Republicans Consider Obamacare Replacement Strategy

Published January 5, 2015

Several weeks ago I wrote a piece that appeared in National Review, arguing that the GOP Congress must have legislation ready to go in the event the U.S. Supreme Court upholds Obamacare’s fairly plain language stating that subsidies are available only through exchanges established by states, not those set up by the federal government (the case is King v. Burwell, and will be heard in March with a decision probably in June).

So I was happy this morning to see Republicans are doing just that, beginning to coalesce around a plan. Here’s a Politico story updated just last night:

GOP searches for elusive Obamacare fix

Republicans have been vowing to repeal Obamacare for nearly five years. But 2015 could be the year that Republicans finally define how they would replace it.

In March, the Supreme Court will hear another case that threatens subsidies that form a core of the Affordable Care Act. That has Republicans putting pressure on themselves to coalesce around a plan, drawing on ideas they’ve discussed for years such as tax credits to buy insurance, high risk pools and allowing insurance to be sold across state lines…

This is good news, suggesting the “Stupid Party” is thinking ahead and understands they can’t just sit back and have a good laugh at the ineptitude of the Democratic authors of the bill, and then move on to some other issue. As I pointed out in my National Review piece, Republicans are going to be under intense pressure to do something if the Supreme Court “takes away” subsidies from millions of Americans (not really, but that’s how it will be framed). Republicans might as well pass what they’ve always said they wanted to pass, if only they hadn’t been so busy stuffing the budget with earmarks when they controlled Congress.

If there’s one piece of advice I’d offer Republicans right now, it’s this – if the Supreme Court does uphold the law as written, don’t try to repeal Obamacare in the states where subsidies are still allowed. President Obama won’t sign it, instead he’ll demand you pass what would likely be single-page bill “fixing” Obamacare’s language by allowing subsidies in exchanges established by the federal government as well. If states want Obamacare, let them have it. Limit the Republican fix – likely some combination of tax credits, deregulated insurance markets, and high-risk pools – to only those states where there is no state-based exchange.

This will give Americans a real education, I think, in which policies work better. It shouldn’t be a hard lesson to draw – Obamacare’s exchanges are already faltering, with enrollment running well below what was projected, and costs continue to soar, as do deductibles.

Some Republicans will likely see not repealing Obamacare everywhere as a failure or even a betrayal. I’d remind them that one principle that many conservatives at least give lip service to is the idea that the Tenth Amendment actually means something, and that states should be allowed to chart their own path.

Take the 80 percent victory, enact Republican ideas in those states that prefer them to the Washington-knows-best approach embodied in Obamacare, and then let the voters see the results.