Nov. 08--Whew! Tough week for Obamacare.
On Friday, the U.S. Supreme Court agreed to hear a legal challenge to the tax subsidies that are provided to thousands of people who obtained health insurance through the Affordable Care Act. If the high court finds that the law doesn't allow subsidies in states that haven't established their own health care exchanges, the law could be all but crippled. Without subsidies, many people won't be able to afford insurance coverage.
On Tuesday, voters handed control of the U.S. Senate to the Republicans. Those would be the Republicans who vow to repeal and replace the Affordable Care Act.
There's not much the Obama administration can do about the Supreme Court, other than prepare for its day in court.
There's much the administration could do about the Republican target on Obamacare. Starting with the admission that the law has failings that cry out to be fixed.
Given all the political acrimony over Obamacare, a bipartisan agreement on fixes would seem remote. But there's a way for that to happen.
Republicans in control of the House and Senate will go through the ritual of voting to repeal the law. If repeal gets to the president's desk, he will veto the legislation.
So let's get that out of the way.
Then, it would be wise for Republicans to get beyond repeal and replace, and focus on how to repair Obamacare. A lot of Democrats support changes in the law, and even the most ardent defenders of Obamacare can't pretend that it is so popular with Americans that it should clank along as is.
Several significant Obamacare fixes would draw considerable support from Republicans and Democrats. A repair bill with significant Democratic support would create more pressure on the president to sign it.
Such a bill would:
--Scrap the widely loathed medical device tax, a 2.3 percent levy on sales of hip implants, MRI machines, heart valve replacements and other equipment. Last year the Senate favored scrapping the tax on a 79-20 roll call. The tax stifles innovation and hurts U.S. competitiveness in a vital world market.
--Spare thousands of small businesses from the Obamacare mandate of offering insurance or paying a penalty. Employers who have 50 or more full-time workers must provide coverage or pay penalties. Several Democratic senators introduced a measure earlier this year that would raise that threshold to 100 employees. That would exempt the vast majority of small and midsized businesses, sponsors say, freeing them from a mandate many can't afford.
--Ease the mandate that forces employers to cover employees who work 30 hours a week or more as full-timers. The 30-hour threshold has prompted some employers to curb workers' hours or cut jobs to avoid the insurance requirement. There should be bipartisan support to raise that threshold to 40 hours.
--Allow insurers to offer a less expensive "copper" option to Americans who don't want soup-to-nuts coverage. Right now, insurers offer four levels of plans -- platinum, gold, silver and bronze. Platinum is the most generous, covering 90 percent of a typical person's medical bills. A copper plan would cover about 50 percent of those bills. It would appeal to people who want low premiums and protection from the cost of treating a catastrophic illness or injury. Giving people more choices should have broad appeal in Congress.
The law needs significant changes to provide flexible coverage for Americans at a price they can afford. These changes must be made with a key fact in mind: Millions of Americans already rely on Obamacare for coverage. Many more will sign up in the upcoming enrollment period beginning in just a few days. There are hundreds of new policies offered by a rising number of carriers in many states. Obamacare has a constituency of people who couldn't afford or couldn't qualify for health care.
Broader Republican support has built for provisions that keep children on their parents' policies until age 26 and that protect people who have pre-existing health conditions.
Last week, Obama sounded close to clueless about the impact of the Tuesday election results. There were precious few feints at conciliation. But he did say he would be "very open and receptive" to "responsible changes" to the health care law. "... We think we can do even better," he said.
Some Republicans will see political risk in such a negotiation -- a fix to Obamacare would be a tacit admission that it is here to stay. But the alternative is to do nothing, and let Obamacare continue with all its warts.
They might be enticed by that, but they should remember that Senate Majority Leader Harry Reid just rode his fierce obstruction to bipartisanship to a crushing loss of control of the Senate.
Republicans, repair Obamacare. Some Democrats will enlist and many voters will thank you.
