How to explain the history of the "Republican alternative to Obamacare?" It seems to reside in a realm where time elongates and reality warps. I cannot remember a time in which Republicans weren't fervently offering an "Obamacare alternative." Simultaneously, I cannot remember a time in which Republicans weren't fervently urging the creation of new "Obamacare alternatives." To borrow a line from Christopher Durang, I don't know if this is the trick of memory, or the memory of some trick.
At times, the "Republican alternative to Obamacare" seems to be forever on its way, but never arriving -- as if it were the public policy embodiment of Zeno's dichotomy paradox. New York magazine's Jonathan Chait, who's spent many a day navigating this Beckettian wilderness, suggests that the "Republican alternative to Obamacare" exists in a quantum reality, where they "reside in a state of quasi-existence, and any attempt to summon them into political reality will cause them to disappear."
More often than not, the history of the "Republican alternative to Obamacare" reveals itself as a cyclical set of traditions, repeating themselves over the years in political press conferences and pundit sparring. It goes something like this:
1. Republicans propose "alternatives" to Obamacare that don't go anywhere.
2. Allied partisans urge them to finally get serious and come up with a replacement.
3. They make new promises to keep at it.
4. Their return to the drawing board prompts columns from liberals about how the GOP lacks an alternative.
5. Allied partisans then criticize liberal pundits for saying there is "no alternative plan," citing the many plans that have been proposed, that went nowhere.
6. New alternatives are proposed and/or promised nonetheless, and the cycle repeats.
This cycle resembles Rust Cohle's "membrane theory" from the HBO show "True Detective." Time is a flat circle, in which Republicans have always been proposing alternatives to Obamacare, their proposals just cycling through their lives like carts on a track. The "Republican alternative to Obamacare" exists in an eternity where there is no time, nothing can grow, nothing can become, nothing changes, and everyone is reborn, but into the same effort to replace Obamacare that they've always been born into.
How many times have we had this conversation? I went back to the beginning to find out. By the end, I was ready to crush some Lone Star tallboys.
As Democrats begin to coalesce around a plan of their own, the GOP alternative is still nonspecific. Rep. Roy Blunt (R-Mo.) offers that Medicare's prescription drug benefit is "a good pattern of how a competitive marketplace works."
"Health care is a privilege." -- Rep. Zach Wamp (R-Tenn.)
Igor Volsky of ThinkProgress reports that the GOP's alternative plan still basically resembles the McCain plan: "The recent trickle of so-called consumer-driven health care 'principles and recommendations' are a preview of the likely Republican alternative to comprehensive health care reform. Earlier this month, the Health Policy Consensus Group, headed by the conservative Galen Institute, published 'a vision for consumer-driven health care reform' and today Ramesh Ponnuru of National Review pens a New York Times editorial in which he explains that ... 'universal coverage' is 'misguided." Policy makers should focus on giving Americans 'more control' of their coverage instead."
Sens. Tom Coburn (R-Okla.) and Richard Burr (R-N.C.), along with Reps. Paul Ryan (R-Wis.) and Devin Nunes (R-Calif.) introduce their Patient's Choice Act. Ezra Klein notes: "It's clear that many traditionally Democratic concepts have been embraced. To put it simply, the plan wants to encourage a version of the Massachusetts reforms ... in every state. There are some differences, of course. The plan doesn't have an individual mandate. It doesn't have an obvious tax on employers. But it strongly endorses State Health Insurance Exchanges."
The bill was referred to committee, but nothing ever came of it.
"I guarantee you we will provide you with a bill." -- Rep. Roy Blunt (R-Mo.)
Karl Rove: "In politics you can't beat something with nothing, so it is critical that the GOP offers an alternative to President Barack Obama's government-run monstrosity."
So here they come! The next semi-official GOP alternative to Obamacare is presented by Rep. Eric Cantor (R-Va.) and Dave Camp (R-Mich.). Time's Jay Newton-Small terms it "a four-page exercise in public relations that left out how many of the 47 million uninsured Americans would be covered, how it would be paid for or even how much it would cost." It rolls out alongside nine other "alternative plans."
"I started reading a couple, three of the Republican plans, but frankly, there's only so much time in the day." -- Sen. Max Baucus (D-Mont.)
In late July, the GOP-alternative effort briefly falls into contradictions. In a July 23 conference with GOP House leadership, Blunt declared, "As the president has gotten less specific, we have been more specific." Cantor proclaimed that the GOP had a "third way" to do health care reform. A day before, however, Blunt had said that the GOP would not bother introducing a bill: "Our bill is never going to get to the floor, so why bother? We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they've got to whatever we're offering right now?"
The next week, Rep. Tom Price (R-Ga.) would give it another shot, introducing the "Empower Patients First Act." Igor Volsky remarked that it was "almost identical" to four other GOP proposals that had been previously floated, and wondered, "What was wrong with the other four bills?"
GOP partisans begin to get testy. Morton Kondracke, writing for Real Clear Politics, says, "There's no question that Republican criticism has helped undermine support for President Barack Obama's health plan. But it hasn't done much to help Republicans. That's because while Republicans actually do have alternative ideas on health care reform, they have spent most of their time accentuating Obama's negatives." American Thinker's Paul Shlichta suggests that the GOP's failure to coalesce around a "counterproposal" is "political suicide."
Easier said than done, and the partisans aren't any better at coming to consensus. Justin Quinn urges the GOP to unite behind the "Improving Health Care For All Americans Act." Herman Cain begs the GOP to unite behind the "Empowering Patients First Act."
"The Republican health care plan for America: don't get sick ... if you do get sick, America, the Republican health care plan is this: die quickly." -- Rep. Alan Grayson (D-Fla.)
The Hill reports that the GOP is still at square one, debating what to do:
Some House Republicans are growing frustrated that their leaders have not yet introduced a health care reform alternative.
For months, the message from House GOP leaders on a health care bill has been similar to ads for yet-to-be-released movies: Coming soon.
According to several GOP lawmakers, the leadership is split over how to proceed in terms of unveiling an alternative to the final Democratic bill that Speaker Nancy Pelosi (D-Calif.) intends to unveil as soon as this week.
A GAME-CHANGING IDEA EMERGES: Philip Klein in the American Spectator: "Taken together, these criticisms have helped to weaken support for and build opposition to Democratic initiatives, but they have done nothing to advance an alternative vision for the health care system."
The GOP introduces its alternative in the form of an "Amendment in the Nature of a Substitute Offered by Mr. Boehner of Ohio" to what was then the Democrats' bill, the "Affordable Health Care for America Act."
The Congressional Budget Office promptly torches it. Ezra Klein surveyed the damage: "The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It's already been shown to interest groups and advocacy organizations and industry stakeholders. It's already made its compromises with reality. It's already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans."
Jonathan Chait: "The Republicans eschewed a halfway compromise and put all their chips on an all or nothing campaign to defeat health care and Obama's presidency. It was an audacious gamble. They lost. In the end, they'll walk away with nothing."
The Weekly Standard offers a "one-page" alternative to Obamacare called "the Small Bill." Its praises are sung by people ranging from "people who work at the Weekly Standard" to "people who work at the National Review."
The White House offers to meet with legislators to hash out a health care reform bill. GOP lawmakers are optimistic that they can convince the White House to "scrap" the bill that's emerging. Their counterproposal? "A blank piece of paper." Meanwhile, the Patient Protection and Affordable Care Act is shaping up to resemble a 1993 health care reform proposal floated by the GOP.
"And, once we defeat Barack Obama, we need to proceed to repeal this disastrous plan before it can ruin our health care system. Then we must replace it with a Republican alternative that relies on the marketplace, tax incentives and individual responsibility to provide health care to all Americans." -- Dick Morris
Sen. Bob Bennett (R-Utah) is defeated in the second round of balloting at the 2010 Utah State Republican Convention. Among Republicans, Bennett was the most earnest in working on an Obamacare alternative. His sin, however, was partnering with a Democrat, Sen. Ron Wyden (D-Ore.) in the effort. As the Deseret News reported, "His seven opponents had claimed he was not conservative enough for Utah, and had attacked him for voting for a banking bailout and for pushing a bipartisan health care reform proposal."
Once again, the GOP managed a pileup of competing alternatives. Rep. Paul Broun (R-Ga.) offers RedState readers "four commonsense alternatives to Obamacare," detailing H.R. 5421, "To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010." The bill was referred to committee, and nothing came of it.
Meanwhile, House leadership microwaved an old alternative plan, repackaging it as H.R. 5424, "To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and enact the Common Sense Health Care Reform and Affordability Act." The bill was referred to committee, and nothing came of it.
A GAME-CHANGING IDEA EMERGES: Fred Barnes in the American Spectator: "Republicans have two great issues: health care and reform. They ought to go beyond advocating repeal of ObamaCare, tell voters what they'd replace it with, and explain the benefits."
Writing for Fox News, Christian Wilton suggests that a GOP-controlled Congress needs to "refuse to appropriate money required for federal agencies to implement Obamacare, buying time to offer a Republican alternative." Buy time? They've been at this for over a year and a half!
The GOP releases its "Pledge To America," which includes a promise to repeal Obamacare and replace it with ... a bunch of stuff that's already in Obamacare.
"We could come up with a health care system that the American people would not only be proud of, but would actually love. ... We've never had a real conservative majority." -- Sen. Orrin Hatch (R-Utah)
The Los Angeles Times' Noam Levey reports: "Conservatives are campaigning on promises to repeal Obama's overhaul, but a few admit their proposals haven't changed much in the last few years."
Some conservatives acknowledge that the healthcare program offered by party leaders is largely unchanged from the proposals the GOP pushed when it held majorities from 2000 to 2006. During that period, insurance premiums skyrocketed, businesses reduced benefits and the number of Americans without health insurance rose.
With a new House majority, Cantor reboots the effort to come up with an alternative. In a letter to incoming members, he writes: "Our new Republican majority will move to repeal ObamaCare and replace it with commonsense alternatives that lower costs while protecting those with pre-existing conditions." Newly minted House Speaker John Boehner (R-Ohio) echoed the sentiments: "We must do everything we can to try to repeal this bill and replace it with common-sense reforms to bring down the cost of health care." Rep. Camp tries to interest people in one of his old proposals.
The GOP struggles, once again, to unify its approach. Cantor's call to protect patients with pre-existing conditions -- ground he ceded to Obamacare -- wasn't embraced by the incoming freshmen. As Andrea Stone reported:
North Carolina's Renee Ellmers, a Palin protege, opposes requiring insurers to accept patients with pre-existing conditions -- including pregnancy. Austin Scott of Georgia, another House freshman, was asked if there was any part of the law he supported. He replied, "No, ma'am, there are not."
Meanwhile, right-wing pundit infighting commences over Charles Krauthammer's suggestion to not attempt to defund Obamacare, on the grounds that a defunding effort would naturally be blamed for the law's failings. Krauthammer supported allowing the bill to be implemented, so it would fail on its own. This was met with disagreement.
House Republicans check off one of the entries on their bucket list by passing the "Repeal And Replace The Job Destroying Health Care Law." While the symbolic bill is long on "repeal," it doesn't offer much in the way of "replace." In fact, Cantor characterized the effort to construct an alternative to Obamacare as something that Republicans were, once again, embarking on for the first time, telling reporters that the vote for the bill meant they were ready "to begin work to construct an alternative health-care vision" that would be their "so-called replacement bill."
Bloomberg reported that "Republican leaders didn't offer specific alternatives" or a "timeline for moving forward with their proposals." The bill would die in the Senate.
A GAME-CHANGING IDEA EMERGES: Jeffrey Anderson in the Weekly Standard: "But while Americans want repeal, they don't just want repeal. And thus the House Republicans are now confronted with their greatest challenge -- and opportunity -- in the whole span of the health care debate. They need to show the American people that the choice is not between Obamacare and nothing. They need to provide a meaningful, sensible alternative to Obamacare's comprehensive failings."
Days later, the American Thinker's Jim Guirard had a brainwave: "We must focus on an alternative plan which can and should result in a simultaneous repeal and replacement of ObamaCare."
"As soon as the time is right," he specified.
WNYC reports that the GOP was hard at work "mull[ing]" an "Obamacare alternative": "Because now, Republicans (and their presidential hopefuls) must face the task of figuring out just what kind of health care law they'd like to see." Meanwhile, Ezra Klein opines:
It's put-up-or-shut-up time for Republicans. They managed to make it through the health-care debate without offering serious solutions of their own, and -- perhaps more impressive -- through the election by promising to tell us their solutions after they'd won. But the jig is up. They need a health-care plan -- and quickly.
Jennifer Rubin -- missing Klein's point by a country mile -- responded by citing numerous past examples of Republicans coming up with plans and insisting that Klein was "pretending there is no alternative to the deeply flawed ObamaCare."
A GAME-CHANGING IDEA EMERGES: Ramesh Ponnuru and Yuval Levin in The New York Times: "Republicans have an effective slogan for their health care agenda: 'repeal and replace.' The problem is, they can agree only on the first half; agreeing on what to put in place of last year's health care law is the hard part."
2012 hopefuls Mitt Romney and Newt Gingrich wade into the health care reform waters, with mixed success. The Wall Street Journal offers the optimistic assessment that the "Republican primary contest ... could feature a robust debate on health care, with GOP candidates challenging the Democratic law while defending their own variations."
"When they took control of the House, Republicans could barely stop talking about their plans to 'repeal and replace' the health care reform law. Six months later, they hardly talk publicly about those plans at all. And they're nowhere close to 'replacing' the law." --Politico
Ryan gives the "Republican alternative to Obamacare" another shot, proposing an expanded variation on his voucher system for Medicare.
Another dispatch from LA Times reporter Noam Levey indicates that, once again, the effort to come up with the "Republican alternative to Obamacare" is just getting underway: "Other conservative healthcare experts are developing an alternative to the law, an effort that could protect Republicans from past critiques that their healthcare plans left tens of millions of Americans without medical coverage."
Later in the same article, Levey reports, "A Republican replacement plan could build off a 2009 House GOP plan, said James Capretta, a former George W. Bush administration official who is developing a replacement strategy." (So much for dodging those "past critiques.")
A GAME-CHANGING IDEA EMERGES: Deroy Murdock in the National Review: "Washington Republicans nevertheless have been unwilling or unable to lock themselves in a hotel ballroom for a long weekend and devise a single plan as the official GOP alternative to Obamacare. Lacking a proposal around which Republicans and their limited-government allies could coalesce, the Right rightfully hammered Obamacare but never offered its own coherent package. Lesson: Never try to defeat something with nothing."
The Hill reports that "House Republicans will be ready with a plan to replace President Obama's healthcare law once the Supreme Court determines the law's fate this summer," thus giving them six more months to come up with something. Rep. Joe Pitts (R-Pa.) -- who told The Hill that the "Republican alternative to Obamacare" would be ready regardless of the court's decision, "listed a number of policy ideas Republicans would consider in a replacement bill"...that were already part of Obamacare.
Meanwhile, it is reported that Romney's alternative plan is "light on details."
Months after she castigated Ezra Klein for "pretending there is no alternative to ... ObamaCare," Jennifer Rubin says that the Republicans need to come up with the "Republican alternative to Obamacare." She writes, "Conservatives need to let the public know what the alternative to ObamaCare may be. If, unlike Obama, Republicans care about getting a mandate for their agenda, they would be wise to start laying out what a market-oriented alternative to ObamaCare would look like."
A GAME-CHANGING IDEA EMERGES: James Capretta and Robert Moffit in National Affairs: "Now that Obamacare is with us, the law cannot be reversed without a credible proposal for what should take its place."
Meanwhile, Senate Minority Leader Mitch McConnell (R-Ky.) is reportedly scaling back expectations, telling Ramesh Ponnuru, "We would want to more modestly approach this with more incremental fixes ... Not a massive Republican alternative."
The mystery of the "Republican alternative to Obamacare" deepens. "Do Republicans have an alternative to ObamaCare?" asks The Week. "Is There a Republican Alternative to Obamacare?" wonders Uwe Reinhardt. Fox News insists, "There is a Republican health plan. The only problem: Just as Democrats don't want to talk about ObamaCare, Republicans are just as afraid to talk about their plan as well."
The Hill reports:
Republicans might not offer a comprehensive plan to replace President Obama's healthcare law if the Supreme Court strikes it down this summer.
House Republicans had said they would have a healthcare bill ready to go by the time of the ruling to present a clear alternative to the Democrats' Affordable Care Act.
But now, with the high court's ruling just weeks away, some conservatives are urging the party to abandon that strategy, fearing voters will recoil from another sweeping revamp of the healthcare system.
"The political dynamics are such that you can loudly promise to craft an alternative a million times, and then quietly take back that promise in a small article published in The Hill." -- Jonathan Chait
A year and a half after Eric Cantor said the GOP was ready "to begin work to construct an alternative health-care vision" that would serve as his party's "so-called replacement bill," Cantor tells Tom Brokaw: "Tom, you knew back in 2009 when the Obamacare bill was being considered on the House floor, we put forward our alternative. So to sit here and say we don't have a replacement is not correct."
Meanwhile, other Republicans were proceeding under the assumption that alternative plans were still needed -- and they continually offered "alternatives" that resembled the Affordable Care Act.
By mid-month, however, the L.A. Times reports that the GOP had "all but given up pushing alternatives to the sweeping legislation the president signed in 2010."
A GAME-CHANGING IDEA EMERGES: Gail Wilensky, who headed the Medicare and Medicaid programs under President George H.W. Bush and advised Sen. John McCain (R-Ariz.) during his 2008 presidential campaign, says: "One of the big questions that the public needs to ask Republicans who are so focused on repeal is what will come in its place."
A GAME-CHANGING IDEA EMERGES: Ex-Romney adviser Avik Roy in Forbes: "Republicans have, rightly, spent the last three years campaigning against Obamacare. ... But conservatives are sorely mistaken if they believe that they can continue to campaign against Obamacare, without offering their own strategy for making health care more affordable for American families and the federal treasury."
Politico reports that Rep. Price becomes the latest GOP figure to suggest that the process of developing a "Republican alternative to Obamacare" needed to be rebooted: "It's incumbent upon us to put forward positive, alternative solutions," Price said at a Politico Pro breakfast panel discussion.
Jennifer Rubin offers a post-election lamentation:
The problem in the 2012 election was not that Mitt Romney didn't seek to repeal Obamacare or that he had a state plan with one element (an individual mandate with an exchange); it was that he refused to spell out in particular detail an alternative. James Capretta and Jeffrey Anderson make a compelling case in the Weekly Standard that Republicans must do this ... without an alternative, the duo correctly point out, there will be no groundswell of support to dump Obamacare and no effective scene setting for the 2014 and 2016 elections."
Once again, I'll remind you that at one point Rubin got awfully snippy at Ezra Klein for "pretending there is no alternative to the deeply flawed ObamaCare." Now the lack of an alternative is the backbone of her urgings.
A GAME-CHANGING IDEA EMERGES: Mona Charen in Washington Examiner: "As Obamacare's rising costs and constricted choices alienate the American people, Republicans should be ready with an alternative that is market-oriented, assembled and on the launchpad."
The "Republican alternative to Obamacare" returns to its conceptual stages, where it becomes part of a pundit pileup in Cloudcuckooland. Yuval Levin and Ramesh Ponnuru write in National Review that Republicans "need to realize that without ... an alternative their objections to Obamacare will ring increasingly hollow," adding, "Even though they cannot become law for at least four years, such ideas must become Republican orthodoxy if the party is plausibly to call for repeal."
Jonathan Chait notes that the GOP has had ample opportunity to come up with an alternative, but hasn't put many to a vote:
Republicans haven't done so for pretty clear reasons. These alternative proposals are much less technocratically simple than they pretend. (You can't just throw terms like "well-designed" at the Congressional Budget Office.) They cost money Republicans don't want to spend. They upset voters and interest groups Republicans don't want to upset.
"Together, we could provide more cost-effective care and do something more about spiraling healthcare costs. But really, the only true Republican alternative to Obamacare is Nothingcare." -- Rep. Lloyd Doggett (D-Texas)
Ryan becomes the latest Republican to reboot the effort to create the "Republican alternative to Obamacare," telling those gathered at the Wisconsin state party convention: "The nation is watching. The broken promises are being realized in front of their eyes and in their daily lives. ... This is the moment that we have to offer them real hope and give them real alternatives."
A GAME-CHANGING IDEA EMERGES: Ross Douthat writes in The New York Times: "The fact that the G.O.P. isn't really offering such an alternative at the moment clearly makes the case for repeal weaker than it otherwise might be, and it makes the case for resistance weaker as well."
Rep. Price of Georgia decides to give the "Republican alternative to Obamacare" another try, with H.R. 2300, the "Empowering Patients First Act of 2013," which repeals the Affordable Care Act and, among other things, replaces it with "refundable tax credits of up to $5,000 for low-income individuals and families to purchase health insurance on the private market." In June, the bill is referred to committee, and nothing further comes of it.
Meanwhile, the Weekly Standard's Jeffrey Anderson laments that his party's candidates for the 2012 presidential nomination didn't succeed in their efforts to develop a "Republican alternative to Obamacare," writing, "if a credible Republican candidate had entered the presidential race with the goal of making Obamacare -- and a compelling GOP alternative -- the focus of the campaign, Obama would likely now be living in Hyde Park rather than across from Lafayette Square (albeit still at public expense)."
Rep. Kevin Brady (R-Texas) tells Newsmax that "House Republicans plan to have an alternative to Obamacare ready by this fall." Really. They totally mean it this time.
Meanwhile, Jennifer Rubin is increasingly sounding like the people she once haughtily criticized: "Without a GOP alternative to Obamacare, their complaints are empty and their votes unlikely to be taken seriously by voters. It is long, long past the point at which Republicans should have begun crafting and selling their alternative. ... Where is the market-based health-care plan?"
August brings another spin of the "Republicans need an alternative!" to "Not fair, we have lots of alternatives!" cycle. Obama, in a news conference, criticized Republicans for not proposing a replacement bill: "They used to say they had a replacement. That never actually arrived, right? I mean, I've been hearing about this whole replacement thing for two years." It's understandable: let's recall that mere weeks ago, Rep. Brady was saying the alternative would not arrive until the fall.
Obamacare opponents did not take this well. John C. Goodman insists that "there is a serious GOP proposal," citing the "Patients Choice Act" proposed by Ryan and Coburn. ("This is essentially the health reform plan that John McCain proposed when he ran for president in 2008," he writes.) He'd later tell Fox News' Jim Angle, "I think the president has an incredibly short memory." Forbes contributor Chris Conover was similarly incensed: "It's arguably the favorite myth of progressives, the oft-repeated claim that Republicans have no health plan."
Meanwhile, former House Speaker Newt Gingrich tells "a gathering of GOP operatives that lawmakers who criticize Obamacare but offer no alternatives will be left with 'zero answer' for constituents who ask for a policy solution to the president's health care reform law."
"I would bet for most of you, you go home in the next two weeks while your members of Congress are home and you look at them in the eye and you say, 'What is your positive replacement for Obamacare?' and they will have zero answer," said Gingrich.
Short memory, I guess.
Having missed all of August's harangues about how unfair it was to suggest that there were no "Republican alternatives to Obamacare," because so many already existed, the Republican Study Committee goes ahead an unveils a new one anyway, called the "American Health Care Reform Act of 2013":
"First of all, we start by repealing Obamacare," RSC Chairman Steve Scalise, Louisiana Republican, said of the new bill.
Among other reforms, the GOP-sponsored bill would allow consumers to shop for insurance across state lines, let individuals and families deduct health care costs for tax purposes the way employers do and inject billions of dollars into state high-risk pools so people with preexisting medical conditions can gain coverage.
ThinkProgress' Sy Mukherjee remarks: "If that all of this sounds familiar, it's because Republicans have been proposing some combination of these ideas since at least 2007." The bill is referred to committee on Sept. 18, and nothing ever comes of it.
Rep. Darrell Issa (R-Calif.) jumps into the "create a Republican alternative to Obamacare" game on Twitter, proposing that every American should receive the same benefits that lawmakers receive through the Federal Employee Health Benefits program. Business Insider's Josh Barro terms this replacing "Obamacare with Obamacare."
A GAME-CHANGING IDEA EMERGES: Rob McKenna in Smarter Government Washington: "It's time for Congressional Republicans to unite under solid, practical alternatives to Obamacare and give the public a positive vision."
The Republican Study Group's alternative plan, the "American Health Care Reform Act of 2013," is said to be gaining "support" and "momentum," but I've already spoiled the ending for everybody, so I guess you'll have to appreciate the dramatic irony.
Meanwhile, the Onion gets into the game of making fun of the "Republican alternatives to Obamacare," with a list of their own that includes such proposals as "Repeating the phrase 'you can keep your current doctor' over and over until something happens," and "A true market-based solution -- perhaps a convenient website -- where uninsured people would pay for their own health insurance from private providers," and "Whatever the opposite of tyranny is."
A GAME-CHANGING IDEA EMERGES: Ramesh Ponnuru and Yuval Levin offer a breakout idea in The Wall Street Journal: "What Republicans can and should do is offer the public something better. Now is the time to advance a conservative reform that can solve the serious, discrete problems of the health-care system in place before ObamaCare, but without needlessly upending people's arrangements or threatening what works in American medicine."
Despite the fact that the calls for a "Republican alternative to Obamacare" are coming from inside the house, conservative partisans ignore the urgings of Ponnuru and Levin and lapse into another round of being aggrieved at the way Democrats keep saying that they've not come up with an alternative.
Meanwhile, Rep. Price tells Fox News that the GOP will really, totally, seriously "bring forth a bill" that will "unite Republicans around health care issues" sometime after the first of the year, and that's a promise, for real, this time.
"You can't beat something with nothing," Price added, sagely.
A new year dawns and with it comes yet another unveiling of a "Republican alternative to Obamacare." And the GOP had been at it for such a long time that it was second-bite-at-the-apple time for Sens. Coburn and Burr, who joined Sen. Hatch in creating the "Patient Choice, Affordability, Responsibility and Empowerment Act." "Mirabile dictu," sang out Ross Douthat, "an actual health care reform proposal!"
The glad tidings did not last long. "Within hours of the new plan coming into contact with political reality, things began to fall apart," wrote Jonathan Chait:
The first blow to its coherence came when the authors faced questions about their proposal to cap the tax deduction for employer-sponsored health insurance, a politically risky but economist-approved change that provided most of its money for covering the uninsured. Asked about this piece of their plan, the authors changed the language within hours to ratchet back its scope, insulating them from political attacks, but also neutering its value.
After that came the Congressional Budget Office report that described the way Obamacare would cause labor supply to shrink from the labor markets, as recipients escaped "job lock," or took advantage of the Obamacare subsidies to reduce their hours or retire. The GOP opted to describe this as "job killing," but what they didn't take into consideration was that this new plan from Coburn, Burr, and Hatch "would likely have approximately the same "job-killing" impact as Obamacare."
"Republicans can easily pick [Obamacare] apart, but they won't win over voters without their own ideas." -- Karl Rove, once again
Chait returns to this theme a month later, gathering string from numerous pieces of reporting, all suggesting that the process of crafting a "Republican alternative to Obamacare" is beginning anew.
Daniel Newhauser, giving Roll Call readers the inside scoop in a piece titled "GOP Leaders to Huddle on Obamacare Alternative," describes the process with sentences like: "House Republican leaders will meet Friday to begin crafting an alternative to Democrats' health care law." An interview with Eric Cantor by The Wall Street Journal's Gerald Seib (in a piece titled "Cantor Pushes the GOP to Spell Out Its Agenda"), yields these quotes from the House majority leader:
"Our members are going to get very excited if we can provide alternatives, not just be a party that's against whatever the president is for."
"We may have an opportunity for an alternative to be put in place."
Emphasis mine throughout. As Chait notes, all of this has a purpose:
Carping from the sidelines is a great strategy for Republicans because status quo bias is extremely powerful. It lets them highlight the downside of every trade-off without owning any downside of their own. They can vaguely promise to solve any problem with the status quo ante without exposing themselves to the risk any real reform entails. Republicans can exploit the disruption of the transition to Obamacare unencumbered by the reality that their own plans are even more disruptive.
"The amazing thing," says Chait, "is that House Republicans have managed to sustain this any-day-now stance since the outset of a health-care debate that began five years ago."
Welcome to Year Six.
If you've got a story you want to share on Sunday, feel free to drop me a line!