Thomas Jefferson said many things on which classical liberals and libertarians agree. The one most apropos to Obamacare is this: “The natural progress of things is for liberty to yield and government to gain ground.”
Anything that requires government force (or threat of) to gain compliance is, on its face, immoral. But Obamacare did something else: it was a deliberate forced attempt to shift personal responsibility for one’s health care from a citizen to his government. Jefferson had this to say about that:
Single acts of tyranny may be ascribed to the accidental opinion of a day. But a series of oppressions, begun at a [particular] period and pursued unalterably through every change of ministers, too plainly prove a deliberate, systematic plan to reduce [a people] to slavery.
That’s why Senator Rand Paul’s bill, flawed though it is, is so refreshing: it not only represents a shift away from government meddling where it doesn’t belong, but it moves responsibility back to where it belongs: the citizen himself. Said Paul, in announcing his Obamacare Replacement Act (ORA):
This is a big, big day for conservative Republicans. We owe this to the conservatives around the country who elected us to repeal, to completely repeal, Obamacare.
But I think if you’re going to repeal something, you should replace it.
At least he got half of it right: repeal. Libertarians would disagree that Obamacare “should” be replaced with something else. They would likely say: repeal it and be done with it. Let the free market sort it out afterwards.
But Paul’s bill goes a long way down that road, back from slavery and forward to freedom and personal responsibility. ORA puts the decision to purchase health insurance coverage back in the hands of the people paying for it, and allows them the freedom not to purchase coverage if they don’t want to. The Obamacare mandates requiring either “purchase or pay penalties” would disappear. It would allow those citizens choosing to buy health coverage to choose whatever plan they want. Insurance companies will be allowed to offer coverages across state lines, and expand their offerings without federal interference or demands that certain expenses be covered even when unwarranted or unnecessary.
Rather than punishing with IRS penalties those who decided under Obamacare not to buy coverage, ORA offers incentives instead. Individuals may set up their own Health Savings Accounts (HSAs) to pay for future medical and health expenses. Any amounts may be added to those accounts and those funds may be invested without incurring taxes on any earnings. And a tax credit of up to $5,000 per person putting away funds into an HSA is granted. Those without insurance through their employer but wanting to buy coverage will be able to join in voluntary associations for the sole purpose of buying insurance, taking advantage of better coverages at lower rates.
Funds invested in HSAs may be used to buy health insurance and pay for prescriptions and over-the-counter drugs along with dietary supplements and physical exercise regimens offered by personal trainers and workout centers and facilities. And, of course, those funds may be used to cover any deductibles in the coverages they decide to purchase. HSAs may also be set up by those already covered under the VA, Medicare, Tricare, HIS (Indian Health Service), or health care sharing ministries.
In other words, HSAs under the new law will be tax-deferred savings accounts, with tax credits added in as a bonus to encourage people to set them up.
ORA is a “consensus” bill combining the elements of at least four plans being offered to replace Obamacare. While there are still some issues to be ironed out, especially regarding Medicaid and the size of the tax credit, the bill in final form will likely arrive on President Trump’s desk no later than the end of March.
ORA is also a political move by the House Freedom Caucus, which supports it unanimously. The 40-member caucus is using this as a lever to move Obamacare’s repeal along more rapidly. That caucus voted on Monday night to repeal the bill passed by both houses in 2015 undoing Obamacare, putting in its place ORA.
Once it becomes law, individuals will enjoy the freedom they lost under Obamacare, along with the new responsibility of determining just how they should spend their own money. They will be able, once again, to decide whether they want health insurance or not. If so, then they will have vastly greater options open to them, with choices of coverage, benefits, deductibles, hospitals, and doctors and other health care providers built in to their plan of choice. It not, then they are free to go naked and spend their own money elsewhere, as they wish.
Paul’s bill, despite its flaws built on assumptions that something must take the place of the odious Obamacare, represents a dramatic turnabout from dependency to individual responsibility. For that, freedom fighters, liberty lovers and classical liberals can rejoice.
Jefferson’s quote on freedom
Jefferson’s quote on slavery
The Obamacare Replacement Act (S. 222)
DailySignal.com: Conservatives Coalesce Around New Obamacare Replacement Plan
Politico.com: Obamacare repeal-replace effort begins to jell
Dr. Rand Paul Unveils Obamacare Replacement Act