Now that the Affordable Care Act‘s subsidies have kicked in and millions have supposedly enrolled in exchanges, much is being said about Republicans backing away from repeal and replace. I would propose a more honest and accurate phrase about what comes next: rescue and recovery.
In short, our goal shouldn’t be to sink the ship that is the ACA but to rescue people from a ship that is already sinking.
While I share the goal of repeal and replace — few fought harder to prevent the ACA from passing than I did — it would be disingenuous for candidates in 2014 to promise to undo a health law that President Obama will defend as long as he’s in office. What candidates can and should do, however, is speak in clear and specific terms about the choices voters face in health reform alternatives and describe why a rescue and recovery effort is so essential.
Of course, Obama claims the ACA is a settled matter, but that is far from true. Politicians like to declare The End of Ideological History when their preferred ideas become law, but history rarely cooperates. In a free society, free people and their elected representatives constantly reshape existing law. When it comes to the proper role of the market in health care, the debate is only beginning.
The ACA has many flaws, but its two fatal ones are the ways in which it increases costs and limits choice.