The Media's "Republicans Have No Obamacare Replacement" Myth
Of all the absurd memes repeated by the policy-bereft media these days, the idea that Republicans have no plan to replace Obamacare is one of the most irritatingly false. Here’s the latest example at Politico. Keep in mind how bizarrely ignorant this piece is by considering this context: it would’ve been as absurd to claim that Democrats had no plan for health care in 2009 because there were bills introduced with key elements differing, and occasionally clashing, with each other - or saying they had no plan in the summer of 2008 because Barack Obama's plan was only bullet points on a page, not legislation.
A legislative process inevitably involves internal negotiation and give and take between the ideal and the feasible, and should Republicans have the opportunity to pass something after November, that’s exactly what they’ll do.
What’s more, there’s far more agreement internally in the Republican Party on the broad strokes of this replacement than there was in the Democratic Party at this point in 2008, when Hillary Clinton and Barack Obama were slamming each other openly about the individual mandate and the public option was a single line in a campaign white paper.
Regardless of what the Romney campaign proposes to do on health care, Congressional Republicans know what they want to do. Here are eight things they agree about:
- They want to end the tax bias in favor of employer-sponsored health insurance to create full portability (either through a tax credit, deductibility, or another method);
- They want to reform medical malpractice laws (likely through carrot incentives to the states);
- They want to allow for insurance purchases across state lines;
- They want to support state-level pre-existing condition pools;
- They want to fully block grant Medicaid;
- They want to shift Medicare to premium support;
- They want to speed up the FDA device and drug approval process; and
- They want to maximize the health savings account model, one of the few avenues proven to lower health care spending, making these high deductible + HSA plans more attractive where Obamacare hamstrung them.
This is a picture of broad agreement throughout the caucus on numerous health policy issues – the only real disagreements are about how to achieve these goals, not what the goals are. But what’s notable about this approach is that unlike PPACA, you don’t need the Rube Goldberg-like assemblage of a 2,700 page bill to do it. You can do this in fifty pages, as Rep. Paul Broun does (he also reforms EMTALA, too!), or you could break them up and pass them separately. You don’t have a situation where pulling one block out makes the rest collapse, as we’re seeing even now in the arguments over states passing on the Medicaid expansion. Journalists who say this more gradualist approach to reform means there is no plan betray their ignorance or their bias or both.
Oh, and here are twenty-seven pages of health care bills Republicans introduced in this Congress – some comprehensive reforms, some partial. These are some of the best ones.