Reject Universal Coverage, Offer Targeted Reforms

Tens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal?  We posed this question to NewMajority’s contributors.

The Democrats’ proposals for universal coverage include several core elements that are significantly problematic from the perspective of a conservatism that remains committed not just to free markets but to addressing the costs associated with entitlement programs – an individual mandate, significant new regulations on entry and exit from health plans, new coverage mandates, a business mandate, and a public option. And the GOP seems to have successfully exploited the resistance of many Americans to such a comprehensive makeover of the American healthcare system. In addition to the fear that this will be financed with higher taxes and lower quality care, it appears that independent voters and soft-partisans are not confident in the ability of a federal government unable to manage the Cash-for-Clunkers program to micro-manage 1/7th of the American economy.

That said, the numbers are clear – people have little faith that the GOP will promote solutions to what is a genuine healthcare crisis threatening the future well-being of American families through crowded emergency rooms, lack of portability, and skyrocketing costs.

It is well past time for the GOP to offer a positive agenda on healthcare. The ‘just say no’ strategy does nothing to build public confidence in the GOP as a governing option. Republicans would be wise to pick 4 or 5 proposals that appeal to those with health insurance and demand that they be included in the final House and Senate bills. As noted by Chuck Todd last week, the Obama White House is attempting to win back, among others, suburban women – those who fear the loss of their families’ health insurance through Obamacare, but who understand all too well the pathologies of the existing system. Rather than embrace Obamacare-lite, Republicans interested in a deal, or at least interested in appearing serious, should promote a handful of policies that would appeal to these currently insured families.

Anything addressing medical malpractice reform, portability, and the extension of tax breaks – including a refundable tax credit – currently reserved for those with employer-provided coverage to the self-employed and those in the individual market would fit the bill.

Furthermore, as Democrats press for the public option and argue – as Senator Charles Schumer (D-NY) did this morning – that competition from the government is necessary because in some states there are only 1 or 2 plans operating, Republicans should promote the ability of small employers and those in the individual market to purchase coverage across state lines.

To read other contributions to this symposium, click here.