Do conservatives have the blueprint to replace Obamacare?

posted at 6:01 pm on August 15, 2014 by Matt Vespa

In May of 2013, I had the pleasure of meeting Manhattan Senior Fellow and Forbes Opinion Editor Avik Roy at Freedomworks’ BlogCon in Dallas, Texas. He was on a panel with then-Freedomworks Vice President for Public Policy Dean Clancy to discuss health care, which was inexcusably left off the Conservative Political Action Committee’s agenda earlier that winter. He quickly brought some hard truths to the “repeal Obamacare” crowd: that goal is not longer politically feasible.

Our chance to repeal Obamacare ended when Republicans failed to win the presidency and retake the U.S. Senate. Now, millions of Americans are enrolled in Obamacare; it’s the law. Are we seriously going to have a 2016 GOP candidate who runs on taking away someone’s health care? That’s millions of votes we just lost; that’s the election.  I can’t stand the thought of Obamacare. But, what should conservatives do? Well, Avik looked to other countries that have achieved universal health care coverage with free market mechanisms.

In his white paper, he uses Switzerland and Singapore as his examples:

In 2011, the Singaporean government spent $851 per capita on health care: less than a quarter of what the U.S. spent, adjusted for purchasing power parity. Singapore has achieved its savings using a universal system of consumer-driven health care. The government funds catastrophic coverage for every Singaporean, and reroutes a portion of workers’ payroll taxes into health savings accounts that can be used for routine expenses.

Switzerland offers its citizens premium support subsidies, on a sliding scale, for the purpose of buying private health insurance; there are no “public option” government insurers. Low-income individuals are fully subsidized; middle-income individuals are modestly subsidized; and upper-income individuals are unsubsidized. The sliding scale addresses a key challenge posed by welfare programs: mitigating the disincentive for welfare recipients to seek additional work, for fear of losing their benefits.

The Swiss system shares some of the unattractive features of the ACA, including the individual mandate. But because Switzerland focuses its public resources solely on lower-income individuals, the federation’s universal coverage system is far more efficient than America’s. In 2012, Switzerland public entities spent approximately $1,879 per capita on health care: 45 percent of U.S. public spending. Put another way, if U.S. government health spending was proportional to Switzerland’s, the U.S. would be able to eliminate its budget deficit.

Of course, the U.S. is neither Switzerland nor Singapore. Each country has its own political system, its own culture, and its own demography. Those differences, however, are not large enough to erase the gains that would accrue here by adapting the most relevant features of the Swiss and Singaporean health care systems to that of the United States.

Roy’s “Universal Exchange” reforms seek to insure 12.1 million Americans above Obamacare levels by 2025. Oh, and it’s projected to cut the deficit by $8 trillion over the next thirty years. So, what are the details?

The Plan would repeal many of the ACA’s cost-increasing insurance mandates, including the individual mandate. But it would preserve the ACA’s guarantee that every American can purchase coverage regardless of preexisting conditions. And it would utilize the concept of using federal premium support subsidies, on a means-tested basis, to defray the cost of private health coverage.

It would gradually migrate most Medicaid recipients, along with future retirees, onto these reformed exchanges. This change would dramatically increase the quality of health coverage offered to Americans at or below the poverty line, and preserve the guarantee of health coverage for low- and middle-income seniors, while ensuring the fiscal sustainability of both federal health care commitments. The Plan proposes minor changes to the treatment of employer-sponsored health coverage, while giving workers additional tools to lower their health care bills. It would curb the pricing power of hospitals, cap malpractice damages, and accelerate medical innovation.

Here are some additional figures from Roy’s reforms:

  • Over the first ten years, the Plan will reduce federal spending by $283 billion and federal revenues by $254 billion, for a net deficit reduction of $29 billion.
  • Over the first ten years, the Plan will reduce state tax revenues by $331 billion, off- set by a larger reduction in net state Medicaid spending due to the transfer of acute-care Medicaid enrollees onto the federally funded exchanges.
  • Over the first 30 years, the Plan will reduce federal spending by approximately $10.5 trillion and federal revenues by approximately $2.5 trillion, for a net deficit reduc- tion of approximately $8 trillion.
  • The Plan will render the Medicare Trust Fund permanently solvent, if the entirety of the proposal’s Medicare savings were ap- plied to the trust fund instead of toward deficit reduction.

Over at National Review, Callie Gable says Avik’s Medicare reform is basically Paul Ryan’s plan ton steroids. She notes that the program’s age of eligibility will increase every four months every year until it’s eliminated entirely:

Right now, seniors can’t even collect their Social Security benefits unless they sign up for Medicare — Avik would put them on the exchanges and encourage employers to offer consumer-driven coverage for them. This would effectively means-test Medicare, reducing spending on the entitlements that are driving the federal government bankrupt (Avik has specific ways to do this with the existing Medicare program too, making Medicare Part D less generous for prosperous seniors, for instance).

For Medicaid, Avik wants to put these people on private insurance plans. Gable added, “There are certain aspects of Medicaid that Roy would put entirely on the federally subsidized exchanges and parts of it (e.g., long-term care and policies for the disabled) that Roy would leave to the states. (The system is currently a mess of conflicting state and federal mandates and priorities.)”

Oh, and there’s the whole saving $5.1 trillion in the process as well.

Roy has long described Medicaid as a “humanitarian catastrophe.” On average, the uninsured are actually better off those enrolled in this miserable government program. In Virginia alone, one in four doctors aren’t accepting new Medicaid recipients. Those who are on the program don’t like the care they receive, which only makes its proposed expansion under Obamacare a massive tax increase on residents who aren’t guaranteed access to medical professionals.

As for the individual mandate, Roy wants to get rid of it. “The first is that it may be too weak to persuade healthier and younger people to overpay for insurance they don’t need,” he says. “The second is that, despite the mandate’s weakness, it represents an unprecedented—if not un- constitutional—expansion of congressional power: compelling individuals to purchase a privately delivered service.”

With the disincentive of on individual mandate gone, Roy proposes a six-month enrollment period for Americans to enroll into the Universal Exchanges every two years. Those who decide not to participate can’t “simply enter and exit the system at will and take advantage of consumer protections such as coverage for preexisting conditions, and cross-subsidies such as community rating.”

He added that this method would actually incentivize private insurance companies to draft competitive health care plans since the sooner they enroll these young Americans, the more time they’ll be able to manage their care.

Admittedly, I’m no health care policy wonk, but it’s an issue that’s imperiling America’s economic health and fiscal solvency. Perhaps, Roy has greased the skids to move this thing in a direction that will ensure we can provide good quality health care to Americans at lower costs.

At a lecture at the U.S. Navy War College three years ago, George Will aptly noted that the one of the pressing questions facing our health care system is how much of our national wealth are we willing to spend to subsidize the last twenty-five years of Americans’ lives, especially the last twelve months. Will added that 28% of all Medicare spending is devoted to end of life care.  Isn’t it time to change course?

Conservatives needed ideas and it seems like we have one.

Now, it’s up to Congress. Who on the Republican side (Democrats will never go for this) will use this entirely–or as a blueprint–to help us transform Obamacare into a workable program?  It’s an interesting narrative; Democrats botched Obamacare, but Republicans fixed it.  I like the sounds of that, although in theory; I would like to see the whole program disintegrate without a trace.  Alas, you can’t always get what you want.

Read the full report here.


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Just repeal it – no replacement is necessary.

Pork-Chop on August 15, 2014 at 6:05 PM

Why do conservatives have to replace a pathetic Liberal policy to destroy personal freedom & private insurance with a better idea??

drivingtheview on August 15, 2014 at 6:09 PM

Oh, why don’t we use Romney’s blueprint for Obamacare. We’ll recruit him to be the nominee again and Romney will know how to replace the blueprint for Obamacare. /s

anotherJoe on August 15, 2014 at 6:10 PM

“Fixing” Obamacare is a fool’s errand. (So naturally, the GOPe should be all for it.) Democrats win big — Obama keeps his legacy AND the Democrats can point the finger of blame squarely at the Republicans for anything and everything that goes wrong with the fixed version (and be assured, gentle reader, it WILL go wrong).

Jedditelol on August 15, 2014 at 6:11 PM

Just repeal it – no replacement is necessary.

Pork-Chop on August 15, 2014 at 6:05 PM

Amen.

Theophile on August 15, 2014 at 6:12 PM

Are we seriously going to have a 2016 GOP candidate who runs on taking away someone’s health care? That’s millions of votes we just lost; that’s the election.

Sorry, but I personally loathe that type of thinking.

Democrats can run around advocating the confiscation of things that are guaranteed in the freaking Constitution (certain types of speech, property, religious freedom, gun rights, etc.), yet conservatives are wrong for telling America that 5 million people don’t deserve free things from the government if it ends up harming 50 million?

This is precisely why Republicans lose and remain unpopular even when they have tremendously weak opposition like Obama and the current crop of Democrats.

Once you accept the arguments of the media and the Left, you’ve already lost. Don’t even bother running with such a platform, because it won’t win. The people would rather vote Democrat and get free stuff than vote Republican and get not as much free stuff.

Aizen on August 15, 2014 at 6:12 PM

Repeal it. The replacement option is just a bad RINO pipe dream.

ROCnPhilly on August 15, 2014 at 6:13 PM

Just think — as soon as “American Male Health Insurance” doesn’t need an office in 50 states, some venture capitalists will bankroll an entrepreneur to sell “catastrophic” insurance plans for males ages 18-39 at $50/month. And eventually “United Women’s Health Co-operative” will be founded to do likewise for double X-chromosome Americans.

Too bad YAY BIG GOVERNMENT prevents that from being a reality.

Jedditelol on August 15, 2014 at 6:14 PM

It’s an interesting narrative; Democrats botched Obamacare, but Republicans fixed it.

MATT VESPA, You are so naive. You do not understand the Republican Party’s TeaNutty base.

This whole Avik Roy plan will remain a pipe dream.

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

Die-hard Democrats will never support this. Their entire identity is wrapped up in ObamaCare……..and it’s continued existence will be similar to the British system. Every year Parliament has to “tinker” with a dysfunctional system in order to “fix” it. And each year requires a new “fix”.

Sort of what King Barack does right now with his illegal “executive orders”.

GarandFan on August 15, 2014 at 6:15 PM

Repeal Obamacare, repeal Medicare, repeal Medicaid and repeal all federal regulations on the Health Care industry (leave these things up to the individual states) and you will eventually see a return to a free market, inexpensive, very good health care system. Until then, we will continue to circle the drain.

Theophile on August 15, 2014 at 6:18 PM

Do conservatives have the blueprint to replace Obamacare?

The best replacement is repeal.

Stoic Patriot on August 15, 2014 at 6:19 PM

For anybody that gets soft, that start to think that maybe Obamacare isn’t that bad, remember that massive govt subsidies into a cost-insensitive govt run system results in sending the cost of medical care through the roof.

People need to have skin in the game as far the costs. A better system would be safety net welfare type subsidies that can be used to buy inexpensive insurance rather than to directly subsidize medical care (because that ratchets up the costs!).

In Singapore people have (mandatory) health saving accounts and with limited exception pay their own medical bills. The result is that in Singapore medical costs are up to 80% less than the US for the same procedures: http://www.brookings.edu/~/media/press/books/2013/affordableexcellence/affordableexcellencepdf.pdf

anotherJoe on August 15, 2014 at 6:19 PM

It’s called the Free Market.

Duh.

beatcanvas on August 15, 2014 at 6:24 PM

You can’t fix stupid.

RedPepper on August 15, 2014 at 6:25 PM

Ned Pepper on August 15, 2014 at 6:14 PM

You keep trying….To bad it keeps making you look like an idiot.

Barred on August 15, 2014 at 6:26 PM

It’s an interesting narrative; Democrats botched Obamacare, but Republicans fixed it.

The accepted narrative would actually be: Democrats delivered a sleek, workable Obamacare, but Republicans were quick to mess with it and f□♡k it all up for everybody.

How stupid does a Republican have to be to rush in and get his name and party associated with this disaster?

ROCnPhilly on August 15, 2014 at 6:26 PM

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

Obamacare is already collapsing on it’s own you moron … or should I say illegal alien moron.

darwin on August 15, 2014 at 6:27 PM

Why do we take on the left’s insane ideas and try to make insanity better?

The Fascist democrats take as big a but as they can and wonder why the board is still too short.The republican elite seam to think that by taking smaller cuts on the piece of wood that it will somehow not be shorter every time.

jukin3 on August 15, 2014 at 6:27 PM

He quickly brought some hard truths to the “repeal Obamacare” crowd: that goal is not longer politically feasible. Our chance to repeal Obamacare ended when Republicans failed to win the presidency and retake the U.S. Senate. Now, millions of Americans are enrolled in Obamacare; it’s the law. Are we seriously going to have a 2016 GOP candidate who runs on taking away someone’s health care?

Roy brought no “truths” to the table. He’s a Bush guy who’s all for big government programs. It’s a shame Forbes prints anything by him. Obamacare would not have been repealed with Romney in the White House. That is absurd. Millions are enrolled in a program that does not provide them with affordable, quality healthcare. On the contrary, they will be complaining about Obamacare for years to come as their standard of living erodes from the the costs of it, and from so much else the government has no business doing. It means nothing but further decline in the health of the economy and in the quality of health-care itself. “It is the law” – So was slavery at one time. For anyone to defend government run health-care, is to defend the basis by which socialism and tyranny exist. It is disappointing HotAir would publish this.

rickv404 on August 15, 2014 at 6:27 PM

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

What happens to the “only game in town” when nobody can afford to play anymore?

Left Coast Right Mind on August 15, 2014 at 6:33 PM

MATT VESPA, You are so naive. You do not understand the Republican Party’s TeaNutty base.

This whole Avik Roy plan will remain a pipe dream.

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

ObamaCare is a $2 trillion dollar failure built on lies and hated by the American people.

You own it, douchebag.

Chuck Schick on August 15, 2014 at 6:34 PM

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

Obamacare is indeed a game – a poorly designed one. That’s why Americans deserve a real policy.

BKennedy on August 15, 2014 at 6:34 PM

What happens to the “only game in town” when nobody can afford to play anymore?

Left Coast Right Mind on August 15, 2014 at 6:33 PM

The government makes it all free!!!!!!

Yay!!!!!!!

I can’t wait to get sh!tty Soviet Union style health care comrade!

darwin on August 15, 2014 at 6:35 PM

Will Obamacare be repealed or won’t it? Will Congress fund it or won’t it? Will the web site be fixed or not? Blah, blah, blah. We the people just need to do what we need to do and Democrats be damned. Resist. Refuse. Revolt. EXEMPT OURSELVES! We did not comply with Prohibition and we simply should not comply with Obamacare. For religious reasons. For privacy reasons. For the cause of liberty and freedom and in protest of the idea that the federal government (under one party rule, no less), can force private citizens to purchase anything with our own money. Are we citizens or subjects? Mice or (wo)men? Just say NO to socialism and to the corrupt, unionized, far left IRS: the gestapo of America’s political class. Afraid of arrest? not to worry! After all, the federal government ignores millions of illegals who are breaking U.S. immigration law every day. Our Founders pledged their lives, their fortunes and their sacred honor. All we have to do is just say no to a scheme we all know is un-American and a violation of our most basic founding fundamentals of privacy, self reliance, limited government and individual freedom.
How To Opt Out Of Obamacare. Know your options and become savvy self-pay patients. Join a health care sharing ministry. These are voluntary, charitable membership organizations that agree to share medical bills among the membership. They function similar to insurance, and are probably the best alternative to conventional health insurance. There are four of them, at least that I know of. Three are open only to practicing Christians (Samaritan Ministries, Christian Healthcare Ministries, and Christian Care Ministry) while a fourth, Liberty HealthShare, is open to anyone who agrees with their ethical commitment to religious liberty. They operate entirely outside of Obamacare’s regulations, and typically offer benefits for about half the cost of similar health insurance. Members are also exempt from having to pay the tax for being uninsured. From the article by Sean Parnell http://thefederalist. com/2013/12/04/opt-obamacare/#.Up9MwGKiM_o.email

devan95 on August 15, 2014 at 6:37 PM

For anyone to defend government run health-care, is to defend the basis by which socialism and tyranny exist. It is disappointing HotAir would publish this.”

Amen. This site has been slipping down the slope towards RINO-ism ever since Michelle Malkin left.

Theophile on August 15, 2014 at 6:40 PM

The question posed in this article’s title contains the problem for conservatives. Must conservatives have an alternative to every problem created/posed by liberals? The Republican party is known as “the party of no,” and I’m okay with that. Sometimes the answer/alternative is no/nothing.

The Bringer on August 15, 2014 at 6:44 PM

Replace WHAT?
There is nothing there THERE!
I have plenty of prints (blue and some old brown-line cepias) but none of them depict a COMPLETE AND UTTER FRAUD.

Missilengr on August 15, 2014 at 6:47 PM

The only way to replace Obamacare is to Let It Burn.

I keep alternating with two theories:
1) Be an activist, work as hard as possible to change peoples hearts and minds to save the country via the electoral process as well as being a good human being, and
2) Let the decline happen, maybe even hasten it if it is possible.

I’m torn over being cautiously optimistic, or continue being pessimistic.

The real solution is to let it burn to the ground, which would separate the wheat from the chaff, so to speak. Then rebuild from the ashes up.

Then there are theories such as controlled burns…

Eastwood Ravine on August 15, 2014 at 6:47 PM

Are we seriously going to have a 2016 GOP candidate who runs on taking away someone’s health care? That’s millions of votes we just lost; that’s the election.

This is idiotic. Getting rid of the piece-of-crap Obamacare is not “taking away someone’s health care”, it’s just a change of their insurance plan which under the piece-of-crap Obamacare happens every year anyway.

“Taking away someone’s health care” may be welcomed by many millions of those FORCED into Obamacare, if it means going back to 2013 insurance rates which were lower than the piece-of-crap Obamacare rates.

Obamacare is a piece of crap, when your dog craps on the living room floor you just throw it out and clean up. No fool comes along and asks “now what are you going to replace that crap with?”

slickwillie2001 on August 15, 2014 at 6:55 PM

Will added that 28% of all Medicare spending is devoted to end of life care. Isn’t it time to change course?

This argument has always seemed like sophistry to me. It is extraordinary that with all the Big Data and Models and Algorithms that analysts are so proud of that we don’t have Big Models for health care

By definition, you will be expensive when you are sick…and you will probably (in our society) be sick before you die. Duh

Here’s a stat…a larger percent of Medicare goes to dialysis patients…way large compared to their percentage in the population. Solution? Would Will say plan for you end of life…take the red pill.

r keller on August 15, 2014 at 6:56 PM

Are we seriously going to have a 2016 GOP candidate who runs on taking away someone’s health care?

Thank you very much for the Progressive talking points, Scooter, but healthcare and health insurance are 2 different things (and Obamacare isn’t even insurance, as it was formerly understood).

Who won’t have health CARE in the future if we don’t dismantle O’care?

Why, it will be those exactly those lucky subsidized Obamacare recipients, either because their insurance is refused by caregivers (exactly as Medicare and Medicaid are refused now) or because no matter how low those premiums are, those high deductibles they must pay before O’care kicks in will mean they NEVER can actually access care they can’t pay cash for.

Funny how that works.

Dolce Far Niente on August 15, 2014 at 7:03 PM

You wanna blueprint”?

It’s called repeal!

formwiz on August 15, 2014 at 7:04 PM

Hmmm How bouts we replace Obamacare with the actual Constitution…let’s start there. The Government has no role and no Constitutional authority in Health Care. Period. ’nuff said

Afterseven on August 15, 2014 at 7:12 PM

Driving along, minding your own business, when a gang of thugs force you off the road. Bizarrely, they fill your trunk with wet concrete and leave you there. An emergency repair crew shows up before the mixture sets.

“Oh sure we can get that stuff outta there. Easy. But whatcha gonna replace it with?”

Lolo on August 15, 2014 at 7:12 PM

The real solution is to let it burn to the ground, which would separate the wheat from the chaff, so to speak. Then rebuild from the ashes up.

Then there are theories such as controlled burns…

Eastwood Ravine on August 15, 2014 at 6:47 PM

Everyone here knows I’m in the Let.It.Burn camp.

To you Rush-In-and-Save-It folks: The majority of Americans now are not like you. They are spoiled and selfish and arrogant in their stupidity. They scream for what they want and spit in your face every single time you save them from the consequences of their actions. At some point, you just gotta let the mob of idiots set themselves and their neighborhoods afire, you know? Sure, your house may burn, too, but at least there will still be folks around who know how to rebuild; that won’t be true after 25 more years of this kind of decay.

ROCnPhilly on August 15, 2014 at 7:15 PM

No no no, a thousand times no. Repeal. Then we can talk about how to achieve necessary health insurance reform. Not remotely interested in replacing a Democrat big government freedom-stealing exercise with a Republican one. (“This one won’t suck as bad as the other, trust us!”)

It is incumbent upon all of us to resist Obamacare as much as possible. Every single step of the way. We must NEVER allow them their victory, for it is a victory against what makes America America. You don’t compromise with that. Ever.

Andy in Colorado on August 15, 2014 at 7:17 PM

why do we need to replace it?
repeal it, there was nothing hugely wrong with prior setup that a few rule changes could not have addressed.
why the hell do people want more laws?

dmacleo on August 15, 2014 at 7:19 PM

MATT VESPA, You are so naive.

Ned Pepper on August 15, 2014 at 6:14 PM

If NED PECKER dislikes Matt Vespa, I suddenly like Matt Vespa alot.

Obamacare is and will remain the only game in town.

Of course you’d think so, comrade.

Diluculo on August 15, 2014 at 7:21 PM

why do we need to replace it?
repeal it, there was nothing hugely wrong with prior setup that a few rule changes could not have addressed.
why the hell do people want more laws?

dmacleo on August 15, 2014 at 7:19 PM

Politics and votes.

Many are getting a freebie now. If repubs take away their freebie, the freebie takers take away any vote that might have gone to repubs, even though the freebie takers aren’t repubs anyway, but the repubs are askeered of losing a vote they never had to begin with.

See?

Diluculo on August 15, 2014 at 7:23 PM

devan95 on August 15, 2014 at 6:37 PM

http://thefederalist.com/2013/12/04/opt-obamacare/

FIFY

ROCnPhilly on August 15, 2014 at 7:24 PM

Obamacare is and will remain the only game in town.

Ned Pepper on August 15, 2014 at 6:14 PM

Bad news Ned Peckerwood, for you and your illegal alien Irish brood:

Health Coverage to End Without Proof of Citizenship or Legal Residency

slickwillie2001 on August 15, 2014 at 7:34 PM

A Brief History Of The Republican Alternative To Obamacare:

March 2009:

As Democrats begin to coalesce around a plan of their own, the GOP alternative is still nonspecific. Rep. Roy Blunt (R-Mo.) offers that Medicare’s prescription drug benefit is “a good pattern of how a competitive marketplace works.”

“Health care is a privilege.” — Rep. Zach Wamp (R-Tenn.)
April 2009:

Igor Volsky of ThinkProgress reports that the GOP’s alternative plan still basically resembles the McCain plan: “The recent trickle of so-called consumer-driven health care ‘principles and recommendations’ are a preview of the likely Republican alternative to comprehensive health care reform. Earlier this month, the Health Policy Consensus Group, headed by the conservative Galen Institute, published ‘a vision for consumer-driven health care reform’ and today Ramesh Ponnuru of National Review pens a New York Times editorial in which he explains that … ‘universal coverage’ is ‘misguided.” Policy makers should focus on giving Americans ‘more control’ of their coverage instead.”

May 2009:

Sens. Tom Coburn (R-Okla.) and Richard Burr (R-N.C.), along with Reps. Paul Ryan (R-Wis.) and Devin Nunes (R-Calif.) introduce their Patient’s Choice Act. Ezra Klein notes: “It’s clear that many traditionally Democratic concepts have been embraced. To put it simply, the plan wants to encourage a version of the Massachusetts reforms … in every state. There are some differences, of course. The plan doesn’t have an individual mandate. It doesn’t have an obvious tax on employers. But it strongly endorses State Health Insurance Exchanges.”

The bill was referred to committee, but nothing ever came of it.

rove alternative obamacare

June 2009:
“I guarantee you we will provide you with a bill.” — Rep. Roy Blunt (R-Mo.)
Karl Rove: “In politics you can’t beat something with nothing, so it is critical that the GOP offers an alternative to President Barack Obama’s government-run monstrosity.”

So here they come! The next semi-official GOP alternative to Obamacare is presented by Rep. Eric Cantor (R-Va.) and Dave Camp (R-Mich.). Time’s Jay Newton-Small terms it “a four-page exercise in public relations that left out how many of the 47 million uninsured Americans would be covered, how it would be paid for or even how much it would cost.” It rolls out alongside nine other “alternative plans.”

“I started reading a couple, three of the Republican plans, but frankly, there’s only so much time in the day.” — Sen. Max Baucus (D-Mont.)
July 2009:

In late July, the GOP-alternative effort briefly falls into contradictions. In a July 23 conference with GOP House leadership, Blunt declared, “As the president has gotten less specific, we have been more specific.” Cantor proclaimed that the GOP had a “third way” to do health care reform. A day before, however, Blunt had said that the GOP would not bother introducing a bill: “Our bill is never going to get to the floor, so why bother? We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they’ve got to whatever we’re offering right now?”

The next week, Rep. Tom Price (R-Ga.) would give it another shot, introducing the “Empower Patients First Act.” Igor Volsky remarked that it was “almost identical” to four other GOP proposals that had been previously floated, and wondered, “What was wrong with the other four bills?”

August 2009:

GOP partisans begin to get testy. Morton Kondracke, writing for Real Clear Politics, says, “There’s no question that Republican criticism has helped undermine support for President Barack Obama’s health plan. But it hasn’t done much to help Republicans. That’s because while Republicans actually do have alternative ideas on health care reform, they have spent most of their time accentuating Obama’s negatives.” American Thinker’s Paul Shlichta suggests that the GOP’s failure to coalesce around a “counterproposal” is “political suicide.”

Easier said than done, and the partisans aren’t any better at coming to consensus. Justin Quinn urges the GOP to unite behind the “Improving Health Care For All Americans Act.” Herman Cain begs the GOP to unite behind the “Empowering Patients First Act.”

September 2009:
“The Republican health care plan for America: don’t get sick … if you do get sick, America, the Republican health care plan is this: die quickly.” — Rep. Alan Grayson (D-Fla.)
October 2009:

The Hill reports that the GOP is still at square one, debating what to do:

Some House Republicans are growing frustrated that their leaders have not yet introduced a health care reform alternative.
For months, the message from House GOP leaders on a health care bill has been similar to ads for yet-to-be-released movies: Coming soon.
According to several GOP lawmakers, the leadership is split over how to proceed in terms of unveiling an alternative to the final Democratic bill that Speaker Nancy Pelosi (D-Calif.) intends to unveil as soon as this week.
A GAME-CHANGING IDEA EMERGES: Philip Klein in the American Spectator: “Taken together, these criticisms have helped to weaken support for and build opposition to Democratic initiatives, but they have done nothing to advance an alternative vision for the health care system.”
November 2009:

The GOP introduces its alternative in the form of an “Amendment in the Nature of a Substitute Offered by Mr. Boehner of Ohio” to what was then the Democrats’ bill, the “Affordable Health Care for America Act.”

The Congressional Budget Office promptly torches it. Ezra Klein surveyed the damage: “The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It’s already been shown to interest groups and advocacy organizations and industry stakeholders. It’s already made its compromises with reality. It’s already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans.”

December 2009:

Jonathan Chait: “The Republicans eschewed a halfway compromise and put all their chips on an all or nothing campaign to defeat health care and Obama’s presidency. It was an audacious gamble. They lost. In the end, they’ll walk away with nothing.”

February 2010:

The Weekly Standard offers a “one-page” alternative to Obamacare called “the Small Bill.” Its praises are sung by people ranging from “people who work at the Weekly Standard” to “people who work at the National Review.”

The White House offers to meet with legislators to hash out a health care reform bill. GOP lawmakers are optimistic that they can convince the White House to “scrap” the bill that’s emerging. Their counterproposal? “A blank piece of paper.” Meanwhile, the Patient Protection and Affordable Care Act is shaping up to resemble a 1993 health care reform proposal floated by the GOP.

March 2010:
“And, once we defeat Barack Obama, we need to proceed to repeal this disastrous plan before it can ruin our health care system. Then we must replace it with a Republican alternative that relies on the marketplace, tax incentives and individual responsibility to provide health care to all Americans.” — Dick Morris
May 2010:

Sen. Bob Bennett (R-Utah) is defeated in the second round of balloting at the 2010 Utah State Republican Convention. Among Republicans, Bennett was the most earnest in working on an Obamacare alternative. His sin, however, was partnering with a Democrat, Sen. Ron Wyden (D-Ore.) in the effort. As the Deseret News reported, “His seven opponents had claimed he was not conservative enough for Utah, and had attacked him for voting for a banking bailout and for pushing a bipartisan health care reform proposal.”

June 2010:

Once again, the GOP managed a pileup of competing alternatives. Rep. Paul Broun (R-Ga.) offers RedState readers “four commonsense alternatives to Obamacare,” detailing H.R. 5421, “To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.” The bill was referred to committee, and nothing came of it.

Meanwhile, House leadership microwaved an old alternative plan, repackaging it as H.R. 5424, “To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and enact the Common Sense Health Care Reform and Affordability Act.” The bill was referred to committee, and nothing came of it.

July 2010:
A GAME-CHANGING IDEA EMERGES: Fred Barnes in the American Spectator: “Republicans have two great issues: health care and reform. They ought to go beyond advocating repeal of ObamaCare, tell voters what they’d replace it with, and explain the benefits.”
August 2010:

Writing for Fox News, Christian Wilton suggests that a GOP-controlled Congress needs to “refuse to appropriate money required for federal agencies to implement Obamacare, buying time to offer a Republican alternative.” Buy time? They’ve been at this for over a year and a half!

September 2010:

The GOP releases its “Pledge To America,” which includes a promise to repeal Obamacare and replace it with … a bunch of stuff that’s already in Obamacare.

October 2010:

“We could come up with a health care system that the American people would not only be proud of, but would actually love. … We’ve never had a real conservative majority.” — Sen. Orrin Hatch (R-Utah)
The Los Angeles Times’ Noam Levey reports: “Conservatives are campaigning on promises to repeal Obama’s overhaul, but a few admit their proposals haven’t changed much in the last few years.”

Some conservatives acknowledge that the healthcare program offered by party leaders is largely unchanged from the proposals the GOP pushed when it held majorities from 2000 to 2006. During that period, insurance premiums skyrocketed, businesses reduced benefits and the number of Americans without health insurance rose.
November 2010:

With a new House majority, Cantor reboots the effort to come up with an alternative. In a letter to incoming members, he writes: “Our new Republican majority will move to repeal ObamaCare and replace it with commonsense alternatives that lower costs while protecting those with pre-existing conditions.” Newly minted House Speaker John Boehner (R-Ohio) echoed the sentiments: “We must do everything we can to try to repeal this bill and replace it with common-sense reforms to bring down the cost of health care.” Rep. Camp tries to interest people in one of his old proposals.

December 2010:

The GOP struggles, once again, to unify its approach. Cantor’s call to protect patients with pre-existing conditions — ground he ceded to Obamacare — wasn’t embraced by the incoming freshmen. As Andrea Stone reported:

North Carolina’s Renee Ellmers, a Palin protege, opposes requiring insurers to accept patients with pre-existing conditions — including pregnancy. Austin Scott of Georgia, another House freshman, was asked if there was any part of the law he supported. He replied, “No, ma’am, there are not.”
Meanwhile, right-wing pundit infighting commences over Charles Krauthammer’s suggestion to not attempt to defund Obamacare, on the grounds that a defunding effort would naturally be blamed for the law’s failings. Krauthammer supported allowing the bill to be implemented, so it would fail on its own. This was met with disagreement.

January 2011:

House Republicans check off one of the entries on their bucket list by passing the “Repeal And Replace The Job Destroying Health Care Law.” While the symbolic bill is long on “repeal,” it doesn’t offer much in the way of “replace.” In fact, Cantor characterized the effort to construct an alternative to Obamacare as something that Republicans were, once again, embarking on for the first time, telling reporters that the vote for the bill meant they were ready “to begin work to construct an alternative health-care vision” that would be their “so-called replacement bill.”

Bloomberg reported that “Republican leaders didn’t offer specific alternatives” or a “timeline for moving forward with their proposals.” The bill would die in the Senate.

February 2011:
A GAME-CHANGING IDEA EMERGES: Jeffrey Anderson in the Weekly Standard: “But while Americans want repeal, they don’t just want repeal. And thus the House Republicans are now confronted with their greatest challenge — and opportunity — in the whole span of the health care debate. They need to show the American people that the choice is not between Obamacare and nothing. They need to provide a meaningful, sensible alternative to Obamacare’s comprehensive failings.”
Days later, the American Thinker’s Jim Guirard had a brainwave: “We must focus on an alternative plan which can and should result in a simultaneous repeal and replacement of ObamaCare.”

“As soon as the time is right,” he specified.

March 2011:

WNYC reports that the GOP was hard at work “mull[ing]” an “Obamacare alternative”: “Because now, Republicans (and their presidential hopefuls) must face the task of figuring out just what kind of health care law they’d like to see.” Meanwhile, Ezra Klein opines:

It’s put-up-or-shut-up time for Republicans. They managed to make it through the health-care debate without offering serious solutions of their own, and — perhaps more impressive — through the election by promising to tell us their solutions after they’d won. But the jig is up. They need a health-care plan — and quickly.
Jennifer Rubin — missing Klein’s point by a country mile — responded by citing numerous past examples of Republicans coming up with plans and insisting that Klein was “pretending there is no alternative to the deeply flawed ObamaCare.”

April 2011:
A GAME-CHANGING IDEA EMERGES: Ramesh Ponnuru and Yuval Levin in The New York Times: “Republicans have an effective slogan for their health care agenda: ‘repeal and replace.’ The problem is, they can agree only on the first half; agreeing on what to put in place of last year’s health care law is the hard part.”
May 2011:

2012 hopefuls Mitt Romney and Newt Gingrich wade into the health care reform waters, with mixed success. The Wall Street Journal offers the optimistic assessment that the “Republican primary contest … could feature a robust debate on health care, with GOP candidates challenging the Democratic law while defending their own variations.”

July 2011:
“When they took control of the House, Republicans could barely stop talking about their plans to ‘repeal and replace’ the health care reform law. Six months later, they hardly talk publicly about those plans at all. And they’re nowhere close to ‘replacing’ the law.” –Politico
September 2011:

Ryan gives the “Republican alternative to Obamacare” another shot, proposing an expanded variation on his voucher system for Medicare.

October 2011:

Another dispatch from LA Times reporter Noam Levey indicates that, once again, the effort to come up with the “Republican alternative to Obamacare” is just getting underway: “Other conservative healthcare experts are developing an alternative to the law, an effort that could protect Republicans from past critiques that their healthcare plans left tens of millions of Americans without medical coverage.”

Later in the same article, Levey reports, “A Republican replacement plan could build off a 2009 House GOP plan, said James Capretta, a former George W. Bush administration official who is developing a replacement strategy.” (So much for dodging those “past critiques.”)

November 2011:
A GAME-CHANGING IDEA EMERGES: Deroy Murdock in the National Review: “Washington Republicans nevertheless have been unwilling or unable to lock themselves in a hotel ballroom for a long weekend and devise a single plan as the official GOP alternative to Obamacare. Lacking a proposal around which Republicans and their limited-government allies could coalesce, the Right rightfully hammered Obamacare but never offered its own coherent package. Lesson: Never try to defeat something with nothing.”
January 2012:

The Hill reports that “House Republicans will be ready with a plan to replace President Obama’s healthcare law once the Supreme Court determines the law’s fate this summer,” thus giving them six more months to come up with something. Rep. Joe Pitts (R-Pa.) — who told The Hill that the “Republican alternative to Obamacare” would be ready regardless of the court’s decision, “listed a number of policy ideas Republicans would consider in a replacement bill”…that were already part of Obamacare.

Meanwhile, it is reported that Romney’s alternative plan is “light on details.”

February 2012:

rubin alternative obamacare

Months after she castigated Ezra Klein for “pretending there is no alternative to … ObamaCare,” Jennifer Rubin says that the Republicans need to come up with the “Republican alternative to Obamacare.” She writes, “Conservatives need to let the public know what the alternative to ObamaCare may be. If, unlike Obama, Republicans care about getting a mandate for their agenda, they would be wise to start laying out what a market-oriented alternative to ObamaCare would look like.”

March 2012:
A GAME-CHANGING IDEA EMERGES: James Capretta and Robert Moffit in National Affairs: “Now that Obamacare is with us, the law cannot be reversed without a credible proposal for what should take its place.”
Meanwhile, Senate Minority Leader Mitch McConnell (R-Ky.) is reportedly scaling back expectations, telling Ramesh Ponnuru, “We would want to more modestly approach this with more incremental fixes … Not a massive Republican alternative.”

April 2012:

The mystery of the “Republican alternative to Obamacare” deepens. “Do Republicans have an alternative to ObamaCare?” asks The Week. “Is There a Republican Alternative to Obamacare?” wonders Uwe Reinhardt. Fox News insists, “There is a Republican health plan. The only problem: Just as Democrats don’t want to talk about ObamaCare, Republicans are just as afraid to talk about their plan as well.”

May 2012:

The Hill reports:

Republicans might not offer a comprehensive plan to replace President Obama’s healthcare law if the Supreme Court strikes it down this summer.
House Republicans had said they would have a healthcare bill ready to go by the time of the ruling to present a clear alternative to the Democrats’ Affordable Care Act.
But now, with the high court’s ruling just weeks away, some conservatives are urging the party to abandon that strategy, fearing voters will recoil from another sweeping revamp of the healthcare system.
“The political dynamics are such that you can loudly promise to craft an alternative a million times, and then quietly take back that promise in a small article published in The Hill.” — Jonathan Chait
July 2012:

A year and a half after Eric Cantor said the GOP was ready “to begin work to construct an alternative health-care vision” that would serve as his party’s “so-called replacement bill,” Cantor tells Tom Brokaw: “Tom, you knew back in 2009 when the Obamacare bill was being considered on the House floor, we put forward our alternative. So to sit here and say we don’t have a replacement is not correct.”

Meanwhile, other Republicans were proceeding under the assumption that alternative plans were still needed — and they continually offered “alternatives” that resembled the Affordable Care Act.

By mid-month, however, the L.A. Times reports that the GOP had “all but given up pushing alternatives to the sweeping legislation the president signed in 2010.”

A GAME-CHANGING IDEA EMERGES: Gail Wilensky, who headed the Medicare and Medicaid programs under President George H.W. Bush and advised Sen. John McCain (R-Ariz.) during his 2008 presidential campaign, says: “One of the big questions that the public needs to ask Republicans who are so focused on repeal is what will come in its place.”
November 2012:
A GAME-CHANGING IDEA EMERGES: Ex-Romney adviser Avik Roy in Forbes: “Republicans have, rightly, spent the last three years campaigning against Obamacare. … But conservatives are sorely mistaken if they believe that they can continue to campaign against Obamacare, without offering their own strategy for making health care more affordable for American families and the federal treasury.”
December 2012:

Politico reports that Rep. Price becomes the latest GOP figure to suggest that the process of developing a “Republican alternative to Obamacare” needed to be rebooted: “It’s incumbent upon us to put forward positive, alternative solutions,” Price said at a Politico Pro breakfast panel discussion.

January 2013:

Jennifer Rubin offers a post-election lamentation:

The problem in the 2012 election was not that Mitt Romney didn’t seek to repeal Obamacare or that he had a state plan with one element (an individual mandate with an exchange); it was that he refused to spell out in particular detail an alternative. James Capretta and Jeffrey Anderson make a compelling case in the Weekly Standard that Republicans must do this … without an alternative, the duo correctly point out, there will be no groundswell of support to dump Obamacare and no effective scene setting for the 2014 and 2016 elections.”
Once again, I’ll remind you that at one point Rubin got awfully snippy at Ezra Klein for “pretending there is no alternative to the deeply flawed ObamaCare.” Now the lack of an alternative is the backbone of her urgings.

March 2013:
A GAME-CHANGING IDEA EMERGES: Mona Charen in Washington Examiner: “As Obamacare’s rising costs and constricted choices alienate the American people, Republicans should be ready with an alternative that is market-oriented, assembled and on the launchpad.”
April 2013:

The “Republican alternative to Obamacare” returns to its conceptual stages, where it becomes part of a pundit pileup in Cloudcuckooland. Yuval Levin and Ramesh Ponnuru write in National Review that Republicans “need to realize that without … an alternative their objections to Obamacare will ring increasingly hollow,” adding, “Even though they cannot become law for at least four years, such ideas must become Republican orthodoxy if the party is plausibly to call for repeal.”

Levin and Ponnuru propose an alternative. Matt Yglesias and Ezra Klein are not impressed. Ben Domenech is not impressed with their non-impressediveness.

Jonathan Chait notes that the GOP has had ample opportunity to come up with an alternative, but hasn’t put many to a vote:

Republicans haven’t done so for pretty clear reasons. These alternative proposals are much less technocratically simple than they pretend. (You can’t just throw terms like “well-designed” at the Congressional Budget Office.) They cost money Republicans don’t want to spend. They upset voters and interest groups Republicans don’t want to upset.
May 2013:
“Together, we could provide more cost-effective care and do something more about spiraling healthcare costs. But really, the only true Republican alternative to Obamacare is Nothingcare.” — Rep. Lloyd Doggett (D-Texas)
Ryan becomes the latest Republican to reboot the effort to create the “Republican alternative to Obamacare,” telling those gathered at the Wisconsin state party convention: “The nation is watching. The broken promises are being realized in front of their eyes and in their daily lives. … This is the moment that we have to offer them real hope and give them real alternatives.”

A GAME-CHANGING IDEA EMERGES: Ross Douthat writes in The New York Times: “The fact that the G.O.P. isn’t really offering such an alternative at the moment clearly makes the case for repeal weaker than it otherwise might be, and it makes the case for resistance weaker as well.”
June 2013:

Rep. Price of Georgia decides to give the “Republican alternative to Obamacare” another try, with H.R. 2300, the “Empowering Patients First Act of 2013,” which repeals the Affordable Care Act and, among other things, replaces it with “refundable tax credits of up to $5,000 for low-income individuals and families to purchase health insurance on the private market.” In June, the bill is referred to committee, and nothing further comes of it.

Meanwhile, the Weekly Standard’s Jeffrey Anderson laments that his party’s candidates for the 2012 presidential nomination didn’t succeed in their efforts to develop a “Republican alternative to Obamacare,” writing, “if a credible Republican candidate had entered the presidential race with the goal of making Obamacare — and a compelling GOP alternative — the focus of the campaign, Obama would likely now be living in Hyde Park rather than across from Lafayette Square (albeit still at public expense).”

July 2013:

Rep. Kevin Brady (R-Texas) tells Newsmax that “House Republicans plan to have an alternative to Obamacare ready by this fall.” Really. They totally mean it this time.

Meanwhile, Jennifer Rubin is increasingly sounding like the people she once haughtily criticized: “Without a GOP alternative to Obamacare, their complaints are empty and their votes unlikely to be taken seriously by voters. It is long, long past the point at which Republicans should have begun crafting and selling their alternative. … Where is the market-based health-care plan?”

August 2013:

August brings another spin of the “Republicans need an alternative!” to “Not fair, we have lots of alternatives!” cycle. Obama, in a news conference, criticized Republicans for not proposing a replacement bill: “They used to say they had a replacement. That never actually arrived, right? I mean, I’ve been hearing about this whole replacement thing for two years.” It’s understandable: let’s recall that mere weeks ago, Rep. Brady was saying the alternative would not arrive until the fall.

Obamacare opponents did not take this well. John C. Goodman insists that “there is a serious GOP proposal,” citing the “Patients Choice Act” proposed by Ryan and Coburn. (“This is essentially the health reform plan that John McCain proposed when he ran for president in 2008,” he writes.) He’d later tell Fox News’ Jim Angle, “I think the president has an incredibly short memory.” Forbes contributor Chris Conover was similarly incensed: “It’s arguably the favorite myth of progressives, the oft-repeated claim that Republicans have no health plan.”

Meanwhile, former House Speaker Newt Gingrich tells “a gathering of GOP operatives that lawmakers who criticize Obamacare but offer no alternatives will be left with ‘zero answer’ for constituents who ask for a policy solution to the president’s health care reform law.”

“I would bet for most of you, you go home in the next two weeks while your members of Congress are home and you look at them in the eye and you say, ‘What is your positive replacement for Obamacare?’ and they will have zero answer,” said Gingrich.

Short memory, I guess.

September 2013:

Having missed all of August’s harangues about how unfair it was to suggest that there were no “Republican alternatives to Obamacare,” because so many already existed, the Republican Study Committee goes ahead an unveils a new one anyway, called the “American Health Care Reform Act of 2013″:

“First of all, we start by repealing Obamacare,” RSC Chairman Steve Scalise, Louisiana Republican, said of the new bill.
Among other reforms, the GOP-sponsored bill would allow consumers to shop for insurance across state lines, let individuals and families deduct health care costs for tax purposes the way employers do and inject billions of dollars into state high-risk pools so people with preexisting medical conditions can gain coverage.
ThinkProgress’ Sy Mukherjee remarks: “If that all of this sounds familiar, it’s because Republicans have been proposing some combination of these ideas since at least 2007.” The bill is referred to committee on Sept. 18, and nothing ever comes of it.

October 2013:

Rep. Darrell Issa (R-Calif.) jumps into the “create a Republican alternative to Obamacare” game on Twitter, proposing that every American should receive the same benefits that lawmakers receive through the Federal Employee Health Benefits program. Business Insider’s Josh Barro terms this replacing “Obamacare with Obamacare.”

A GAME-CHANGING IDEA EMERGES: Rob McKenna in Smarter Government Washington: “It’s time for Congressional Republicans to unite under solid, practical alternatives to Obamacare and give the public a positive vision.”
November 2013:

The Republican Study Group’s alternative plan, the “American Health Care Reform Act of 2013,” is said to be gaining “support” and “momentum,” but I’ve already spoiled the ending for everybody, so I guess you’ll have to appreciate the dramatic irony.

Meanwhile, the Onion gets into the game of making fun of the “Republican alternatives to Obamacare,” with a list of their own that includes such proposals as “Repeating the phrase ‘you can keep your current doctor’ over and over until something happens,” and “A true market-based solution — perhaps a convenient website — where uninsured people would pay for their own health insurance from private providers,” and “Whatever the opposite of tyranny is.”

A GAME-CHANGING IDEA EMERGES: Ramesh Ponnuru and Yuval Levin offer a breakout idea in The Wall Street Journal: “What Republicans can and should do is offer the public something better. Now is the time to advance a conservative reform that can solve the serious, discrete problems of the health-care system in place before ObamaCare, but without needlessly upending people’s arrangements or threatening what works in American medicine.”
December 2013:

Despite the fact that the calls for a “Republican alternative to Obamacare” are coming from inside the house, conservative partisans ignore the urgings of Ponnuru and Levin and lapse into another round of being aggrieved at the way Democrats keep saying that they’ve not come up with an alternative.

Meanwhile, Rep. Price tells Fox News that the GOP will really, totally, seriously “bring forth a bill” that will “unite Republicans around health care issues” sometime after the first of the year, and that’s a promise, for real, this time.

“You can’t beat something with nothing,” Price added, sagely.

January 2014:

A new year dawns and with it comes yet another unveiling of a “Republican alternative to Obamacare.” And the GOP had been at it for such a long time that it was second-bite-at-the-apple time for Sens. Coburn and Burr, who joined Sen. Hatch in creating the “Patient Choice, Affordability, Responsibility and Empowerment Act.” “Mirabile dictu,” sang out Ross Douthat, “an actual health care reform proposal!”

The glad tidings did not last long. “Within hours of the new plan coming into contact with political reality, things began to fall apart,” wrote Jonathan Chait:

The first blow to its coherence came when the authors faced questions about their proposal to cap the tax deduction for employer-sponsored health insurance, a politically risky but economist-approved change that provided most of its money for covering the uninsured. Asked about this piece of their plan, the authors changed the language within hours to ratchet back its scope, insulating them from political attacks, but also neutering its value.
After that came the Congressional Budget Office report that described the way Obamacare would cause labor supply to shrink from the labor markets, as recipients escaped “job lock,” or took advantage of the Obamacare subsidies to reduce their hours or retire. The GOP opted to describe this as “job killing,” but what they didn’t take into consideration was that this new plan from Coburn, Burr, and Hatch “would likely have approximately the same “job-killing” impact as Obamacare.”

February 2014:

cantor alternative obamacare

“Republicans can easily pick [Obamacare] apart, but they won’t win over voters without their own ideas.” — Karl Rove, once again
Chait returns to this theme a month later, gathering string from numerous pieces of reporting, all suggesting that the process of crafting a “Republican alternative to Obamacare” is beginning anew.

Daniel Newhauser, giving Roll Call readers the inside scoop in a piece titled “GOP Leaders to Huddle on Obamacare Alternative,” describes the process with sentences like: “House Republican leaders will meet Friday to begin crafting an alternative to Democrats’ health care law.” An interview with Eric Cantor by The Wall Street Journal’s Gerald Seib (in a piece titled “Cantor Pushes the GOP to Spell Out Its Agenda”), yields these quotes from the House majority leader:

“Our members are going to get very excited if we can provide alternatives, not just be a party that’s against whatever the president is for.”

Ned Pepper on August 15, 2014 at 8:12 PM

Ned Pepper on August 15, 2014 at 8:12 PM

Brief?

Try a link next time. It will let us all know where you do your copy & paste work.

Lolo on August 15, 2014 at 8:18 PM

Ned Pecker on August 15, 2014 at 8:12 PM

Perhaps you missed my previous note Ned Peckerwood, -your illegal alien Irish brood is about to lose their Obamacare:

Health Coverage to End Without Proof of Citizenship or Legal Residency

No comments?

slickwillie2001 on August 15, 2014 at 8:19 PM

Shorter Ned:

“PLEEEEEEEAAAASE don’t take away my free stuff!!!”

CurtZHP on August 15, 2014 at 8:58 PM

Well, unless a GOP candidate promises to repeal Obamacare, he won’t get my vote. I don’t want it fixed or replaced. I want it gone. After that, we can work on free market solutions that get government out of health care.

DRayRaven on August 15, 2014 at 9:54 PM

Get over the big gubermint health care solutions — bring Health Care back to the doctor patient, doctors, not politicians provide care.

Make it so any unreimbursed charity care provided is tax deductible for the providers of such care.

Clinics everywhere would quickly figure out how to offer sliding scale care according to their community (not some one size fits all centralized mandates). This care system would be stable through most any gubermint budget crisis and financial meltdown — unlike OCare, Ocaid and it’s many derivatives.

It would provide a reasonable degree of fraud protection since one needs real income (not bloated Medicaid bills), to have something to deduct charity care from. With Medicaid frequently playing 30% or less of regular fees, the cost of deductible charity care is equivalent to Medicaid (and soon Medicare), only without the redtape of the burrOcracy involved.

Many specialty clinics that currently provide little to not Medicaid would likely jump into the game for the tax deductions. Even insurance companies might offer sliding scale plans in lue of taxes on profits…

Prevent pt fraud by allowing clinics to file 1099 forms on charity care provided to anyone — if they are deemed ineligible, they, not the clinic pays the taxes and any penalties.

Sure, deductible charity care would end up ‘costing’ lots of tax revenue, but at the ‘cost’ of providing improved care for those of limited means, all without politics involved. Plus, many of those of limited means would quickly learn that health care isn’t a right, it’s something clinics provide them for being good patients… Or they fall back on Medicaid waiting lists, which fewer clinics are taking…

Basically, it’s long past time to think out of the big gubermint box for solutions to Social Marketplace problems. Tax deductive charity care could also operate just fine without changing Medicare or Medicaid. The social marketplace of health care would choose what works and doesn’t work.

Did you know that most folks think that Doctors already get to deduct their charity care from their income, even though that’s not reality? Microsoft and Apple can donate megabucks to schools to use their software and hardware, and it’s tax deductible — a doctor can’t donate a single physical, or stitch, or shot…

drfredc on August 15, 2014 at 10:24 PM

Repeal Obamacare, repeal Medicare, repeal Medicaid and repeal all federal regulations on the Health Care industry (leave these things up to the individual states) and you will eventually see a return to a free market, inexpensive, very good health care system. Until then, we will continue to circle the drain.

Theophile on August 15, 2014 at 6:18 PM

Exactly. End the monopolies given to the healthcare industry. Just try getting a procedure priced ahead of time at a hospital. What other industry is allowed to do that eh?

I am not a slave Mr. Vespa. I will not submit, I will not go along with any plan. Get your hands off my body you Beltway Bandits. Repeal the law and get government out of the healthcare business. Anything else is socialism or catering to socialism.

Make no mistake people, Obamacare is slavery. Cradle to grave, the government owns your body under this “universal healthcare” plan. It outright violates 3 parts of the Constitution and Bill of rights. Taxation, and the 13th and 14th ammendments.

oryguncon on August 15, 2014 at 11:48 PM

Silly me, I still cannot find in any copy of the Constitution where the government can mandate that each of us buys a government approved healthcare-pre-payment (falsely called insurance) plan. This applies to Obamacare and any of the alternatives.

(For that matter, I don’t see where Social Security, Medicare, and Medicaid are in the Constitution either, but those are other discussion topics.)

My prescription is to repeal Obamcare hook, line, and 2700+ thousand pages. Those couple of things that might be useful can be re-approved in separate legislation. The “replacement” plan is to let the states work it out as the Constitution intended.

Kevin K. on August 16, 2014 at 12:55 AM

I truly HATE this crap that we should acquiesce because of a few votes.

John the Libertarian on August 16, 2014 at 2:33 AM

I still cannot find in any copy of the Constitution where the government can mandate that each of us buys a government approved healthcare-pre-payment (falsely called insurance) plan.

Kevin K. on August 16, 2014 at 12:55 AM

It also doesn’t say we can be drafted into war, but they do it.

In any case, the ACA is based on tax law, which is why it was ruled constitutional. You don’t have to buy it, but your taxes go up as a result, same with every tax deduction or credit.

cimbri on August 16, 2014 at 6:15 AM

ARE YOU KIDDING ME?

This will be soundly rejected. First of all, saving ObamaCare while keeping Obama’s signature “achievement” in place, is just about the dumbest thing the GOP has EVER done-and that’s saying a lot! Way to go, Republicans; saving O’s legacy, pulling his nuts outta the fire, so Obama can still claim it!

Secondly, WTF? Seniors can’t collect their Social Security benefits unless they are signed up for Medicare!? THAT IS CLEARLY NOT THE CASE. Seniors can start collecting SS at 62! If you can’t even get basic facts straight, you surely can’t design any new program.

Thirdly, Means-testing Medicare won’t work; why not? Because the minute you start doing that, you’ve just accepted that all recipients are at risk of being phased out of Medicare based on their income level, thereby ENSURING FOR THE AGES A SYSTEM BASED ON SOCIALISM, and, it’s a class-based division, further dividing society.

This is a joke people; and it’s NOT FUNNY. THESE ARE SO-called “Conservatives” mKing these HIDEOUS” proposals!

mountainaires on August 16, 2014 at 7:35 AM

Too many people here are missing the point of the author’s article: Running for office on a promise to repeal Obamacare and replace it with nothing is not going to work.

Remember, you’re not dealing with just a deep-red state: we’re talking about convincing the general voting public of the entire USA that Obamacare is a disaster and must be eliminated, and hey, vote for me and I will do that!

And the Democrats (along with their major media lapdogs) will, repeat, WILL counter with the usual sob stories like kids with cancer or asthma or epilepsy were bankrupting their families because no one would insure them until Obamacare came along, and this GOP candidate wants to take that away from them. Emotions swayed, opinions galvanized, election lost. Again.

The only way Obamacare is gonna go away is if the GOP and its presidential candidate unite behind a comprehensive conservative health insurance plan that, up front, is easy to understand, reassures those with the preexisting conditions that they will still receive affordable care, and that overall will save billions of dollars for taxpayers. Remember, we need to get elected first.

Then – and only then – we can gradually dismantle Obamacare until we can get to the money-saving health insurance plan that satisfies everyone.

TMOverbeck on August 16, 2014 at 8:58 AM

It is not Obama Care that is the only issue being reviewed for repeal or elimination.

Conservatives Primary Target is to return Constitutional Law and Order to the people, by allowing them to reset the Constitution and all Amendments to return the control over how, where, and what they chose.

As any American we deserve to chose where and how we live with our fellow Americans (immigrants and those born here) and expect the Federal level to curtail their powers as originally developed and fought for.

Not of those who today have convoluted the tenants of the Constitutions to mean something other than actually written. Liberal educational systems have over the last 200 plus years have been trying to implement their rules and regulations via butchering to words of the Constitutions which specifically limit the powers of the Federal Government which they convoluted perceived are contained in the Constitution, only because they chose to define the Constitutions words.

Those who wish to live in Utopia then they are free to develop their own county, city and all those like thinkers are free to evelop their own rules to maintain law and order.

MSGTAS on August 16, 2014 at 9:51 AM

Why do conservatives have to replace a pathetic Liberal policy to destroy personal freedom & private insurance with a better idea??

drivingtheview on August 15, 2014 at 6:09 PM

You mean, with a better liberal idea?

sixerfixer1976 on August 16, 2014 at 9:56 AM

Repeal obamacare. Nobody was dying in the street, citizen or not everyone was seen in emergency rooms – the fee ultimately paid by the public. How-bout we improve the nation’s economy and prosperity for all? Then we can afford to carry even more indigent on our collective backs.

lel2007 on August 16, 2014 at 12:02 PM

Roy for years has been touting singapore and switzerland (and I like the swiss system), but he NEVER EVER EVER explains the full system of these countries. Both have strong controls on the cost side of health care (government prices on pharma and devices, nationally negotiated pharma prices, setting salaries/reimbursement rates on procedure and speciality, etc.)

That’s a huge reason why these countries provide comparable care to their citizens. Compare how much a GP makes in Singapore to the US. Or how much a surgeon makes in the US to Switzerland. Or pharma prices.

Swiss or Singapore won’t work here unless you grafted the entire system here (which IMO is laudable because it ends medicare and medicaid and puts people on market exchanges).

BUT then again, switzerland enacted santesuisse because they as a country believed in universal access at reasonable costs roughly 15-20 years ago.

When the conservative ideal is to repeal Ocare (it sucks) but ALONG WITH repealing medicare and medicaid (ideally) – roy’s half-baked solution is DOA.

uatu1878 on August 16, 2014 at 10:43 PM

Roy for years has been touting singapore and switzerland (and I like the swiss system), but he NEVER EVER EVER explains the full system of these countries. Both have strong controls on the cost side of health care (government prices on pharma and devices, nationally negotiated pharma prices, setting salaries/reimbursement rates on procedure and speciality, etc.)

uatu1878 on August 16, 2014 at 10:43 PM

Don’t forget that they are practically monocultural by our standards. There is no significant bloc of mentally deficient mooches to vote themselves free stuff because they actually care who gets in and enforce their borders worth a hoot.

Were that to be suddenly true of the USA, a good portion of our ‘dilemma’ would vanish overnight.

LawfulGood on August 17, 2014 at 1:51 PM