How to Replace Obamacare

I believe that repealing the Affordable Care Act(ACA) is the appropriate policy because the improvements from ACA come primarily through cost shifting rather than actual health care reform.  As an example the Individual Mandate attempts to force the high cost, uninsurable patients onto the smallest health insurance segment, the individual health insurance market. A Milliman report prepared for Ohio estimates that the insurance rates in the individual health insurance market will go up 55% to 85%. It is not likely that the individual health insurance market will survive and then we will have a much larger uninsured problem.

The Medicaid expansion is even more amazing. While the fiscally responsible states complain about their problems with coming up with their modestly increased matching funds, the federal government has magically raised the money without any raising taxes. With the Medicaid expansion we have confirmation that the mythological free lunch exists. Since most of the ACA policies make it more difficult reform health care(e.g. community rating, essential benefits, health subsidies), we might as well start over and try to make some actual health care reforms without the cost sharing baggage.

For a different perspective how to replace Obamacare we have this article from the National Affairs article, How to Replace Obamacare. Here is their argument against the repeal-only approach.

But repeal will not be enough, for a simple reason: Although Obamacare would worsen many of the problems with our system of health-care financing, that system clearly does call out for serious reform. Despite the widespread public antipathy toward the new health-care law, simply reverting to the pre-Obamacare status quo would be viewed by many Americans, perhaps even most, as unacceptable. After all, a repeal-only approach would leave many of the most grievous flaws in our system of financing health care unaddressed. Chief among them would be steadily rising health-care costs, driven by the same misguided government policies that so evidently demand reform.