It is widely believed that the plan to allow health insurance companies to sell plans across state lines cannot be included in stage one of the ObamaCare reform. That's a real problem since when it is finally introduced, it will require 60 votes to be enacted. And, unless 2018 adds eight Republicans to the Senate, it won't happen. But, why wait? It's a perfect fit for the reform before the House of Representatives right now. And there shouldn't be a problem getting it through the Senate.
Why can't a provision creating a fully free market in medical insurance across all fifty states be added to the Reconciliation Bill? Let's erase the lines, as the President might say. For starters, it would allow the 11-14 million able-bodied Americans who signed onto ObamaCare in the Medicaid expansion (and given generous public subsidies), to purchase affordable coverage in a highly competitive national market. That will save $billions in future Medicaid costs. Hence, it impacts budgetary outlays and certainly is a fiscal component of the American Health Care Act. The Congressional Budget Office (CBO) estimates outlays and revenues ten years down the road. It's folly to fail to take into account the dynamic allowances a free market in medical insurance will indisputably foster.
And then there's this-- eliminating mandates is not just not stopping to collect penalties from people who don't purchase health insurance policies, as many now intimate. Eliminating mandates means lifting the required range of benefits policies must cover and allowing every individual to choose what and how much insurance he/she will purchase. But Establishment interests, such as Medical Associations who benefit from the mandated services (originally imposed by state legislatures, and now, by ObamaCare) are, no doubt, lobbying hard to keep those mandates in force. No one wants to lose the business. But corruption doesn't begin with special interest lobbies pleading for special benefits, but with pols who presume to have the power to grant them.
But, all of the above, aside, pre-existing conditions which all sides seem to support, remains a very grave threat to the health and well-being of the country. Any health reform that preserves pre-existing conditions, preserves ObamaCare, and promotes the so-called "death spiral." Insurance companies cannot profitably operate in a climate where individuals need not be covered until they get sick or have a serious accident, and then they cannot be denied coverage. Under such circumstances, a health insurance provider would be mad to keep advertising his brand.
There is no question but that the nation will now undergo a difficult adjustment period while free choice and free markets are restored. Not every American will come through it unscarred. It can't be avoided, any more than an addicted teen can skip the withdrawal pains he will endure while "getting clean."
We can only hope the world never forgets whom it was that made this anguished period in our history necessary.