REPUBLICAN SENATORS are regrouping after Majority Leader Mitch McConnell (Ky.) put off a vote on his Obamacare repeal-and-replace bill. The stumble was for the better. The bill was drafted in secret. Not a single hearing was held. Democrats were not consulted. With only a single week afforded to absorb the legislation’s contents before a vote, the timetable was absurd. Mr. McConnell’s attempt to jam it through stank of legislative malpractice and hypocrisy.
Republicans should treat this as an opportunity to step away from the brink and reevaluate their foolhardy push to rush through an ill-wrought overhaul of the nation’s health-care system without any input from the other side. Despite President Trump’s claims otherwise, GOP leaders have not engaged Democrats seriously on the health-care issue, as Democrats did for at least a time as they drafted Obamacare. Republicans have instead advanced coverage reductions and tax cuts that Democrats — and, indeed, most of the public — could never embrace.
The Congressional Budget Office has repeatedly exposed these ideas to be abjectly cruel, finding that they would result in north of 20 million more people uninsured in a decade, as government health-care assistance was rolled back to finance a large tax cut for the wealthy. Mr. McConnell has reportedly argued, however, that pressing forward would be better than negotiating with Democrats. What does it say about the Republican Party that even this bill is more appealing than reaching out to moderates on the other side of the aisle?
Not all feel this way. Sen. Susan Collins (R-Maine), one of the Senate bill’s skeptics, this week suggested fixing Obamacare markets in cooperation with Democrats. She and Sen. Bill Cassidy (R-La.) released a compromise health-care proposal before Republicans began their mad repeal-and-replace rush. For his part, Senate Minority Leader Charles E. Schumer (D-N.Y.) urged Republicans Wednesday to “start over” and find a “new, bipartisan way forward on health care.” If Mr. Schumer wants to show that he is interested in doing more than trolling his GOP counterparts, he could appoint a group of moderate Democrats to serve as credible negotiators.
If both sides sat down in good faith, there would be a wide range of possible compromises. Senators could work off the Cassidy-Collins plan, which is not preoccupied with cutting taxes and allows states that want to keep the Obamacare system to do so, while letting others try a different course. In any compromise scenario, Democrats would seek commitments that health-care markets would be properly subsidized and administered, and Republicans would seek some loosening of Obamacare regulations, particularly if doing so allowed younger people to buy bare-bones coverage. That is grounds for an obvious trade.
Both sides have expressed interest in “reinsurance” programs, which would backstop insurance companies in cases of catastrophically large medical costs. Both may be interested in automatically enrolling everyone in a basic insurance plan unless they opt out. Both should seek a stronger and more durable mechanism to compel people to buy insurance, perhaps by withholding government tax benefits from people who refuse.
Reforming the health-care system with Democratic buy-in would also mean the Senate would not have to worry about complex parliamentary rules relating to the “reconciliation” process, which Republicans are currently using to avoid a Democratic filibuster. That greatly expands the reforms that bipartisan negotiators could consider.
What should be off the table, permanently, is the Senate’s bad bill. The unilateral effort to cram it through must end.