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What Would W. Do to Replace Obamacare?



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George W. Bush has a reputation as a big-government conservative. (Personally, I think this is somewhat unfair; the Republican Congress deserves much of the blame for increased spending.) But it has been ignored that in 2007, Bush proposed an excellent health-reform plan, one that would have achieved the critical goal of equalizing the tax treatment of health insurance purchased by individuals and employers. 

The plan would have extended health coverage to around 11 million people. While that wouldn’t completely solve the problem of the 50 million uninsured Americans, it would inject a great deal of competition and consumerism into the health-insurance market place, without any additional federal spending. Indeed, according to the Joint Committee on Taxation, the plan would have reduced the deficit by $334 billion in the first decade, and trillions more in future years. (See my lengthy analysis at Forbes if you want further details.)

While the Bush plan wouldn’t serve as a complete replacement for Obamacare, because it wouldn’t cover as many people as Obamacare would (according to the CBO, Obamacare expands coverage by about 33 million with an individual mandate, 17 million without), it does help frame the fiscal debate about the superiority of market-oriented coverage expansions. And the trillions saved could be used to help fund tax credits for the uninsured, as Paul Ryan and others have proposed.

Despite the fact that the Bush plan would have achieved its deficit reductions by increasing tax revenue, the plan was endorsed by Grover Norquist’s Americans for Tax Reform. (Bush’s National Economic Council designed the plan to be revenue-neutral, though as I noted above, the JCT scored it as deficit-reducing.)

The Supreme Court decision on Obamacare is less than two months away. It’s quite possible that the Court will overturn the law in its entirety. Conservatives need to start thinking about credible alternatives.

Avik Roy is a senior fellow at the Manhattan Institute and the author of The Apothecary, the Forbes blog on health-care and entitlement reform. He is a member of Mitt Romney’s Health Care Policy Advisory Group. You can follow him on Twitter at @aviksaroy.



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