthy first step. This is no time for conservatives' "principles" to defeat an honest attempt to fix the ACA. We need to realize that protection for pre-existing conditions is what people want - and no amount of conservative hectoring about the "unworthy" poor is going to change that. As Kimberley Strassel wrote in this morning's WSJ:
It's a binary choice, rooted in blunt political reality; which ought to make it an easy call. The question is whether conservatives will be savvy enough to forge a face-saving compromise and seek victories elsewhere in the bill. The health care debate has changed over the last decade, and Republicans can't reverse it on a dime. But they can pass a bill that starts the walk back to freer health-car markets.
