September 15, 2015
The next Republican presidential debate is Wednesday. No fewer than 17 candidates are vying for a spot on the stage at the Reagan Library in Simi Valley, California.
But that's not the only crowded field in the GOP. There's also a surplus of Republican proposals for replacing Obamacare.
This infighting needs to end. There's enormous overlap among the GOP's various alternatives to Obamacare. Instead of squabbling over the details, Republicans need to focus on where they agree -- and then communicate a unified vision of our nation's post-Obamacare future to the American people.
Republicans largely agree that their alternative to Obamacare should make health care more affordable and accessible by liberating the market from undue interference by the federal government.
Instead of mandating that every American obtain coverage, for instance, the Republican plans create financial incentives for people to purchase insurance voluntarily.
The House Republican Study Committee's American Health Care Reform Act would grant individual taxpayers a standard deduction of $7,500 -- and families a deduction of $20,500.
Meanwhile, in his Empowering Patients First Act, House Budget Committee Chairman Dr. Tom Price, R-Ga., has opted for a series of refundable, age-based tax credits ranging from $1,200 to $3,000 per person to help offset the cost of coverage.
Wisconsin Governor Scott Walker's recently unveiled Day One Patient Freedom Plan would also institute refundable, age-based credits at the same levels as Price -- although Walker's credits would go directly to the individual while Price's would go the insurer. Sen. Marco Rubio, R-Fla., would also use credits.
In the upper chamber, Sens. Richard Burr, R-N.C., and Orrin Hatch, R-Utah, would also rely on tax credits to make health insurance more affordable. Their Patient Choice, Affordability, Responsibility, and Empowerment Act would means-test those credits, so that lower-income people would receive larger credits.
These plans all share the same goal -- to level the tax playing field so that individuals can shop for health insurance with tax-advantaged dollars, just as businesses can. Such a move will make health insurance portable from job to job and empower consumers to purchase policies that meet their needs and budgets -- not their employers'.
All four proposals would also allow Americans to purchase coverage across state lines.
Eliminating the costly employer and individual mandates and then opening up the insurance market would give consumers more options. Increased competition would force insurers to lower their rates and improve their products. By one estimate, interstate availability of health insurance could reduce costs by 9 percent.
An interstate insurance market would also diminish the pricing power of the group of national mega-insurers that's emerging thanks to Obamacare. Consumers would no longer be captive to one or two dominant insurers in their home states.
The major Republican plans also protect those patients with pre-existing conditions. The Price proposal would create incentives and federal funding for state-based high-risk insurance pools, where those with pre-existing conditions could get affordable coverage. The Republican Study Committee's plan -- as well as those favored by presidential candidates Rubio, Walker, and Bobby Jindal -- would do much the same.
Republicans are united in their support for Health Savings Accounts, which allow people to save money tax-free for healthcare expenses. HSAs give consumers the power to determine how to spend their healthcare dollars -- and inject some consumerist discipline into the healthcare marketplace.
The Hatch-Burr proposal would allow individuals to use HSA funds for several new expenses, from long-term-care insurance to premiums for maintaining employer-sponsored coverage after leaving a job.
Both Price's and Walker's plans would grant consumers a one-time $1,000 tax credit to deposit into an HSA -- and increase the amount that people could put into such an account each year.
Finally, the Republican plans would take on waste, fraud, and abuse in our medical liability system. Burr and Hatch would cap non-economic damages. Price and the Republican Study Committee would protect doctors from cost-inflating lawsuits as long as they followed established best medical practices. Walker's plan would do much the same by encouraging states to implement specialized reviews to assess the validity of lawsuits.
It's time for GOP lawmakers to show the American people that they're united not just in their opposition to Obamacare -- but in their vision for its replacement.
This article originally appeared in the Sun-Sentinel newspaper (Florida).