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Not Obamacare



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Last week, Representatives Paul Ryan and David Nunes, and Senators Tom Coburn and Richard Burr, introduced a comprehensive Republican health-care reform plan, called the Patients’ Choice Act (PCA).

By and large, their plan has been well-received among conservatives (see, for instance, this op-ed in The Wall Street Journal by Grace-Marie Turner and Joe Antos), and for good reason. It calls for shifting today’s tax preference for employer-paid premiums into a refundable credit which individuals, not companies, would control (the credit would initially be worth $5,700 for households and $2,300 for individuals).   Reforming the federal tax treatment of health insurance is the essential first step in building a real marketplace in health-care. The plan also envisions moving today’s low-income Medicaid population out of public coverage and into private insurance.

Today, James Pethokoukis of Reuters has a piece on some of the back and forth among conservatives about the perceived merits or drawbacks of the plan. Of course, like everyone else, I might change some aspects of the bill if I could. But, on balance, I applaud the effort — Pethokoukis quotes me in the piece to that effect — because the bill should help solidify rank and file Republican opposition to Obamacare. 

Which is why I found it so strange to see that some Obamacare supporters — namely Ezra Klein — apparently believe the introduction of the PCA will make passage of the emerging Democratic plan more likely. Klein argues that the new Republican plan looks so much like the plans Democrats want to pass that it will undermine the arguments for opposing Obamacare.

That’s a real stretch, to say the least.

Unlike the Democratic plans, the PCA does not: require individuals to enroll in insurance; impose any mandates on employers; require a minimum benefit package; federalize insurance regulation; expand Medicaid or other public insurance; micro-manage health-care decisions from Washington; or bankrupt the federal government. Moreover, the PCA is built on individual choice of insurance, while the Democratic plans are premised on government and employer control. 

If Klein and others are ready to endorse the PCA and abandon Obamacare because there’s no real difference between them, that would be fine. But he shouldn’t expect PCA’s supporters to feel the same about Obamacare.



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