From Senator Mike Lee, R., UT, comes an important and impressive idea: Give states the right to opt out completely from the replacement for Obamacare that is currently pending before the Senate.
Those who cannot find in the Constitution any clause authorizing federal involvement in health care (hint: there is none) can appease their scruples by getting their state to opt out of the program. Any state that opts out should get the cash equivalent of the amount the feds would have spent to use as it sees fit.
The Tenth Amendment, more honored in the breach than in the observance, delegates to the states anything that is not an expressly authorized federal function. The current nail-biting vote in the Senate over the Obamacare repeal could be hastened if states had this option.
The five conservative Senators who now oppose the bill — Dean Heller of Nevada, Mike Lee of Utah, Ted Cruz of Texas, Rand Paul of Kentucky and Ron Johnson of Wisconsin — would likely support the measure if it had a state opt out provision.
A few other key points to note in the Senate debate:
—The Congressional Budget Office has never been right in its health care estimates. It predicted that 21 million people would enroll in Obamacare and only 10 million did. It predicted that the Medicaid component would cost $42 billion but it actually costs $68 billion. Don't trust the CBO.
—Seventy percent of the new Medicaid enrollees (and probably about 40-50 percent of the total projected to "lose" their insurance under the new bill) were eligible for Medicaid before Obamacare expanded the eligibility. It is wrong to lump their fate in with the 30 percent of new Medicaid recipients who depend on the Obamacare law for their eligibility.
—It is absurd to say that the replacement bill's insurance will cost more than Obamacare. That compares the full soup to nuts insurance required under Obamacare with its cost under the new law with its reduced subsidies. But the whole point of the new law is that it lets people pick and choose what they want covered with the decrease in price that more limited coverage would bring. And it assumes that few young people will choose to buy insurance, despite the new flexibility in the law.
If President Donald Trump does NOT pass a Obamacare repeal and replace bill, the central theme of the Republican Party's last four campaigns will prove to be hypocrisy. Neither he nor the party will survive.