A Republican alternative to Obamacare? Don’t hold your breath


Jonathan Bernstein SAYS the GOP has painted itself into a corner on the issue of health-care reform:

We’re hearing more and more rumblings from top Republicans that the GOP’s current position on Obamacare is untenable — that the party can’t continue to call for the destruction of Obamacare forever without offering any alternative. The push from the right for a shutdown has only drawn that into sharper relief, and so we’re finally hearing that Republicans — finally! — will make good on their promise, now 30 months overdue, to come up with the “replace” part of repeal-and-replace.

It ain’t gonna happen. There won’t be any serious GOP alternative to Obamacare.

The first problem with developing an alternative to the Affordable Care Act is that there just may not be any policy alternative that comes close to accomplishing what the law accomplishes. At first, it looked like conservatives would leave themselves a way to propose their own version of the same reforms in Obamacare, and rename it on their own terms. As such, there seemed to be a method to it when, at the outset, conservatives worked hard to prevent an actual discussion of the substance of the law itself. Much of the initial hatred of the ACA was focused on a series of phony talking points and outright lies (“government takeover” of health care; “death panels”; the law was “rammed through” using corrupt procedural tricks; etc.).

Since none of that was true, it gave Republicans an opening: they may have stigmatized “Obamacare,” but they hadn’t stigmatized the policy ideas at the core of the law — the combination of exchanges and subsidies that actually started out as a Republican plan. In other words, as late as 2012 it seemed plausible Republicans could choose to invent a ConservaCare proposal based on Ronald Reagan Marketplaces that would basically offer a slightly different spin on the same underlying idea.

But conservatives have decided that no policy overlap with Obamacare is acceptable. Tea Partiers have chosen to oppose not only Obamacare but any policy which even faintly resembles any piece of that omnibus legislation. We saw this in the House defeat of Eric Cantor’s high-risk pool bill this spring, when conservatives revolted against his effort to propose a GOP plan protecting those with preexisting conditions.

But that refusal to accept any of the substance of Obamacare has run Republicans right into a brick wall. Thanks to the way that the ACA was put together — it really is a mammoth omnibus bill which incorporated practically every plausible policy idea out there — it turns out that practically everything you can do to provide health insurance is now tainted by Obamacare.

And that’s left Republicans with only one remaining option: turning against the whole concept of health insurance itself.


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