By the August recess, President Obama will have his health care plan more or less drawn up in the versions that come out of committees in each house of Congress. Tomorrow, the conservative Republican Study Committee, chaired by Rep. Tom Price, R-Ga., will officially bring its health bill to the floor as well.
Although there is no chance it will pass, it offers a striking contrast with the Democrats’ bill in its approach to the same problem: how do you get more Americans insured?
Democrats’ solution to the problem has been to expand Medicaid, impose a myriad of new regulations on insurers, and abolish the individual insurance market. In the meantime, they hope that this huge front-end “investment” — paid for by taxpayers — will somehow drive down Medicare costs in the long run.
On the other hand, the RSC prescription is to improve the individual insurance market by taking away its tax disadvantage. They also want to pre-empt the unreasonable state coverage mandates that have made individual policies unaffordable in states like New Jersey and Maine. (Must every insurance policy really cover marriage counseling? Accupuncture?)
Another key contrast between the two approaches is known as “guaranteed issue.” In order to accommodate those with uninsurable pre-existing conditions, Obama and the Democrats have proposed re-shaping everyone’s coverage, at the risk of ruining what’s good in the current system in the process. The RSC plan, on the other hand, treats uninsurable people as the special cases they are. It subsidizes their care and gives states incentives to create risk pools for them.
The RSC plan also deals with several states’ habit of creating middle class welfare programs, even while failing to cover the poor. First, it offers Medicaid and SCHIP recipients a voucher with which they can purchase private insurance instead, if they so choose. And states would be required to insure 90 percent of their populations below 200 percent of federal poverty level before they can expand Medicaid and SCHIP eligibility to people with higher incomes.
In this Democratic Congress, the Republican Study Committee has little influence. But they do have a plan — a plan combining ideas from such conservatives as John Shadegg, R-Ariz., and others, that Republican leaders should have paid more attention to when they controlled Congress. While the RSC plan is not the comprehensive overhaul that Obama envisions, it would dramatically change things for the better at little or no cost to the taxpayer.
