It was just seven weeks ago that House Majority Leader Eric Cantor (R-Va.) offered a fairly specific vow. “This year, we will rally around an alternative to ObamaCare and pass it on the floor of the House,” he said on Jan. 30. A month later, House Speaker John Boehner (R-Ohio) said GOP leaders would have “conversations” with members about possible ideas that could go into a theoretical alternative to the Affordable Care Act.
It was hard to miss the incompatibility of Cantor’s promise and Boehner’s half-hearted hedge.
That said, Robert Costa reports that House Republican leaders are still moving towards some kind of reform blueprint to present to voters in advance of the 2014 midterms. It’ll apparently be called “A Stronger Health Care System: The GOP Plan for Freedom, Flexibility, & Peace of Mind.”
The plan includes an expansion of high-risk insurance pools, promotion of health savings accounts and inducements for small businesses to purchase coverage together.The tenets of the plan – which could expand to include the ability to buy insurance across state lines, guaranteed renewability of policies and changes to medical-malpractice regulations – are ideas that various conservatives have for a long time backed as part of broader bills.
Let me get this straight. It took House Republican leaders five years of secret meetings, held far from public view, to come up an outline of ideas we already knew they supported?
Costa added that this will be “the first time … House leaders will put their full force behind a single set of principles,” and that’s certainly nice. But (a) they’ve spent five years promising a bill, not a set of principles; (b) what’s needed are specific provisions that can be scored, not vague blueprints; and (c) the Affordable Care Act already has some of the Republicans’ favorite provisions in it.
Or put another way, health care policy is hard. A political party that’s serious about substance and policy outcomes will have to invest a lot of time and energy into crafting a health care plan that works.
And yet, at this point, the Republican approach rests with presenting a fragile coin. On one side of the coin we see a bunch of hollow complaints about the ACA; on the other side we see a list of ideas Republicans have always liked, but which do not amount to a real, credible plan.
“We’ve got to get to where you can compare the two perspectives, Republican and Democrat,” House Majority Whip Kevin McCarthy (R-Calif.) told Costa.
That’s actually a compelling point, and a side-by-side comparison would contribute quite a bit to the debate. Which party’s approach would cover more of the uninsured? Which offers more consumer protections? Which would improve the nation’s long-term finances? Which would do more to help lower costs within the system without sacrificing quality of care?
We’ve waited since the summer of 2009 to answer these questions. If Republicans are ready to present a detailed proposal and subject it to independent scrutiny, terrific. But so long as GOP leaders are having “conversations” about “principles” to go into an outline, it’s not entirely clear how we’ll “get to where you can compare the two perspectives.”