The Corner

Replacement Parts

NR editorializes in favor of the Coburn-Hatch-Burr proposal today:

The new health-care plan from Senators Tom Coburn, Orrin Hatch, and Richard Burr is the best one to emerge from Congress yet, and marks real progress in the campaign to replace Obamacare. The plan aims to make health insurance affordable for roughly as many people as Obamacare was intended to, but without the higher taxes, the regulatory micromanagement, the threat of rationing, the reduction in consumer freedom, the vast new bureaucracies, or the perverse incentives. And while not perfect, it largely succeeds in these objectives.

About those imperfections: The editorial, I think, explains the legislation’s regulatory aspects well and judges them correctly. They aren’t great but they differ in character from the regulations in Obamacare in being, in the main, both waivable by states and compatible with the proper definition of insurance.

Yuval Levin also praised the plan, but suggested a few improvements. The tax code has for decades favored employer coverage over individual coverage, which has had all sorts of negative effects on health markets. The plan partly remedies the problem by giving people without access to employer plans a tax credit to buy coverage on the individual market. This credit is means-tested, though, phasing out rapidly as people’s incomes rise. Levin thinks that’s a mistake: “I also think a flat, universal tax benefit for coverage would be better in many respects, as noted here. And that means I think the phasing out of the credit at 300 percent of poverty is not ideal, as it does not extend the tax benefit to much of the middle class.” Avik Roy, also writing in favor of the plan, thinks the plan’s means-testing is appropriate: It limits the budget impact of the tax credit, targets its help at those who most need it, and may not lead to as much political pressure for expansion. If the case for flatness were purely a matter of simplicity and political appeal, then I think that Roy’s counter-arguments would make it a close question. But the other problem with the phase-out of benefits is that it raises implicit marginal tax rates: The more you work, or the more raises and promotions you get, the fewer benefits you get, and thus your incentive to make the extra income goes down. For me, that consideration leads to Levin’s side of the argument.

I suspect that Levin, Roy, and I all agree, however, with the closing thought of NR’s editors:

One of the great liberal conceits of the age is that to extend insurance coverage to the uninsured and make sure the sick do not fall through the cracks requires the centralized political management of the health sector. Given those objectives, the administration and its allies insist, Obamacare or something like it is the only game in town. The great service that Senators Coburn, Hatch, and Burr have performed is to explode that myth.

Ramesh Ponnuru — Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg View, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.

Most Popular

Politics & Policy

Strzok by a Farce

An investigation is one of two things: a search for the truth, or a farce. The House is conducting a farce. That fact was on full display during ten hours of testimony by Peter Strzok, the logorrheic lawman who steered the FBI’s Clinton-emails and Trump–Russia probes. The principal question before the ... Read More


Dear Reader (Especially everyone who got ripped off ordering that giant blimp online), Imagine an alien race that built its civilization on the fact it literally defecated highly refined uranium, or super-intelligent and obedient nano-bots, or simply extremely useful Swiss Army knives. Now imagine one of ... Read More
Film & TV

Stalin at the Movies

Toward the end of The Death of Stalin, two Communist Party bosses size up Joseph Stalin’s immediate successor, Georgy Malenkov. “Can we trust him?” one asks. “Can you ever really trust a weak man?” his comrade answers. Good question. Last week brought the news that the head of Shambhala ... Read More
Politics & Policy

The Rise of the Abortion Cheerleaders

Is abortion a sad and unfortunate reality — regrettable, as we are sometimes told, but often necessary — or is it a breezy nothingburger, completely “normal,” and something to be giddily celebrated like a last-minute NFL touchdown?  For a long time, the abortion lobby has had difficulty deciding. This ... Read More

‘The Warning Lights Are Blinking Red Again’

One of President Trump’s outstanding appointments has been Dan Coats, his director of national intelligence. Coats is a former House member, former senator, and former ambassador to Germany. He is a Hoosier (i.e., from Indiana). Whether he plays basketball, I don’t know. At Wheaton College, he played soccer. ... Read More