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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

GOP’s ACA ‘Reform’ Boils Down to Tax Cuts

Jonathan Weisman’s “With Health Law Cemented, G.O.P. Debates Next Move” at The New York Times does a good job of showing just how utterly bankrupt and bereft of ideas Republicans are when it comes to health care reform alternatives. As Republicans grudgingly accept that repeal and replace just isn’t going to happen, a few of them have ventured what they consider to be salable ‘reforms’. You will not be shocked to see that most of their ideas center around tax credits:

The bill would allow for insurance to be sold across state lines, push small businesses to pool together to buy insurance for their employees, expand tax-free health savings accounts, cap malpractice lawsuits, and offer tax credits of $2,163 for individuals and $5,799 for families to buy health plans.
…Mr. Ryan’s plan will build on one that he and Senator Tom Coburn, Republican of Oklahoma, introduced in 2009, according to aides familiar with it. The proposal, called the Patients’ Choice Act, would have eliminated the tax break for employer-provided health care to finance a tax credit of about $5,700 for families and $2,300 for individuals. States would have been asked to create insurance marketplaces like the ones many have created under the Affordable Care Act.

It’s the old ‘throw money at taxpayers’ strategy, which has never delivered quality health care anywhere in human history. Rooted as it is in the cynical assumption that all American voters want is more money, it is likely to be a tough sell, especially to millions of voters who are already benefiting from the ACA, or who have reason to believe they can get better coverage under Obamacare in the near future.
The unavoidable flaw in the GOP’s tax cut/credit panacea is that most American voters will figure out that giving them more money to buy health insurance will probably give the go-ahead to insurance companies to raise their rates — again and again.
Weisman reports that other Republicans are still yammering about repealing the individual mandate. But we can file that one under “not gonna happen,” unless Republicans win the White House and a filibuster-proof majority of the senate in 2016, while holding a strong house majority. That’s asking a lot, especially since only 19 percent of Americans “approve of the way congressional Republicans are handling health care,” as Weisman notes.
Other Republicans are sending up trial balloons, like Rep.Tom Price (GA), who is pushing the ‘Empowering Patients First Act,’ which Weisman reports “would repeal the health care law but keep its prohibition on exclusions for pre-existing conditions in private health insurance.” Again, not gonna happen. More moderate tweaks of the ACA, like Sen. Kelly Ayotte’s proposal to expand health savings accounts and repeal the tax on medical devices may gain increasing currency with her fellow Republicans as they begin to sober up from their tea party hangovers.
Harsh as some of the findings of recent polls are regarding the ACA, the future looks encouraging for Dems, as increasing numbers of Americans enroll and find their coverage has improved — and the GOP has nothing substantial to replace it.

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