Health Care Act

Can the GOP reform Obamacare piece by piece?

Originally published Feb. 4, 2015.

As the Republican-led Congress begins its 2015 "repeal the Affordable Care Act" season, this seems like a good time to loop back to Philip Klein's examination of GOP alternatives for health care.

Tuesday's vote on H.R. 596 is part of an ongoing political drama that has already featured more than 50 house votes to repeal the ACA. But in "Overcoming Obamacare," conservative health writer Klein delves into three long-term conservative strategies to reshape a broken system.

Avik Roy of the Manhattan Institute, a former adviser to the Mitt Romney presidential campaign, is a leading voice in what Klein dubs the reform camp. Roy's plan preserves some elements of the ACA, including the insurance exchange and protections for people with pre-existing conditions.

"Roy's philosophical starting point on the health care issue differs from that of many conservatives in that he has argued in favor of universal coverage,calling it 'a morally worthy goal.' His plan is also based on the assumption that repeal is unlikely," Klein writes.

Roy's reform plan outlines changes that can be made piece by piece, such as eliminating many of the ACA taxes, allowing insurers to charge higher rates for older customers and extending private-insurance exchanges to Medicaid and Medicare. He touts it as a politically feasible strategy that would make insurance cheaper and more appealing for young people while costing taxpayers less than the ACA.

Klein predicts that it's more likely to alienate members of both parties, with Democrats resisting the changes while Republicans "would be expected to embrace the goal of universal coverage" and "cede major ground to Obamacare on taxes, spending and regulations."

Coming soon: A look at the "replace" and "restart" strategies.

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