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As Peter Suderman writes in Reason any Republican effort to repeal and replace ObamaCare is likely going to be disappointing, given both the enormity of the task and the fact that they’ll be starting with a ball further down left field than when the President took office.
Still, there’s room to maneuver and maybe even to reverse the ratchet in a few areas. Last week, Sen. Marco Rubio and Gov. Scott Walker issued fairly similar plans that attempt to do just that (Walker issued a short white paper; Rubio wrote an op-ed for Politico that sketches his ideas, albeit with fewer details).
After repealing ObamaCare, both plans start by removing the single greatest inanity of our system: that insurance purchased through one’s employer is tax-free, while insurance purchased directly is not. This system is virtually unique in the world — a bad example of American exceptionalism if ever there was one. Moreover, making it easier for people to purchase insurance directly not only removes an extraneous layer from the healthcare system but also will reduce a major source of governmental intrusion (i.e., Hobby Lobby).
The Rubio and Walker plans envision expanded health savings accounts, fewer strings attached to Medicare, the opening of national markets, and other modest moves toward returning things toward an actual insurance market and letting states handle more of the details. The government would remain deeply involved in healthcare, but with less direct meddling.
Is this what we want? Would this be acceptable? Before 2008, all of this would have struck me as sensible, if unexceptionable. Now, I worry that — despite the lingering dislike for ObamaCare — Rubio or Walker’s plan may be too radical to happen.