Basically, we can repeal by reconciliation, but first we have to pass a damn budget. And then:
Future Republican majorities can work with moderate Democrats to enact needed insurance market reforms and the bipartisan Wyden-Ryan Medicare reform plan, which provides a stronger system of competing private health plans as opposed to government-run “fee-for-service” Medicare.
Reform should start by replacing the tax exclusion for employer-provided health insurance with a flat tax deduction or credit. This should be combined with insurance reforms that allow consumers to buy portable health insurance sold anywhere in the nation, through their employer or on their own. That means you’ll be able to take your health insurance with you from one job to the next. Tax policy will no longer push Americans toward lower wages in favor of more expensive health insurance.
Top it all off with expanded contribution limits for health savings accounts, aggressive national medical liability reform, and structural Medicare and Medicaid reforms that dramatically slow the growth of government and deficits.
That all sounds good, even if it’s short on details. But we’d need to know if we can actually find these “moderate Democrats” who will be willing to do business with us. Are there enough who believe enough in market-based reforms? Can a Democrat even say “market-based reform” without being pilloried?
Sure they can. We just have to make sure they know we want one. I think seeing Romney sworn in as the 45th President, Boehner retained as Speaker, and McConnell sworn in as Majority Leader with 55 or so GOP Senators smiling on will have a salutary effect on their considerations of rhetorical possibility.