Conservatives rarely attempted to make a That intuition is understandable, but mistaken, because it is in fact the federal government that has made health insurance so costly through seven decades of unwise policies.

Those policies include the exclusion from taxation of employer-sponsored health insurance, an outgrowth of World War II-era wage controls.

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The law significantly expands the role and scope of the federal government in determining Americans’ personal health-care choices. And its Rube Goldberg-like maze of insurance regulations has made health insurance unaffordable for millions.

But when it came to replacing Obamacare, Republicans usually presented the case in exclusively political terms: Replacement was necessary because the alternative would be daily front-page stories of the millions thrown off of their health-care plans by the GOP Congress.

They include the enactment of the Great Society entitlements, Medicare and Medicaid, in 1965.

They include the EMTALA law, signed by President Reagan, that guaranteed free emergency-room coverage to everyone, including the uninsured and illegal immigrants. (To those who say that the employer tax exclusion is no big deal because “it’s your money,” I say this: If the government only deigns to give “your money” back to you when you elect to work in a W–2 job and hand a fifth of your income over to health-insurance companies, your money isn’t really being treated like it’s your money.) This seven-decade pileup of federal intervention in the health-care system is directly — and exclusively — responsible for the astronomical costs of the present-day American health-care system.

And due to the ambitions of the 100-day legislative agenda, and the peculiar legislative calendar associated with the Senate’s reconciliation process, they chose not to invest the time in getting health-care reform right.

The moral case for replacement Conservatives intuitively understand the moral case for repealing Obamacare.

Large, incumbent companies are addicted to the employer tax exclusion because it makes it harder for employees to leave them for start-up competitors or freelance work. It is a system designed to benefit C-suite executives and multinational corporations at the expense of hourly wage workers and mom-and-pop businesses.

To advocate for a fiscally fairer system — in which we subsidize the wealthy far less while covering more of the uninsured, with less total federal spending as a result — ought to be in the wheelhouse of a conservative movement that aspires to support opportunity for all and favoritism to none.

The Affordable Care Act has substantially decreased the number of uninsured Americans and improved access to health care, though insurance affordability and disparities by geography, race/ethnicity, and income persist.

These are some of the findings revealed in nearly 100 studies, dating back to 2010, pertaining to the ACA in a new research paper.

While the final bill contained some reductions of that new tax credit for the highest earners, its structure was not designed to benefit the working poor; indeed, the AHCA would have made premiums unaffordable for millions of blue-collar Americans.