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Lewis Morris / Dec. 10, 2020

What Is GOP Healthcare Policy?

Now is a good time for Republicans to figure out what they think.

Congressional Republicans emerged from the 2020 election in a relatively strong position. Pending the outcome of the hotly contested Georgia Senate runoff elections on January 5, and House Democrats’ attempts to reverse the outcomes of two House races, the GOP will head into the 117th Congress holding the Senate and significantly chiseling away at the Dems’ majority in the House.

Congressional Republicans are in a good place to start laying the groundwork for taking the House in 2022 and advancing an agenda that will help the GOP reclaim the presidency in 2024. But they will need a rock-solid agenda that must include healthcare reform.

Ever since the passage of the (Un)Affordable (Lack of) Care Act in 2010, Republicans have found themselves in a political and policy quagmire regarding healthcare. They promised repeal, but couldn’t deliver, even after voters gave them the House in 2010, the Senate in 2014, and the presidency in 2016. Congressional leaders couldn’t find common ground on strategy or what they wanted real healthcare reform to look like. And simply being against Democrat policies isn’t going to cut it.

The GOP has a real opportunity to take up the healthcare argument and offer concrete solutions that will improve quality of care and coverage for millions of citizens. But, as former Louisiana Governor and 2016 presidential candidate Bobby Jindal recently noted in a Wall Street Journal op-ed, Republicans need to ask themselves some hard questions about what they want from healthcare reform.

First, do Republicans want a full repeal of ObamaCare? Repeal and replace was the rallying cry ever since ObamaCare passed without a single Republican vote. But replace it with what? It’s nearly impossible to undo a wide-ranging law like ObamaCare, no matter how awful it may be. People learn to adapt to it, and it sinks its tentacles so deep into the bureaucratic system that ripping it out could spell disaster for millions of insured citizens. Rather than end ObamaCare outright, the best opportunity may be to reorient government subsidies toward Medicare block grants that give states more flexibility in managing their healthcare costs. Transparency in healthcare pricing, an initiative that President Donald Trump fought for, will also give consumers more options in managing their healthcare and give the free market more room to breathe.

What is more important? Cost savings or coverage? Barack Obama campaigned for his signature plan by promising to bend the cost curve down and make insurance coverage cheaper, stronger, and more widespread. We all know that didn’t happen. Instead, millions were forced to give up their current doctor, state-managed insurance markets popped up that offered less than adequate coverage, and costs continued to rise — though the real damage was delayed (by design) long enough to help get Obama reelected in 2012. During the initial ObamaCare debate, the public was concerned mostly with cost, which made it ripe for Republican repeal in the early days. But in recent years the focus has shifted to coverage and preexisting conditions. As the population ages, this will become even more important to voters. Republicans will need to offer reforms that protect coverage.

Do Republicans go with a grand bargain or incremental changes? Joe Biden has made it clear with more than one of his Cabinet picks that he is going to run the leftist political playbook. Or at least that’s what his handlers are telling him to do. Either way, another sprawling overhaul of healthcare won’t happen during a Biden term, and that’s probably a good thing. Giant legislative initiatives are not popular with the public. They are wide open for graft and secret provisions that rip off taxpayers, they are bureaucratically unwieldy, and they add to government red tape.

Republicans are better off taking on healthcare reform one piece at a time, making clear to voters that they want to improve the existing system. By offering commonsense proposals that Democrats will reflexively shoot down, the GOP will gain public support and lay the groundwork for real reforms that will stick.

The timing is ripe for Republicans to tackle healthcare reform again. On the congressional and state level, voters soundly rejected the leftward lurch that Democrats were selling in 2020. Americans want a government that works, and Republicans can prove that’s still possible by delivering a measured healthcare reform package that delivers the goods.

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