So over the weekend WaPo’s official congressional Republican-watcher, Robert Costa, reported that House GOP leaders were working towards a consensus “Obamacare alternative” proposal they could hold up to voters and health care lobbying groups this year.
The plan includes an expansion of high-risk insurance pools, promotion of health savings accounts and inducements for small businesses to purchase coverage together.
The tenets of the plan — which could expand to include the ability to buy insurance across state lines, guaranteed renewability of policies and changes to medical-malpractice regulations — are ideas that various conservatives have for a long time backed as part of broader bills.
That is probably code for suggesting that the more interesting conservative proposals–notably the Coburn-Burr-Hatch plan’s use of a phase-down in the tax deduction for employer-sponsored health insurance to fund means-tested tax credits for individual policies–will be put back in the file cabinet, leaving Republicans with their hardy perennials: “tort reform,” interstate sales, medical savings accounts, and state-run high-risk pools.
If Republicans ever do settle on an Obamacare alternative, some serious truth-squad scrutiny will be necessary. A good step in the right direction is the challenge to Costa’s account immediately made by Dean Baker of the Center for Economic and Policy Research:
The Washington Post told readers that the Republicans are putting together an alternative to the Affordable Care Act (ACA). Unfortunately it substituted Republican talking points for an actual description of the plan.
At one point the article told readers:
“They would prefer to see a shift away from the federal government and to the states, with an emphasis on getting more consumers on private plans.”
In fact the Republican plan explicitly takes away authority from the states. It would have the federal government require states to accept insurance plans offered by other states. This is 180 degrees at odds with the Post told readers.
This would be comparable to requiring the United States to allow insurance plans from insurers regulated in the Cayman Islands, Panama, or some other tax/regulatory havens.
Now it’s pretty clear Costa’s role at WaPo is to report what congressional GOPers are saying and doing, but Baker’s absolutely right: a “newspaper of record” needs to retain enough analytical independence to point out blatant misrepresentations, and the “interstate insurance sales” scam is a howler of extraordinary importance. But it’s been blandly reported a thousand times as though it is indeed a simple prescription for health plan competition, instead of a preemption of state insurance regulation designed to destroy any minimum plan standards (to its credit, WaPo’s Wonkblog is one of the rare media outlets that has pointed this out repeatedly).
Some more truth-squad work is also needed to point out the equally blatant contradiction between GOP complaints about high out-of-pocket costs in Obamacare plans and the eternal Republican commitment to MSAs, which are all about increasing the exposure of health care costs to consumers, which will allegedly increase “individual responsibility.”
Indeed, it’s the mendacity embedded in the marketing of conservative health care policies that leads me to doubt congressional Republicans will actually settle on a single Obamacare alternative that might become a fixed target. But the more the GOP makes Obamacare the obsessive focus of its 2014 messaging, the more pressure it invites for dispelling some of the haze around actual plans.