Unlimited Access. Try it Today! Your First 10 Days Always $0.99

Who wants to fix Obamacare?

House Republicans have tried more than three dozen times in the last three years to repeal all or part of the 2010 healthcare law, so it's hard to take them seriously now when they say they're trying to "improve" it.

In fact, when Republicans complain that Democrats won't negotiate about Obamacare, what they're really saying is that Democrats won't agree to kill it, delay the insurance reforms and subsidies until after yet another election, or undermine the law in a way that could send premiums for individual coverage through the roof.

The GOP's clear objective is to dismantle the act, not to improve it — and the single-minded focus on that goal is what has led to the partial government shutdown that began Tuesday. Democrats can hardly be blamed for refusing to bargain over how to sabotage the law before it fully takes effect.

OBAMACARE: News and analysis

It's too bad that Republicans aren't actually trying to make the law better, because the Patient Protection and Affordable Care Act is far from perfect. But the GOP's opposition has limited members of Congress to chipping away at the law, rescinding some provisions and cutting funds for others, rather than modifying its contents to fix problems as they emerge.

There are several things that members of Congress could be doing now to make it work better, if Republicans were interested. They could start by clearing up the uncertainties that have put some federal rules under a legal cloud — for example, by clarifying that Americans in every state can qualify for premium subsidies, not just those in the 16 states that are operating their own insurance-buying exchanges.

They could also look for ways to make the mandate to obtain coverage more effective. The financial penalties in the law are so low, many people would save money by paying the fine instead of signing up for coverage. That's particularly true of the younger, healthier people whose participation is key to holding down premiums. One step that would help on that front: allowing people over age 30 to sign up for less expensive plans with higher deductibles and out-of-pocket costs.

GRAPHIC: Reactions to Covered California's debut

The Affordable Care Act rightly seeks to improve the U.S. healthcare system by advancing simultaneously on multiple fronts: shifting incentives to promote wellness instead of just curing illness, seeking more effective and efficient treatments, and extending coverage to more Americans. Because it's a huge and complex endeavor, lawmakers and the administration will have to make adjustments as it's implemented in order to get it right. Judging by what they've been proposing, though, Republicans aren't interested in making those adjustments — they just want the law to go away.

Copyright © 2015, The Baltimore Sun
Related Content
  • Who should and shouldn't get heart transplants -- and why?
    Who should and shouldn't get heart transplants -- and why?

    When a Georgia teenager named Anthony Stokes got himself killed not long ago, smashing up a stolen car in a police chase after supposedly taking a shot at an old lady in her house, the regret that poured out online was not for the death of the 17-year-old, but for the “waste” of the transplanted...

  • Children's Health Insurance Program deserves funding
    Children's Health Insurance Program deserves funding

    In what may be a hopelessly quixotic effort, supporters of the federal Children's Health Insurance Program are trying to persuade Congress to renew its funding almost a year in advance — and in a lame-duck session. Nevertheless, lawmakers ought to heed that call. The program plugs a troubling gap...

  • The GOP's shameful lawsuit against Obamacare
    The GOP's shameful lawsuit against Obamacare

    The lawsuit the House GOP filed against President Obama on Friday opened a new front in the attack on the 2010 healthcare law, this time targeting the subsidies that reduce deductibles, co-pays and other out-of-pocket expenses faced by lower-income Americans. According to the complaint, the subsidies...

  • A sensible cap on costly prescription drugs
    A sensible cap on costly prescription drugs

    To help prevent Americans from being bankrupted by medical bills, the 2010 federal healthcare law placed an annual cap on deductibles, co-pays and other out-of-pocket costs imposed by health insurers. That's turned out to be a mixed blessing for Americans who suffer from certain chronic diseases,...

  • Stop the guessing game over which doctors are in-network
    Stop the guessing game over which doctors are in-network

    One of the loudest complaints about the policies sold through Covered California, the state's new health insurance exchange, is that they provide access to far fewer doctors than promised. On Wednesday, state regulators finally confirmed and quantified the problem with respect to two leading insurers,...

  • Jonathan Gruber should've been Time's Person of the Year
    Jonathan Gruber should've been Time's Person of the Year

    Jonathan Gruber should have been Time's Person of the Year. The magazine gave it to the "Ebola Fighters" instead. Good for them; they're doing God's work. Still, Gruber would have been better.