Repeal and Replace: The State of the Debate

by Ramesh Ponnuru

My article with Yuval Levin on why the election should not diminish conservatives’ resolve to repeal and replace Obamacare is now online.

Some conservatives are arguing that, given the election results, Republicans should make their peace with Obamacare and seek to improve it. So, for example, some policy wonks on the right argue that the exchanges should be redesigned to encourage high-deductible coverage. Consumers paying out of pocket for routine health-care expenses, they hope, will keep a close eye on prices. Other reformers say the law should be modified so that Medicaid recipients can buy coverage on the exchanges.

Many of the specific ideas these reformers advocate make sense, but they are wrong to think of them as reforms of Obamacare. The law is flawed in its conception and basic design, not just in some of its provisions, and blocking its worst effects would require a rewrite rather than modest modifications. Indeed, the changes these reformers want would amount to that rewrite. Their proponents would therefore have to overcome the advocates of Obamacare — which is another way of saying that enacting these reforms would require assembling the same coalition that repeal would require.

Our response to the (mostly) liberal critics of our article is also online.

The first thing to note is that none of our critics actually defend Obamacare, and therefore none dispute the argument of the piece. Their dispute is entirely with what we propose instead . . . . Their lack of interest in defending the law is interesting.

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