Three Elements of a Conservative Health Care Vision

Recently I wrote about how conservatives failed to articulate a coherent vision of health care, specifically issues related to pre-existing conditions, in the runup to the midterm elections. That article prompted a few Capitol Hill colleagues to ask an obvious question: What should a conservative vision for health care look like? It’s one thing to have answers on specific issues (i.e., alternatives to Obamacare’s pre-existing condition regulations), but what defines the vision of where conservatives should look to move the debate?

Henceforth, my attempt to outline that conservative health-care vision on a macro level with three relatively simple principles. Others may express these concepts slightly differently—and I take no particular pride of authorship in the principles as written—but hopefully they will help to advance thinking about where conservative health policy should lead.

Portable Insurance

Conversely, conservatives believe in insurance purchased by individuals—or, as my former boss Jim DeMint likes to describe it, an insurance policy you can buy, hold, and keep. With most Americans still obtaining health coverage from their employers, a move to individually owned coverage would mean individuals themselves would decide what kind of insurance to purchase, rather than a business’s HR executives.

Conservatives should also promote the concept of portable insurance that can move from job to job, and ideally from state to state as well. If individuals can buy an insurance policy while young, and take it with them for decades, then much of the problem of covering individuals with pre-existing conditions will simply disappear—people will have the same insurance before their diagnosis that they had for years beforehand.

I wrote approvingly about the Trump administration’s proposals regarding Health Reimbursement Arrangements precisely because I believe that, if implemented, they will advance both prongs of this principle. Allowing employees to receive an employer contribution for insurance they own will make coverage both individual and portable, in ways that could revolutionize the way Americans buy insurance.

A Sustainable Safety Net

As it is, the Medicare program became functionally insolvent more than a year ago. The year before Obamacare’s passage, the Medicare trustees asserted the program’s hospital insurance trust fund would become insolvent in 2017. Only the double-counting included in Obamacare—whereby the same Medicare savings were used both to “save Medicare” and fund Obamacare—has allowed the program to remain solvent, on paper if not in fact.

Reasonable people may disagree on precisely where and how to draw the line at the sustainability of our entitlements. For instance, I hold grave doubts that able-bodied adults belong on Medicaid, particularly given the way Obamacare’s expansion of Medicaid has encouraged states to discriminate against individuals with disabilities and the most vulnerable.

But few could argue that the current system qualifies as sustainable. Far from it. With Medicare beneficiaries receiving more from the system in benefits than they paid in taxes—and the gap growing every year—policy-makers must make hard choices to right-size our entitlements. And they should do so sooner rather than later.

Appropriately Aligned Incentives

Four decades ago, Margaret Thatcher hinted at the primary problem in health care when she noted that socialists always run out of other people’s money. Because third-party insurers—in most cases selected by HR executives at individuals’ place of business rather than the individuals themselves—pay for a large share of health expenses, most Americans know little about the price of specific health care goods and services (and care even less).

To state the obvious: No, individuals shouldn’t try to find health care “deals” in the ambulance on the way to the hospital. But given that much health care spending occurs not for acute cases (e.g., a heart attack) but for chronic conditions (i.e., diabetes), policymakers do have levers to try to get the incentives moving in the right direction.

Reforming the tax treatment of health insurance—which both encourages individuals to over-consume care and ties most Americans to employer-based insurance—would help align incentives, while also encouraging more portable insurance. Price transparency might help, provided those prices are meaningful (i.e., they relate to what individuals will actually pay out-of-pocket). Giving individuals financial incentives to shop around for procedures like MRIs, or even surgical procedures, also would place downward pressure on prices.

This post was originally published at The Federalist.

Graham-Cassidy and Conservative Health Reform

In its February budget submission to Congress, the Trump administration endorsed legislation “modeled after” the bill Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) introduced last year, which would devolve much of Obamacare’s entitlement spending to the states.

The budget claims this legislation “would allow states to use the block grant for a variety of approaches in order to help their citizens.” But based on the most recent public version, the Graham-Cassidy bill needs significant changes to deliver true flexibility to states.

The administration endorsed Graham-Cassidy because it believes the legislation would give states flexibility to embrace a “variety of approaches” to health care and health insurance. But would the most recent version of the bill allow Idaho to implement its reforms without federal intrusion? In a word, no.

In at least two respects, Idaho’s plan violates the many federal requirements that would remain intact under Graham-Cassidy. Idaho’s proposal to allow annual limits of over $1,000,000, and its proposal to allow surcharges of up to 50 percent for individuals who do not maintain continuous coverage, both contravene the Washington-imposed regulatory apparatus Graham-Cassidy retains.

This raises an obvious question: If the only state-based insurance reform plan proposed to date violates Graham-Cassidy, then how much “flexibility” does the legislation really provide? To paraphrase Margaret Thatcher, conservatives have not spent the past eight years fighting to roll back a Washington-based, regulatory leviathan imposed by a Democratic Congress, only to see that leviathan reimposed by a Republican one.

To its credit, the Trump administration has worked to roll back Obamacare’s regulatory regime. Consistent with its promise in the budget to generate “relie[f] from many of [Obamacare’s] insurance rules and pricing restrictions,” the administration has proposed rules allowing greater access to short-term insurance coverage and association health plans, both of which are exempt from some or all of the Obamacare statutory restrictions.

But make no mistake: While these actions will give some individuals freedom from Obamacare’s restrictions, they will not give states the control they deserve over their own insurance markets. To give the states the freedom that the Trump administration promised, Congress must repeal the federally imposed regulatory superstructure Obamacare created. Only by doing so will Washington give states the true flexibility to explore alternative visions of health care for their citizens—Graham-Cassidy’s stated goal.

If Congress does not act to give states freedom, a future Democratic administration will reimpose each and every health care regulation the Trump administration loosened—and many more besides. The Center for American Progress made as much crystal-clear recently, when in releasing the Left’s next plan for (more) government-run health care, it proposed legislation that would “leave little to no discretion to the Administration [of the day] on policy matters.”

To the Left, Obamacare isn’t about power so much as control. As President Reagan famously stated, the “little intellectual elite in a far-distant capital” think they can “plan our lives for us better than we can plan them ourselves.” To liberals’ unquenchable desire to arrogate more power in Washington, conservatives must respond with freedom—freedom for states, and ultimately to businesses and individuals, to buy the coverage they want, and innovate in ways that can lower health spending.

The Graham-Cassidy bill has other flaws. It retains most of Obamacare’s spending (albeit disbursed to the states through the block grant) and all of its major tax increases. But at its core, the debate over health care remains one of control: Whether Washington will try to micromanage 50 states and more than 300 million people, or whether states and citizens can lead the way. We stand with the people—and hope that, after eight years of promises, the Republican Congress finally does likewise.

This post, co-written with former Sen. Jim DeMint, was originally published at The Federalist.

AARP’s Own Age Tax

Over the past few weeks, AARP—an organization that purportedly advocates on behalf of seniors—has been running advertisements claiming that the House health-care bill would impose an “age tax” on seniors by allowing for greater variation in premiums. It knows of which it speaks: AARP has literally made billions of dollars by imposing its own “tax” on seniors buying health insurance policies, not to mention denying care to individuals with disabilities.

While the public may think of AARP as a membership organization that advocates for liberal causes or gives seniors discounts at restaurants and hotels, most of its money comes from selling the AARP name. In 2015, the organization received nearly three times as much revenue from “royalty fees” than it did from member dues. Most of those royalty fees come from selling insurance products issued by UnitedHealthGroup.

Only We Can Profit On the Elderly

So in the sale of Medigap plans, AARP imposes—you guessed it!—a 4.95 percent age tax on seniors. AARP not only makes more money the more people enroll in its Medigap plans, it makes more money if individuals buy more expensive insurance.

Even worse, AARP refused good governance practices that would disclose the existence of that tax to seniors at the time they apply for Medigap insurance. While working for Sen. Jim DeMint in 2012, I helped write a letter to AARP that referenced the National Association of Insurance Commissioners’ Producer Model Licensing Act.

Specifically, Section 18 of that act recommends that states require explicit disclosure to consumers of percentage-based compensation arrangements at the time of sale, due to the potential for abuse. DeMint’s letter asked AARP to “outline the steps [it] has taken to ensure that your Medigap percentage-based compensation model is in full compliance with the letter and spirit of” those requirements. AARP never gave a substantive reply to this congressional oversight request.

Don’t Screw With Obamacare, It’s Making Us Billions

Essentially, AARP makes money off other people’s money—perhaps receiving insurance premium payments on the 1st of the month, transferring them to UnitedHealth or its other insurance affiliates on the 15th of the month, and pocketing the interest accrued over the intervening two weeks. That’s nearly $3.2 billion in profit over six years, just from selling insurance plans. AARP received much of that $3.2 billion in part because Medigap coverage received multiple exemptions in Obamacare. The law exempted Medigap plans from the health insurer tax, and medical loss ratio requirements.

Most importantly, Medigap plans are exempt from the law’s myriad insurance regulations, including Obamacare’s pre-existing condition exclusions—which means AARP can continue its prior practice of imposing waiting periods on Medigap applicants. You read that right: Not only did Obamacare not end the denial of care for pre-existing conditions, the law allowed AARP to continue to deny care for individuals with disabilities, as insurers can and do reject Medigap applications when individuals qualify for Medicare early due to a disability.

The Obama administration helped AARP in other important ways. Regulators at the Department of Health and Human Services (HHS) exempted Medigap policies from insurance rate review of “excessive” premium increases, an exemption that particularly benefited AARP. Because the organization imposes its 4.95 percent “age tax” on individuals applying for coverage, AARP has a clear financial incentive to raise premiums, sell seniors more insurance than they require, and sell seniors policies that they don’t need. Yet rather than addressing these inherent conflicts, HHS decided to look the other way and allow AARP to continue its shady practices.

The Cronyism Stinks to High Heaven

AARP will claim in its defense that it’s not an insurance company, which is true. Insurance companies must risk capital to pay claims, and face losses if claims exceed premiums charged. By contrast, AARP need never risk one dime. It can just sit back, license its brand, and watch the profits roll in. Its $561.9 million received from UnitedHealthGroup in 2015 exceeded the profits of many large insurers that year, including multi-billion dollar carriers like Centene, Health Net, and Molina Healthcare.

But if the AARP now suddenly cares about “taxing” the aged so much, Washington should grant them their wish. The Trump administration and Congress should investigate and crack down on AARP’s insurance shenanigans. Congress should subpoena Sebelius and Sylvia Mathews Burwell, her successor, and ask why each turned a blind eye to its sordid business practices. HHS should write to state insurance commissioners, and ask them to enforce existing best practices that require greater disclosure from entities (like AARP) operating on a percentage-based commission.

And both Congress and the administration should ask why, if AARP cares about its members as much as it claims, the organization somehow “forgot” to lobby for Medigap reforms—not just prior to Obamacare’s passage, but now. AARP’s fourth quarter lobbying report showed that the organization contacted Congress on 77 separate bills, including issues as minor as the cost of lifetime National Parks passes, yet failed to discuss Medigap reform at all.

This post was originally published at The Federalist.

Hillarycare Redux? A Review of “The System”

A young president promising hope and change takes over the White House. Immediately embarking upon a major health-care initiative, he becomes trapped amidst warring factions in his party in Congress, bickering interest groups, and an angry public, all laying the groundwork for a resounding electoral defeat.

Barack Obama, circa 2009-10? Most definitely. But the same story also applies to Bill Clinton’s first two years in office, a period marked by a health-care debate in 1993-94 that paved the way for the Republican takeover of both houses of Congress.

In their seminal work “The System,” Haynes Johnson and David Broder recount the events of 1993-94 in detail—explaining not just how the Clinton health initiative failed, but also why. Anyone following the debate on Obamacare repeal should take time over the holidays to read “The System” to better understand what may await Congress and Washington next year. After all, why spend time arguing with your in-laws at the holiday table when you can read about people arguing in Congress two decades ago?

Echoes of History

For those following events of the past few years, the Clinton health debate as profiled in “The System” provides interesting echoes between past and present. Here is Karen Ignani of the AFL-CIO, viewed as a single-payer supporter and complaining that insurance companies could still “game the system” under some proposed reforms. Ironic sentiments indeed, as Ignani went on to chair the health insurance industry’s trade association during the Obamacare debate.

There are references to health care becoming a president’s Waterloo—Johnson and Broder attribute that quote to Grover Norquist, years before Sen. Jim DeMint uttered it in 2009. Max Baucus makes an appearance—he opposed in 1994 the employer mandate he included in Obamacare in 2009—as do raucous rallies in the summer of 1994, presaging the Obamacare town halls 15 years later.

Then there are the bigger lessons and themes that helped define the larger debate:

“Events, Dear Boy, Events:” The axiom attributed to Harold Macmillan about leaders being cast adrift by crises out of their control applied to the Clintons’ health-care debate. Foreign crises in Somalia (see “Black Hawk Down”) and Haiti sapped time on the presidential calendar and press attention, and distracted messaging. During the second half of 2009, Obama spent most of his time and energy focused on health care, leading some to conclude he had turned away from solving the economic crisis.

Old Bulls and Power Centers: “The System” spends much more time profiling the chairs of the respective congressional committees—including Dan Rostenkowski at House Ways and Means, John Dingell at House Energy and Commerce, and Patrick Moynihan at Senate Finance—than would have been warranted in 2009-10. While committee chairs held great power in the early 1990s, 15 years later House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid called most of the legislative shots from their leadership offices.

Whereas the House marked up three very different versions of health-care legislation in 1993-94, all three committees started from the same chairman’s mark in 2009. With Speaker Paul Ryan, like John Boehner before him, running a much more diffuse leadership operation than Pelosi’s tightly controlled ship, it remains to be seen whether congressional leaders can drive consensus on both policy strategy and legislative tactics.

The Filibuster: At the beginning of the legislative debate in 1993, Robert Byrd—a guardian of Senate rules and procedures—pleaded for Democrats not to try and enact their health agenda using budget reconciliation procedures to avoid a filibuster. Democrats (begrudgingly) followed his advice in 1993, only to ignore his pleadings 16 years later, using reconciliation to ram through changes to Obamacare. Likewise, what and how Republicans use reconciliation, and Democrats use the filibuster, on health care will doubtless define next year’s Senate debate.

Many Obama White House operatives such as Rahm Emanuel, having lived through the Clinton debate, followed the exact opposite playbook to pass Obamacare.

They used the time between 1993 and 2009 to narrow their policy differences as a party. Rather than debating between a single-payer system and managed competition, most of the political wrangling focused on the narrower issue of a government-run “public option.” Rather than writing a massive, 1,300-page bill and dropping it on Capitol Hill’s lap, they deferred to congressional leaders early on. Rather than bashing special interest groups publicly, they cut “rock-solid deals” behind closed doors to win industry support. While their strategy ultimately led to legislative success, the electoral consequences proved eerily similar.

Lack of Institutional Knowledge

The example of Team Obama aside, Washington and Washingtonians sometimes have short memories. Recently a reporter e-mailed asking me if I knew of someone who used to work on health care issues for Vice President-elect Mike Pence. (Um, have you read my bio…?) Likewise, reporters consider “longtime advisers” those who have worked the issue since the last presidential election. While there is no substitute for experience itself, a robust knowledge of history would come in a close second.

Those who underestimate the task facing congressional Republicans would do well to read “The System.” Having read it for the first time the week of President Obama’s 2009 inauguration, I was less surprised by how that year played out on Capitol Hill than I was surprised by the eerie similarities.

George Santayana’s saying that “Those who cannot remember the past are condemned to repeat it” bears more than a grain of truth. History may not repeat itself exactly, but it does run in cycles. Those who read “The System” now will better understand the cycle about to unfold before us in the year ahead.

This post was originally published at The Federalist.

Sen. DeMint Op-Ed: A Letter to President Obama

Dear Mr. President:

As the temporary slowdown in government operations enters its second week, I write to explain why conservatives have insisted on making the Patient Protection and Affordable Care Act the prime source of contention. Speaking for our organization, I can tell you we’re in this fight because of the harm the law is inflicting on Americans across the country.

We are fighting for people like Michael Cerpok, a leukemia patient in Arizona, who recently learned he will lose his current health insurance due to this misguided law. He notes that “my $4,500 out-of-pocket [expense] is going to turn into a minimum of $26,000 out-of-pocket to see the doctor that I’ve been seeing the last seven years,” and he worries that he and his wife might need to take second jobs to stay afloat.

We are fighting for people like California resident Tom Waschura, who voted for you twice, yet was shocked by the higher premium bill he recently received in the mail. Tom’s insurance rates will go up by almost $10,000 for him and his family. He fears that these higher premiums will harm his family, and jobs in his area: “When you take $10,000 out of my family’s pocket each year, that’s otherwise disposable income or retirement savings that will not be going into our local economy.”

We are fighting for people like Rod Coons and Florence Peace, a retired Indiana couple satisfied with their current coverage. “I’d prefer to stay with our current plan because it meets our needs,” says Rod. But their plan isn’t government-approved under Obamacare’s new rules, so Rod and Florence are losing their health insurance plan at the end of this year.

You have claimed that Obamacare has nothing to do with the budget. But over the next decade, this widely unpopular program will add nearly $1.8 trillion in new federal spending—and will cost taxpayers trillions more beyond that, making it nearly impossible to balance the federal budget. What’s more, for millions of struggling Americans, the law will crush their family budgets due to fewer work hours, lost jobs, and higher premiums. With the economy still mired in a scattered and sluggish recovery, these people deserve relief from Obamacare—and they deserve it now.

Your Administration has already granted numerous waivers and exemptions during the three years since the law was passed. Millions of union members received temporary waivers from the law’s costly benefit requirements. Big businesses have received a one-year delay from the onerous employer mandate—a delay your Health and Human Services Secretary, Kathleen Sebelius, struggled to defend in an interview earlier this week. And Members of Congress have obtained special treatment for themselves and their staffs—illegally—that allows them to continue to receive taxpayer-funded insurance subsidies.

At a time when so many Americans are suffering because of the rollout of this new law, I remain puzzled by your failure to acknowledge the faults caused by this unfair, unworkable, and unpopular measure. We believe the law should be fully repealed, but at minimum, both sides should agree not to fund the law for one year—a “time-out” that would halt the law’s most harmful effects before they start.

Even though Democrats have thus far refused to negotiate on anything related to the current government slowdown, millions of citizens need relief from this law. I encourage you and your Administration to work with Congress on ways to stop Obamacare from harming the American people and the American economy.

This post was originally published at The Daily Signal.

Sen. DeMint Op-Ed: The House of Representatives Listens to the American People

Today, a bipartisan majority in the House of Representatives voted to stop Obamacare while funding the government to prevent a shutdown. This is a powerful development for the cause of freedom, showing that our representatives are listening to the concerns of the American people about this unworkable, unfair, and unpopular health care law.

When this partisan law was rammed through more than three years ago, its backers publicly stated they could not bother to read the legislation—or give the American people time to read the bill. “We have to pass the bill so that you can find out what’s in it,” as the former Speaker of the House famously remarked.

The people who passed Obamacare didn’t listen to the American people—because, as polling since Obamacare passed has demonstrated, the American people don’t like the law one bit. All the reasons people don’t like Obamacare are the same reasons we need to stop its implementation—to prevent premiums from going up; to prevent massive new tax hikes; and to prevent people from losing their health coverage, or losing their jobs altogether.

Listening to the American people about stopping Obamacare should not be a partisan exercise. Real people have already been harmed by this misguided law. Every day brings new facts to light on how Obamacare will raise costs on struggling families, restrict access to doctors and plans they like, increase our debt, and damage our fragile economy. Congress should work together to protect American families from being hurt and instead work on commonsense reforms that expand health care choices and lower costs.

Today, the House of Representatives voted to stop Obamacare because it listened to people across the country. Here’s hoping the Senate listens to the American people as well.

This post was originally published in The Daily Signal.

Hospital Finds Obamacare Harmful to Its Health

Last night the Newark Star-Ledger reported that Obamacare is causing one large New Jersey hospital to lay off workers:

Barnabas Health, the second-largest private employer in the state, said today it was forced to lay off employees because of pressures brought about by healthcare reform….“Healthcare reform, in combination with Medicare cuts, more patients seeking outpatient care and decreasing patient volumes,” a spokeswoman for Barnabas said in a statement. “As a result, we have made the difficult decision to reduce our workforce.”

This move was both predictable and predicted. Even though hospital industry lobbyists supported Obamacare three years ago, the law contains Medicare provisions that will decimate the industry over the long term. As Heritage Foundation President Jim DeMint wrote earlier this week:

ObamaCare’s reductions in Medicare spending could undermine the health system for millions of seniors. According to the non-partisan Medicare actuary, the law’s arbitrary spending reductions could cause 15% of hospitals to become unprofitable by 2019, and as many as 40% of hospitals to become unprofitable in the long term. These hospitals could face the choice between shutting out seniors or shutting their doors for good.

Nancy Pelosi famously said we had to pass the bill to find out what’s in it. Hospitals, whose Washington lobbyists endorsed the law, are now finding out that Obamacare will harm them significantly—and hospital workers are finding out Obamacare could cost them their jobs.

Expanding health insurance coverage even as hospitals lay off staff—potentially reducing, not increasing, access to care—isn’t reform. For this and many other reasons, Congress needs to stop Obamacare now and focus on creating health care solutions that work.

This post was originally published at The Daily Signal.

Sen. DeMint Op-Ed: We Must Stop Obamacare Before It Becomes Hazardous to Our Health

New York’s famous 42nd Street will offer natives and visitors a new sight later this week: a mammoth, six-story billboard with a striking message: “Warning—Obamacare may be hazardous to your health.”

It’s part of The Heritage Foundation’s continuing public education campaign to inform the American people about the dangerous side-effects of this unfair, unaffordable and unworkable law, and how it can be stopped.

How will Obamacare—a 2,700-page law passed by a single vote over bipartisan opposition— harm Americans’ health?

Well, here are five of its worst side effects.

First, many Americans will lose their current health coverage. That’s what’s happening to Rod Coons and Florence Peace, a married couple in Indianapolis. Rod and Florence like their current plan.

“I’d prefer to stay with our current plan because it meets our needs,” Rod says.

Unfortunately, their current coverage fails to meet new requirements imposed under Obamacare by federal bureaucrats. At the end of this year, that plan will no longer be available to Rod and Florence. They’ll have to find another, Obamacare-sanctioned plan that may restrict their access to certain treatments or force them to buy coverages they neither want nor need.

Second, many Americans will lose access to physicians they trust. The Wall Street Journal recently highlighted the case of John Nowak, who faces a dilemma when he chooses an insurance plan on Obamacare’s Exchanges this fall. He “will be able to pick a [revised, Obamacare-compliant] plan from his current insurer—or go for one that includes his primary-care doctor.”

To save costs, many plans on Obamacare’s Exchanges are limiting physician networks. So if John chooses to keep his current insurance carrier, he may not be able to keep his current doctor. At minimum, he will pay a lot more to see that physician out-of-network.

Third, Obamacare places bureaucrats between doctors and patients. The law imposes new penalties on doctors who do “not satisfactorily submit data” that meet Washington bureaucrats’ standards.

It also creates a panel of unelected, unaccountable bureaucrats empowered to make rulings that reduce Medicare spending.

Little wonder that nearly three in five physicians responding to a recent Deloitte survey think the practice of medicine is in jeopardy.

Fourth, Obamacare dumps millions of patients onto Medicaid—a health program so bad that not even Medicaid patients call it “real insurance.” An analyst for the liberal Consumers Union once admitted that a Medicaid card is but a “hunting license”—“a chance to go try and find a doctor” that actually accepts Medicaid patients.

Moreover, several studies have shown that people enrolled in Medicaid often have worse medical outcomes than those with no health insurance at all.

Expanding a broken Medicaid program is just giving millions of Americans a cruel and empty promise—an insurance card with limited access to real health care.

Fifth, Obamacare’s reductions in Medicare spending could undermine the health system for millions of seniors.

According to the non-partisan Medicare actuary, the law’s arbitrary spending reductions could cause 15% of hospitals to become unprofitable by 2019, and as many as 40% of hospitals to become unprofitable in the long term. These hospitals could face the choice between shutting out seniors or shutting their doors for good.

Either outcome is unacceptable.

Obamacare is not just bad for Americans’ physical health—it’s bad for America’s fiscal health as well. If Congress does not act, on January 1, 2014, Washington will tap a gusher of new federal spending on Obamacare.

Over the next decade, the cost of the law’s new entitlements will soar more than fivefold, from $48 billion in 2014 to $250 billion in 2023.

That will create a lot of pain in taxpayers’ wallets.

For all these reasons and more, Congress must act, and act now, to stop Obamacare before it takes root.

This fall, Congress will have an opportunity to use its “power of the purse” to block Obamacare from going forward.

I recently traveled across the country on a town hall tour sponsored by our sister organization, Heritage Action for America.

I met many Americans concerned about the impact of Obamacare on their health care, who want the law stopped immediately.

There are things we can and should do to improve America’s health care system and reduce costs, but first we must stop Obamacare before it starts.

The law is a dangerous prescription for America, and its side effects will damage our collective health.

This post was originally published at Fox News.

The IRS, Obamacare, and You: The Taxes

With the IRS under fire for its improper targeting of tea party groups, many Americans have also raised concerns about the agency’s activities relating to Obamacare. This week, we’ll be taking a look at just some of the many ways in which the IRS will be intimately involved with implementing the massive law.

It starts with taxes. According to the Congressional Budget Office, Obamacare raises over $1 trillion in revenue in its first 10 years—and more after that. You name it, Obamacare taxes it. As Heritage Foundation President Jim DeMint recently stated:

Obamacare taxes most people with health insurance, and most people without health insurance. Likewise, the law taxes many employers who provide health insurance, and most employers who don’t provide health insurance.

Obamacare contains no fewer than 18 tax increases. What’s more, 12 of these taxes will be borne by the middle class, directly breaking President Obama’s 2008 “firm pledge” to those making under $250,000 per year that he would not “raise any of your taxes.” For instance, many seniors will end up paying the 2.3 percent tax on medical devices as the price of wheelchairs, defibrillators, and other needed medical equipment will rise.

Here’s a list of all the Obamacare taxes to be administered by the IRS.

This post was originally published at The Daily Signal.

Sen. DeMint Op-Ed: Obamacare Isn’t About Health Care–It’s About Power

Members of the House of Representatives are scheduled to vote Thursday to repeal all of Obamacare. Given that the House voted to repeal the law last year, some commentators and observers have questioned the need for another repeal vote.

However, the scandals coming to light over the last week perfectly make the case for why Congress must eradicate the law from the statute books.

On Friday, the Internal Revenue Service finally disclosed that it had spent years targeting Tea Party and other conservative groups, delaying their applications for non-profit status and giving those applications additional scrutiny — solely because of those groups’ political beliefs.

Also on Friday, the Washington Post revealed that Health and Human Services Secretary Kathleen Sebelius personally asked health industry groups to contribute to Enroll America, a pro-Obamacare front group working to “educate” the public about the law’s supposed benefits.

While we don’t yet know all the details about these scandals, we do know that the IRS grossly abused its power at a time when Obamacare grants it massive new authority. The Treasury Department’s Inspector General has said Obamacare represents “the largest set of tax law changes in 20 years,” with at least 42 provisions adding to or amending the tax code.

Obamacare taxes most people with health insurance, and most people without health insurance. Likewise, the law taxes many employers who provide health insurance, and most employers who don’t provide health insurance.

Obamacare’s heavy reliance on the IRS seems somehow fitting, as the entire law relies on a scheme of government controls and regulations to work its will on the health care system. The law imposes price controls on insurance companies and extends a system of price controls for pharmaceutical companies. Obamacare also places a board of unelected, unaccountable bureaucrats at the center of its plans to control health care costs.

A 2010 Congressional Research Service report found that the number of new bureaucracies “that will ultimately be created” by Obamacare “is currently unknowable.” Little wonder that Vice President Biden boasted shortly before the law was passed, “We’re going to control the insurance companies.”

That’s what Obamacare is about. It’s not about health care. It’s about government control and power. And the record of this administration shows its willingness to use this power in arbitrary and harmful ways.

Secretary Sebelius’ recently disclosed fundraising campaign tried to make an end-run around Congress, forcing private companies to give money for a pro-Obamacare marketing campaign that Congress itself has refused to fund.

It isn’t the first time the secretary has skirted the law, either. HHS’ infamous waivers, the majority of which went to individuals in union health plans, weren’t mentioned in Obamacare. And in recent weeks, Democrats who support the law have criticized the secretary for taking funds from other programs to fund Obamacare implementation.

Just like the IRS, HHS has also targeted the First Amendment rights of private organizations. In 2009, the department applied an infamous “gag order” on Medicare Advantage plans, ordering them not to communicate with seniors about how Obamacare’s cuts to Medicare Advantage would affect their coverage.

If past experience is any guide, IRS and HHS could use their newfound Obamacare powers to target their political opponents. Will individuals who choose not to buy insurance under Obamacare’s mandate find themselves subjected to government audits?

Will corporations who choose not to “donate” to Sebelius’ fundraising campaign find themselves targeted by Obamacare regulators — or even the IRS itself? Given the events of the past week, few can answer these questions with an unequivocal “no.”

There’s one easy way to stop the rot, and that’s to repeal Obamacare once and for all. At a time when this week’s revelations show how the government has abused its existing powers, it’s exactly the wrong time to give the government yet more authority. Congress should instead focus on repealing Obamacare and restoring freedom.

This post was originally published in The Washington Examiner.