Standing in front of a stack of wood crates with his sleeves rolled up, Scott Walker on Tuesday unveiled a plan to repeal and replace Obamacare. Gesturing to a projector screen as he ticked through slides, Walker looked almost like a management consultant dropped onto the floor of the machine-parts manufacturer in Brooklyn Center, Minn., where he delivered his remarks.
Walker’s proposal, which he’s calling the Day One Patient Freedom Plan, is the second detailed health-care platform released by a Republican presidential candidate, and it puts him firmly in the camp of conservative policymakers who want to repeal Obamacare but replace it with a plan that would continue to provide subsidies for Americans to buy health insurance on the individual market. The other camp is spearheaded by Louisiana governor Bobby Jindal, who released his own health-care plan last spring. It would scrap Obamacare and proceed as if it had never passed — that is, without providing a coverage alternative for Obamacare’s beneficiaries. These are the broad terms on which the GOP’s candidates will debate the issue, and Walker is among the first to plant his flag in the ground.
Walker’s health-care plan, which would provide tax credits to those who do not receive health insurance through their employer and allow consumers to shop for insurance across state lines, is largely based on the proposal released by the 2017 Project in February of 2014. That plan has long had advocates in conservative policy circles. “Well, obviously I like it,” Jeffrey H. Anderson, the executive director of the 2017 Project, says. “I think it’s a very well-conceived plan that would be much more attractive than Obamacare to the vast majority of Americans.” Anderson also says adoption of the plan would be “a win for limited government and liberty.”
Jindal’s criticism of the Walker plan went well beyond its price tag. In a blistering statement, he said he’s shocked a Republican candidate would endorse a “cradle to grave” entitlement. “When did conservatism die?” he asked. “When did we accept the idea of dependence on government? Governor Walker is confused here.”
Jindal’s Freedom and Empowerment Plan gives states $100 billion over ten years to create health-insurance programs, provided that they guarantee access for those with preexisting conditions and comply with other federal demands. Like Walker’s, it allows individuals to purchase insurance across state lines. Jim Capretta, a health-care expert and a senior fellow at the Ethics and Public Policy Center and the American Enterprise Institute, says the drawback of the Jindal plan is that many lower-income people “will not be able to access health insurance through it.”
Walker, who has been losing ground in recent polls and fighting to regain momentum, won’t have the microphone to himself for long. Even as Walker released his plan today, Florida senator Marco Rubio was up with an op-ed trumpeting the broad outlines of his proposal to “fix health care.” Since early 2014, Rubio has been working with Ways and Means Committee chairman Paul Ryan on his own detailed health-care plan, which he will release in the coming months. The op-ed indicates the plan will be similar to Walker’s but will also phase out the tax preferences for employer-based insurance.
Walker’s plan, now available on his website, promises to ‘restore the full freedom to choose your own health care.’
That proposal is likely to be controversial. Back in 2008, John McCain’s presidential platform included a health-care plan that would have eliminated the tax breaks on employer-sponsored insurance and replaced them with tax credits; the Obama campaign, in turn, produced one of the most effective ads of the election season, charging that McCain aimed to deregulate the health-care industry just as Republicans had deregulated the big banks.
Health-care experts say trying to take on the employer-based system is risky. “While I like it from a policy standpoint, I think it’s much smarter to go in incremental steps here,” Anderson says. He advises repealing and replacing Obamacare and attempting to tweak the employer-based system at a later date. “For this round of legislation, it’s more important to reassure people in the employer-based system,” says Capretta. “Just in terms of being able to garner a coalition to be able to move away from Obamacare, I think it’s the wrong choice.”
In choosing to unveil his plan in Minnesota, Walker was thinking along political lines, too. A spokeswoman for the governor, AshLee Strong, says the state is “a natural choice in location for Walker to take this important step in his candidacy.” The governor, she says, is “playing to win in the early states, but he is also committed to states holding March contests and beyond. Minnesota is no exception.”Walker’s decision to deliver his speech in the Twin Cities is part of a broader political statement by the campaign. He has long said that the path to the White House runs through the Midwest, and that the Republican nominee must recapture blue and purple states such as Iowa, Michigan, Ohio, and Pennsylvania where the GOP has struggled in recent years.
Walker’s plan, now available on his website, promises to “restore the full freedom to choose your own health care.” He told his audience he’d begin by issuing an executive order repealing the legislative jujitsu that allowed Congress to qualify as a small business under Obamacare, and thus preserved federal health-insurance subsidies for legislators and their staffs. Stripping the subsidies, he promised, would “light a fire under Congress” to make some changes.
Right now, in conservative circles, the health-care wonks who have been hammering away on the details of these plans and waiting for politicians to take them up are celebrating as the public begins to take notice.
“I think all three of them should be out there, compared, and debated,” Capretta says of the competing plans. At this point in the race, few conservative intellectuals would disagree.
— Eliana Johnson is Washington editor for National Review.