An Olympiad ago yesterday, President Obama signed Obamacare into law. Four years later, it is clear that Republicans are committed to running against it. Far less clear, however, is whether they are committed to repealing it.
In Friday’s USA Today, Republican National Committee chairman Reince Priebus listed many of the horrors of Obamacare. He noted that the Democrats’ “struggle to defend the law” on the merits causes them to resort to a “feeble . . . something-is-better-than-nothing” defense. He quoted Debbie Wasserman Schultz, his counterpart at the Democratic National Committee, as asking, “What is the Republican solution . . . to ensuring that everybody in America has access to quality, affordable healthcare?” And then, having set himself up to take the big shot and win the game . . . Priebus didn’t shoot. He didn’t provide the answer to Wasserman Schultz’s question.
Priebus listed six discrete policy proposals. But the combination of those proposals wouldn’t give every American “access to quality, affordable health care.” Instead, they would leave open a political hole big enough to drive a liberal truck — or an entire fleet of Toyota Priuses — through it. All that an Obamacare supporter would have to do is ask this question: Under the Republicans’ proposal, what would happen to someone who was made eligible for Medicaid because of Obamacare’s Medicaid expansion, or someone who gets the most lavish taxpayer-funded Obamacare subsidies because he or she has an income that’s just above the Medicaid line? Under Priebus’s proposals, the answer would be: They’d get very little or nothing — an answer that almost certainly won’t lead to full repeal.
Indeed, Priebus is already coming out in favor of keeping, rather than repealing, Obamacare’s ridiculous federal mandate that says that no family in America should be able to save some money by buying an insurance plan that doesn’t cover their 25-year-old “child.” Obamacare bans anyone from choosing such a plan. (To be fair, Priebus does give himself some wiggle room with his phrasing: “I think we can agree on allowing young people to stay on their parents’ insurance until age 26.” It’s unclear whether he would simply allow insurers to continue covering adult children — a no-brainer — or keep the Obamacare ban in place.)
Just because Republicans don’t have an answer to Wasserman Schultz’s question, however, doesn’t mean there isn’t one. Indeed, the 2017 Project has advanced a conservative alternative to Obamacare under which health costs would drop, liberty would be secured, and every American who wants to buy health insurance would be able to do so. It’s an alternative that is designed to bring about Obamacare’s full repeal.
The plan would offer a refundable tax credit to Americans who buy health insurance in the individual market — an approach that Senator Jim DeMint wisely advocated as far back as 2009 — thereby finally ending the unfairness in the tax code (which allows employer plans to be purchased with pre-tax dollars but offers nothing to millions of people who shop in the individual market). The value of the credit would be as follows: $1,200 for those under 35 years of age; $2,100 for those between 35 and 50; $3,000 for those who are 50 or over; and $900 per child. According to the federal government’s own numbers on the cost of insurance shortly before Obamacare went into effect, credits of these amounts, supplemented by no more than $15 a month from a person’s own income, would cover the cost of “catastrophic” health insurance for a typical healthy person in all but five states. Those five states — all in the Northeast — have ruined their insurance markets through hyper-regulation, but the proposal would allow their residents to buy insurance across state lines and thereby escape these artificially inflated prices. And for those with an expensive preexisting condition, the proposal would guarantee coverage — at a price that, while higher, would still be affordable — through a state-run high-risk pool, from which no one could be turned away. (States would establish eligibility rules and pricing for the high-risk pools in such a way as to ensure affordability across incomes.)
If Republicans were to advance such an alternative, which would save over $1 trillion in direct spending as compared with Obamacare over a decade, they could repeal every last letter of Obama’s attempted overhaul of American medicine — thereby undoing its unprecedented consolidation and centralization of power and money at the expense of Americans’ liberty. But until the GOP advances an alternative that can provide the answer to Wasserman Schultz’s question, the Democrats can be confident that, while Obamacare might get tweaked, changed, or “fixed,” it won’t get repealed.
Four years after the Democrats passed Obamacare in clear defiance of public opinion, it still remains to be seen which Republican(s) will take the lead on repeal — by championing a well-conceived alternative that can bring it to fruition.
— Jeffrey H. Anderson is executive director of the 2017 Project, which is working to advance a conservative reform agenda.