For many years now, Sally Pipes and I make a trip to Washington in the early part of the year to take the political and policy pulse of the nation’s capital. We meet with members of Congress, their staffs, and executive branch officials to get firsthand knowledge of the policy agenda for the year, and to better understand the political climate on the issues that are important to PRI, such as health care reform.
This time last year, Washington was abuzz with the imminent repeal and replacement of Obamacare. Our meetings with officials in President Trump’s new administration and leadership staff on Capitol Hill were full of optimism. Our conversations were less about “if” Obamacare would be repealed and replaced, but “how” to do it. My take on the flight back to California: Wow, after a seven-year rollercoaster, it’s really going to happen.
What a difference a year makes.
Optimism in early 2017 has turned into the winter of discontent in 2018. While there have been some reforms to Obamacare – the most important being the repeal of the individual mandate – our sources in Washington tell us that repeal and replace is not likely going to happen this year. The Senate doesn’t have the votes, so the House won’t take up precious legislative time to write and debate a bill that can’t pass.
What’s on the legislative agenda? Infrastructure and workforce development. While these issues are important, in an election year, spending money on highly visible projects like these is a lot easier than saving money or spending less. That’s the political reality.
There may be one health care skunk in this party, however, and that’s if health care insurance premiums rise significantly. Insurance companies start making announcements on rates in the second half of the year for what consumers will pay for the following year. If those rates prove to be high, there could be a public outcry for Washington to “do something”, and low and behold the political will for health care reform will reemerge. Of course, if this happens, PRI will be ready with policy ideas, such as high-risk pools for people with pre-existing conditions. Every little bit helps to chip away at Obamacare and move health care towards free market competition.
So while repealing and replacing Obamacare may be off the table this year, single-payer health care, which was the policy darling of the fringe left a decade ago, is inching its way into mainstream. In times like these, it’s always helpful to go back to the wisdom of Yogi Berra: “It’s like déjà vu all over again,” and “it’s never over till it’s over.”
Rowena Itchon is senior vice president of the Pacific Research Institute.