Keep Obamacare on life support while you get it replaced

It’s an imperfect solution, but Republicans likely need to do a temporary extension of Obamacare subsidies while they get fixes up and running.

This week, the House passed a bill full of vital health-insurance reforms (the Lower Health Care Premiums for All Americans Act), but several GOP moderates also end-ran Speaker Mike Johnson to keep alive hope of some bipartisan deal that would extend the COVID-era subsidies that make the existing system affordable for middle-class Americans who have no better choice as the law now stands.

As a matter of hard practical politics, extending the subsidies some is vital to saving several Republicans in next year’s midterms, and so to keeping the GOP majority that makes Johnson the speaker.

Yes, the subsidies were always supposed to be temporary, and it was Democrats who gave them an expiration date.

But Dems refuse to face what a house of cards the Affordable Care Act has made of health insurance for all too many Americans; their only solution to its near-collapse is to throw more taxpayer billions at it, the soaring federal debt be damned.

But the Obama law failed to deliver on its most basic promises (for one, it raised premiums instead of lowering them; for another, you couldn’t keep the policy you already had and liked), even as it left tens of millions with no better alternative to its increasingly-cruddy coverage.

Republicans are between a rock and a hard place: The nation can’t forever keep pumping ever-more money into a program that’s dying of its weight; they need to start unwinding Obamacare ASAP — while still keeping the collapse from leaving millions with no affordable coverage at all.

The obvious solution is a this-time-it’s-truly-time-limited extension of the expiring subsidies (a year should do it, maybe two) paired with the House’s longer-term reforms: Then it’s up to moderate Democrats to stop their leadership from blocking a compromise solution.

The House bill aims to cut costs for individuals who buy their own health insurance and beef up non-Obamacare options for small businesses.

Other reforms may be needed to unwind Obamacare’s biggest mistakes, such as trying to have everyone pay the same premiums even though, for example, older people naturally consume a lot more care.

Not every American needs or wants insurance that covers everything, and the GOP should keep pushing to get those folks expanded and cheaper options: Increased competition in the marketplace is what’s actually going to bring costs down and push insurers to provide better service.

Yet untangling the Obamacare web can’t happen overnight, and Republicans should own up to the political need to give consumers and insurers breathing room to adapt.

Obamacare is dying, whether Democrats want to admit it or not.

But ensuring it doesn’t create too many victims as it collapses requires keeping it on life support a bit longer, whether Republicans want to admit it or not.