Repeal Obamacare, But Replace It With Free Market Reforms

If there is any one issue that symbolizes the hubris that is the Obama Administration, it is the so-called Affordable Care Act, aka Obamacare. This issue is one of the founding causes of the Tea Party, and won back the House of Representative after only 4 years of Democratic rule. Unlike other Big Government laws, it grows less popular the more impact it makes. Health care had long been an issue that was an advantage for the Democrats, but now Republicans have an edge.

Conservatives have an opportunity to propose Free Market reforms that not only roll back Obamacare, but also correct some of the real problems in the healthcare industry.

But we need to have a plan. So I took a look at the healthcare plans on each of the 17 campaign websites. I will detail below what exactly each candidate had to say, but here is a brief overview of some basic ideas:

Five Key Proposals:
  1. Health Savings Accounts, or HSA’s. These allow people to create tax deductible accounts reserved for healthcare, allowing them to purchase minimal coverage.
  2. Enable to purchase insurance over state lines.
  3. Medical malpractice reforms, to lower costs.
  4. Wellness Programs. Insurance carriers would be allowed to give incentives to people who live healthier lifestyles.
  5. Enable consumers to pool together and purchase group plans. For example, this would benefit farmers and religious groups.

There are two thorny issues that must be addressed when repealing Obamacare:

  1. Pre-Existing Conditions. We simply can’t force carriers to cover pre existing conditions without having an individual mandate. But covering pre-existing conditions is popular.
  2. The difficulty that many people have with purchasing health care.

Many replacement plans call for state-level high-risk pools for to cover pre-existing conditions, and tax deductions to help individuals buy coverage.

Another issue that must be addressed is the linkage between health coverage and employment. Employers use pre tax income to pay for insurance, and get tax deductions not available to individuals. The benefit of easy access to individual plans is clear, if you can purchase your own insurance, you can take it with you to your next job.

What Have The Candidates Proposed?

While all candidates have of course publicly supported repealing and replacing Obamacare, only 7 candidates had any mention of healthcare policy on their campaign websites, and only 3 had detailed plans.

I could not find any Policy or Issues page on the campaign websites for Jeb Bush, Carly Fiorina, John Kasich or George Pataki. Jim Gilmore’s website contained a campaign video with and a phone number for contact info. (Gotta be with the times, the young ‘uns don’t use telegraph anymore.)

Donald Trump has no policy positions outside of immigration. That bears repeating. Donald Trump has no policy positions outside of immigration. He is quite literally a single issue candidate.

Lindsey Graham is also a single issue candidate, focused on National Security, with a pro-life statement added.

Chris Christie, Rick Perry and Rick Santorum all have policy or issues pages, but none mention healthcare. I am surprised at Rick Perry because he hired Avik Roy, a well-respected healthcare expert. Why hire him and not make use of him?

It frankly is quite disappointing that so many candidates are neglecting this crucial topic.

Marco Rubio has a decent plan up, incorporating many of the conservative reform ideas I listed above. But I won’t go into his specifics, because his “policy statement” is simply a recycled Fox News Op-ed from March. Is that a reference to an ongoing case King v. Burwell? Yes, because it hasn’t been updated. Copy/paste ain’t gonna cut it, Marco. Let’s see a plan.

Ben Carson’s main appeal is as a doctor who understands healthcare. Right? Maybe, but aside from HSA’s, you won’t find any policy proposals here. He does mention that he wants more freedom and less government. Glad to hear it.

Mike Huckabee would “address pre-existing conditions with common sense”. Common sense is good.

Rand Paul and Ted Cruz both promise repeal. But neither have any replacement. Rand also has a statement about medical malpractice reform. As a physician, doesn’t it sound opportunistic that that’s the only policy he’s proposing?

Finally, A Plan. Or Two.

This brings us to the 2 candidates who have outlined detailed proposals; Bobby Jindal and Scott Walker

Both Walker and Jindal include the five proposals listed above; HSA’s, state lines, malpractice reform, wellness programs and pooling. These are all excellent proposals.

Walker’s plan is based on a simple yet elegant system of tax credits for individual plans. The exact credit is linked to age, not income. One of the features of this is that the credit can turn into a straight subsidy. Jindal’s plan also feature tax credits for individual insurance, but only if the individual owes taxes. While I’m a bit uncomfortable with the subsidies, I do think Walker has the right of it. The benefit to the individual must be the same as to the employer.

I would definitely not agree that this makes it “socialism”, as Jindal has challenged. That is unproductive, we should be discussing policy merits, not slinging insults.

Walker’s plan also included a provision that anyone with preexisting conditions, is is guaranteed coverage, but only if they had uninterrupted coverage. This seems fair. Combined with opening up the markets for individual plans, I think most will see this as an acceptable compromise.

The plan also shifts regulations to states. specifically mentioned is that Wisconsin had already required this the family plans cover until age 26, pre-Obamacare). There is a bit of an ideological inconsistency between allowing to purchase over state lines, and putting the regulations on the state level. But I’m sure something can be worked out.

Jindal has a pretty detailed plan on his campaign site, and a link to his think tank, where he has a 24 page document. There seems to be a lot in of ideas for policy reform on the state level. That’s commendable for a think tank, but is he running for governor of 50 states, or for president?

One interesting idea in Jindal’s plan is a proposal for online data, for price and quality transparency. Do we really think government websites can do the trick? Haven’t we learned anything?

There are many ideas conservatives can and should be selling, that will in fact make healthcare more affordable. So far Scott Walker has the best plan, and the easiest to market. It’s time for the other candidates to step up and propose plans of their own. Let’s have a marketplace of ideas!