Today the U.S. House of Representatives passed an amended draft of the American Health Care Act, described by Congressional leaders as the first phase of a replacement package for Obamacare. Its passage was not without drama, obviously, as the vote had to be put on hold earlier this year when consensus language couldn't be reached in the lower chamber. The conflict was driven both by substantive policy differences and by concerns that if the entire Obamacare law wasn't repealed in the AHCA, that it would never be repealed. I share concerns in both categories; I am disappointed that the reform continues to track with insurance as a primary vehicle for health care, and I am hesitant to believe politicians when they say they'll finish the job of unwinding Obamacare.
But as has been said, a journey of a thousand miles begins with a single step. The House's action today is an important step of a longer journey, not only at the federal level but among the states as well. From licensure reciprocity to direct primary care promotion to Medicaid reform, the list of projects to be undertaken by free marketeers at the state level is a lengthy one that would never be accomplished in a single law, federal or otherwise. Indeed, ours is a policy journey that will span years and even decades to reach anything resembling completion.
That said and with the initial passage of the AHCA, I am hopeful that the federal government is commited to taking that long and important policy trip with us.