Obamacare – Why Don’t Republicans Have a Replacement Plan?

After 7 years of demanding that Obamacare be “repealed and replaced”, Trump and the Republican’s still have nothing concrete to replace Obamacare.  What is the problem? Why can’t Republicans deliver a replacement plan?

The answer is pretty simple and quite ironic: Obamacare co-opted all of the Republicans best ideas. Republicans are out of ideas because President Barak Hussein Obama stole them all.

Way back in 1989, the conservative, Republican leaning think tank, the Heritage Foundation, proposed a market based solution for America’s health care affordability and access problems that included a mandate that everyone purchase insurance, subsidies to offset the cost of insurance for the poor and other elements that were ultimately included in Obamacare.

Then in 1993 Republicans were forced to develop an alternative to the Clinton Healthcare Plan. (Details of the proposed Clinton’s plan can be found here.) One of the most prominent plans put forth was called the Health Equity and Access Reform Today Act(HEART) and was sponsored by prominent Republican Senators Chaffee, Dole, Hatch, Grassley, Lugar and others. This plan included many elements that were ultimately included in Obamacare including the individual mandate and subsidies.

Below are the elements of Obamacare that originated with Republicans.

  • Individual Mandate – Heritage and HEART
  • Expansion of Medicaid – Heritage
  • Purchasing pools – Heritage and HEART
  • Minimum required package of benefits – Heritage and HEART
  • Subsidies to enable poor to purchase insurance – Heritage and HEART
  • Ban on denying coverage based on pre-existing conditions – Heritage and HEART
  • Tax credits for purchasing insurance – Heritage

Just as ironic, the Heritage Foundation recognized that one of the impacts of its plan would be an increase in premiums. Heritage argued that this would be offset by tax incentives and overall lower costs.  Wow, that sounds familiar.

So why did Republicans spend the last 7 years railing against Obamacare if it is in fact based on their ideas? The answer is painfully clear and can be found in then Senate Minority Leader Mitch McConnell statement in October of 2010 “The single most important thing we want to achieve is for President Obama to be a one-term president.”

So this is the pickle Republicans find themselves in, they’ve vilified and demonized their own policy proposals. As a result these proposals are likely to be unacceptable to the Republican base. At the same time Trump’s team and some Republicans are promising that if you have health insurance right now you will not become uninsured.

The proverbial elephant in the room is that Republicans have not offered one plan that will do that. Republicans have an easy way out of this issue if they would just take it.

The majority of Americans don’t have a clear idea what Obamacare is. At the same time Obamacare does need some fixes that address issues with the insurance exchanges, subsidies, and penalties for not purchasing insurance to name just a few. Republicans could introduce legislation that addresses these and other issues and simply change the name of the program. This is exactly what Obama suggested in his meeting last week with Congressional Democrats.

Most Americans would not realize it was not a wholesale replacement of Obamacare nor would they care. My guess is a significant number of Democrats would go along with it as well.

Now the health of at least 20 million Americans is on the line as we wait to see if Republicans will take advantage of this obvious way out of their 7 years of blustering and grandstanding. Or will they continue to vilify their own health care proposals and ideas for political expediency?

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