Why replacing Obamacare is so hard: It's fundamentally conservative

[DonViejo]

By Craig Garthwaite July 10 at 2:22 PM

<< Craig Garthwaite is an associate professor of strategy and director of the Healthcare Program at Northwestern University’s Kellogg School of Management. >>

Republicans are engaged in a brutal civil war between hard-liners and moderates as they struggle to craft legislation to repeal and replace Obamacare. The episode invites an almost existential question for the GOP: Why, after seven years of nearly endless war against Obamacare, is the party unable to deliver a more conservative policy that provides access to health care to a similar number of Americans?

As a life-long Republican who has spent months contemplating this question, I’ve come to an answer that will be hard for many conservatives to swallow: Passing an Obamacare replacement is difficult because the existing system is fundamentally a collection of moderately conservative policies.

In crafting their health-care plan, Republicans have come to the uncomfortable realization that there simply isn’t much room to the political right of Obamacare for a policy that covers as many people with high-quality insurance. Furthermore, many have realized that there isn’t much political will for a bill that covers meaningfully fewer people or that places low-income individuals in insurance plans with cost-sharing elements they can’t afford.

To be sure, the suggestion that Obamacare is based on conservative principles is anathema to the modern incarnation of the GOP. Opposition to the legislation has become so central to the party’s agenda that simply writing these words will surely brand me as a Republican apostate.

But before I am drummed out of the party, it’s important that we consider our history. Given current rhetoric, it seems Republican leadership has forgotten that even Ronald Reagan saw a role for the government to provide quality health insurance for those who could not otherwise afford access. At the time, this wasn’t surprising because the Republican Party wasn’t dominated by the purely anti-government ideals of the House Freedom Caucus and the more conservative members of the Senate. Instead, it was a party that at its core supported a limited, well-run and efficient government.

This fact can be seen in the structure of the social insurance policies we’ve historically supported. Rather than embracing unconditional cash transfers or regressive minimum-wage increases, we supported welfare reform and the earned-income tax credit. In areas where government service is needed, we’ve supported the expanded use of government contractors and outsourcing rather than an ever-growing leviathan.

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https://www.washingtonpost.com/opinions/why-replacing-obamacare-is-so-hard-its-fundamentally-conservative/2017/07/10/c5d64634-6351-11e7-84a1-a26b75ad39fe_story.html

[LonePirate]

1. Replacing it is quite easy but Republicans will never adopt the liberal solutions which do that.

[Thomas Hurt]

2. The GOP is not interested in addressing their constituents' needs or fixing anything...

this exercise is all about ideological purity and political spite.

[stuffmatters]

3. Dems fail to counter always that ACA is the Republican/Romneycare/Heritage program.

Last edited Mon Jul 10, 2017, 06:40 PM - Edit history (1)

All the bogus Republican butt hurt defending Trumpcare, whining that they were not able to participate in ACA, should have been automatically shut down by factually countering that the Republican contribution to ACA WAS ACA...it drives me nuts that this fact goes unmentioned lately by Democratic legislators, pundits and all of the MSM.

And,sure, it makes it difficult now for Repugs to come up with an alternative to what was their best effort, as usual from the Koch think tanks and ALEC,the bill mill they rely upon tp furnish their written legislation. Without ALEC, you've just got a bunch of old, selfish white guys slashing America's basic health insurance plan to give back almost a trillion to their Owners. I guess, despite the masquerade of distancing from TC of billionaires like the Kochs, they really have grown to despise paying taxes for Americans lives to be saved.( I remember how Jim de Mint, after ACA passed, took his unrequitted blood thirst straight to head Heritage and start the fight against their own program (ACA)!

The Democratic ideal was always single payer, part of the social safety net like Medicare and Social Security.; ACA was the Republican plan of still depending upon corps, without ability to cut their middleman costs or power, not even the ability to negotiate drug prices like the Va or reimport to cost cut.. .

So ACA was not only THE Republican plan, it's also been "tweeked" repeatedly by Republican SCOTUS, Senators (Rubio) and states to sabotage its fulfillment. The improvements that Democrats have hoped to make, like gradualizing the
income amounts for subsidy qualification ...the positive tweeking any such sweeping legislation needs (like social security did)after passage the Republicans thwarted.

ACA is probably the last Republican legislation that I'll see in my lifetime that displays even a glimmer of the social contract. IMHO.

[BigmanPigman]

5. And that is one of the main reasons that it IS failing!

We compromised too much to pass it and since then they have done everything at state and federal levels to destroy what remained. I agree that the Dems message should be to throw it back in their faces that it has always had Republican ties. They are such hypocrites yet the Dems hardly ever call them out on it. The media is the same. It took months for them to use the word "lie" instead of "not truths" and some still don't use the actual word like it is profanity or worse. When will liberals finally call a spade a spade for god's sake? It is SO frustrating.

[pangaia]

4. It's all about the black guy...

[iamateacher]

6. We have Romneycare thru Massachusetts

It is not failing. But everyone is mandated to have it (insuring that the young and healthy are in the risk pool).
ACA started failing when Rubio cut out the risk pool insurance $$ for the insurance companies and Repubs kept putting off the mandate for the young and healthy.
Granted, I would rather have single payer, but it does work better than the old system.