As GOP presidential contenders begin to outline concrete policy plans ahead of the 2016 race, one thing is becoming clear: Even as the health care landscape has dramatically changed over the past several years, Republicans still can’t come up with any new health policy ideas.
This week, both Scott Walker and Marco Rubio released details about how they plan to repeal and replace Obamacare if they take over the White House. But each candidate is essentially recycling Republican ideas about the insurance market that date back at least eight years.
There are a handful of policies that the GOP continues to trot out: Establishing state-based high-risk pools for Americans with costly pre-existing conditions; allowing Americans to purchase insurance across state lines; extending refundable tax credits to Americans regardless of income level; expanding Health Savings Accounts (HSAs); and reforming medical malpractice.
Nonetheless, they remain quite popular among candidates today. Walker’s plan, for instance, involves allowing Americans to buy insurance across state lines and extending refundable tax credits. Rubio, meanwhile, says he supports establishing state-based high-risk pools and extending refundable tax credits.
Republican politicians have been proposing some combination of these policies since the 2008 election, when John McCain countered Barack Obama’s health care platform with the same ideas.
In 2008, McCain said he supported extending refundable tax credits — which he eventually acknowledged would ultimately result in raising taxes among middle class Americans — and creating state-based high-risk pools. He also proposed leveling a tax on the insurance premiums paid by employers, which health policy experts predicted could have led 20 million people to lose their employer-based coverage.
The following year, when GOP leaders in the House formed a working group to propose alternatives to Obamacare, their talking points closely mirrored McCain’s 2008 plan. At the time, the Congressional Budget Office estimated that the House GOP’s Obamacare alternative would leave 52 million people uninsured.
When Mitt Romney ran against Obama in 2012, his health care plan was simply more of the same. Romney endorsed allowing people to buy insurance across state lines, expanding Health Savings Accounts, and enacting medical malpractice reform. (Obama himself also supported reforming medical malpractice, though this policy didn’t make it into the final version of the ACA.)
There’s been plenty of rhetoric swirling around Obamacare; however, apart from the same few proposals at the heart of every GOP health care plan, there haven’t been a lot of new ideas. The Republican party has failed to coalesce around a viable Obamacare replacement plan for the better part of five years. Some Obamacare critics have also proposed replacing the Affordable Care Act with policies that are already in the law.
“When I am president, repealing and replacing Obamacare will be an urgent priority of my administration,” Rubio wrote in Politico Magazine this week to announce his health care plan. That’s something that Americans have heard over and over again — along with the same ideas about how exactly ACA opponents plan on accomplishing that.