Speaker Ryan, this is not what conservative reform looks like

The current healthcare plan proposed by Republicans, in preserving a lot of spending and regulations, was designed to blunt Democratic attacks that they are stripping health insurance away from millions of people. But by providing less generous subsidies than Obamacare, the GOP is already subjecting itself to such an attack. Because it repeals Obamacare’s taxes but retains a significant amount of spending, it isn’t clear it would reduce the deficit. If it doesn’t, Democrats could be able to use a score from the Congressional Budget Office to make the following politically potent attack: the Republican plan throws millions of people off of health coverage while increasing deficits.

If Republicans were to have pushed a true free market plan, it would have removed the regulations and mandates on the type of insurance that must be sold and drastically reduced spending through Obamacare. By reforming the tax code, it could have used money from changing the bias in favor of employer-based coverage to help individuals purchase coverage in an open market. To be sure, under this scenario, Republicans would still be fighting off attacks that their plan covers fewer individuals than Obamacare. But they’d also be able to credibly argue that their plan reduces premiums, increases choices, reduces spending, and cuts deficits. This would all fit into the narrative that they’ve been trying to push for months: Obamacare was an unsustainable promise, they inherited a mess, and they had to act responsibly to clean it up.