The Radical Transformation of our Health Care System

The Cato Institute’s Josh Blackman explains the unraveling of Obamacare.

In a brief moment of candor, former-president Clinton called the ACA’s collapse “the craziest thing in the world,” and lamented that people who liked their insurance have found their “premiums doubled and their coverage cut in half.” The law wasn’t supposed to implode so quickly. Its success was supposed to pave the way for advocates to enact universal health care in five or ten years, but that didn’t pan out. So now, never letting a crisis go to waste, President Obama and Hillary Clinton are prematurely scurrying to back “a public plan to compete alongside private insurers.”

The radical transformation of our health-care system is closer than you may think. A Clinton presidency would have two routes to impose single payer.

First, she would grant so-called “innovation waivers” to “empower states to establish a public option choice.

Second, she could enact a public option through budget reconciliation, provided Democrats control both chambers of Congress.

The sole glimmer of hope is that these same two mechanisms could be employed by a Republican administration to unravel the Affordable Care Act. First, the executive branch could grant conservative states a waiver to experiment with more flexible health-care markets. Second, if Republicans controlled both chambers of Congress, the reconciliation process could be used to rescind the law’s costly and confining mandates on a national scale.