EDITORIAL: Josh Hawley wants to end Obamacare. He doesn't have a better idea

 
 
Updated 10/11/2018 10:56 PM
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U.S. Senate candidate Josh Hawley continues to struggle with facts and logic in the debate over health insurance in America and coverage for people with pre-existing medical conditions.

Hawley, the Republican looking to knock off Missouri Sen. Claire McCaskill, recently wrote a column outlining his plan to protect patients with pre-existing conditions from losing health insurance.

His proposal is incoherent.

Remember: Missouri is one of 20 states suing the federal government to fully repeal the Affordable Care Act, also known as Obamacare. Officials in those states argue that since Congress ended penalties for people who don’t buy insurance, all of Obamacare should fall.

McCaskill has criticized Hawley for pursuing the case. Full repeal of the Affordable Care Act, she knows, will eliminate popular parts of the law, including the guarantee that sick people can get good insurance coverage at a reasonable cost.

Hawley knows it, too. That’s why he’s insisted he wants to protect people with pre-existing conditions if Obamacare is killed.

But the plan he released this week doesn’t come close to delivering on that promise.

Hawley says everyone would get insurance at roughly the same price with the same coverage. He goes on to say: “The federal government would then pay for insurance costs that exceed, say, $10,000. And the insurers, in turn, would be required to give most of the premiums they collect from these patients to the government.”

The Hawley campaign says that means the federal government would pay premium costs “above a certain threshold” for patients with pre-existing conditions. It says that will keep premium costs low.

But that also means insurance companies would be getting a taxpayer-financed federal subsidy to cover those patients. Hawley’s answer? Require insurers to send premiums back to Washington.

That’s just silly. If you give a barber $15 to cut your hair, and she cuts your hair, you can’t ask for the money back when she’s done. She’ll soon go out of business. Insurance companies would face the same fate.

And there’s an easier way to accomplish the same goal: Allow patients with pre-existing conditions to enroll in Medicare, which is taxpayer-supported. This, Hawley will not do.

Hawley’s plan also leaves a serious problem unaddressed: Why would anyone buy health insurance? Americans could wait until they get sick, apply for pre-existing condition coverage, and Uncle Sam would pay for it.

The Affordable Care Act is far from perfect. But there’s a reason Republicans have failed for years to find a workable alternative: Health insurance that covers everyone must include everyone.

Without an individual insurance mandate, claims are too expensive for private companies to pay. They have to raise rates for everyone, or turn people away, or both.

Republicans used to understand this. That’s why they invented the individual mandate.

There are only three ways to approach this problem. One is to deny coverage for patients with pre-existing conditions, which Hawley says he opposes. The second is the mechanism in Obamacare, which Hawley wants repealed.

The third is public health coverage for everyone, sometimes known as single-payer insurance. We’re not ready to endorse that concept. But the Affordable Care Act should not be discarded entirely, which Hawley seeks to do, unless there’s an alternative that covers all Americans at a reasonable cost without excessive government spending.

Hawley’s proposal fails to achieve either goal.

A federal judge in Texas heard arguments on the case in September and could rule before Election Day. He should do so. It would be helpful for all Missourians to think about what it would mean if Obamacare ends without anything to replace it.

In the meantime, Hawley should work on improving his health care plan, which is confusing and unfinished.

Copyright Kansas City Star. Reprinted with permission.

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