Republicans are tying themselves in knots over how to wind down the Obamacare experiment when Donald Trump takes office in January. Eager to be seen as keeping his promise to "repeal and replace" Obamacare, but worried about denying ongoing insurance to the 20 million Americans the program now covers, party leaders are stumbling in the dark in search of a solution.
Some have proposed a typical Washington compromise: Repeal Obamacare now but don't let the death sentence be carried out until 2018 or 2019. The idea is that as the clock ticks down, Republicans — aided by patriotic Democrats — will find a program to take its place.
The reality, of course, is that as we approach the cliff, Obamacare will go on and on with nobody having the courage to pull the plug.
But doctors, patients and insurance companies are fleeing Obamacare in droves. The spiraling premiums, rising deductibles and limitations on treatment options have kept tens of millions from signing up — many preferring to pay a fine and have no insurance to enrolling in the program.
Here's what the Republicans should do:
—Immediately repeal the requirement that everyone has to buy health insurance and any mandate that forces an employer to purchase it for employees.
—Let people choose how much insurance they want and repeal the Obamacare requirement that everyone buy expensive, soup-to-nuts coverage.
—Continue Obamacare requirements that bar discrimination against people with pre-existing conditions and that make parental plans cover children through age 26.
—Make health insurance premiums deductible on federal tax forms.
—Allow interstate competition among insurance firms to broaden choice and reduce costs.
—Continue subsidies to those who qualify — whether or not they buy policies through the Obamacare exchanges.
—Let people keep their Obamacare policies if they'd like to.
And then, let Obamacare wither away from the inside out. Millions now covered will want to switch to lower-cost policies more closely tailored to their needs. Why pay extra premiums to cover drug abuse therapy or sex-change surgery if you don't want it? Many young and healthy men and women will opt for low-cost catastrophic coverage since it's all they need.
As the young and the healthy move out of the rigid, costly Obamacare plans, the premiums of these plans will rise, driving even more to leave.
Then, when Obamacare is down to the truly needy with very high medical bills and chronic conditions, put these four or five million folks under Medicaid and let the government provide for their needs. But don't let their medical needs drive up premiums for the rest of us.
Let Obamacare wither away from within.