Column | GOP has new opportunity on health care

January 26, 2014 

My parents tell me my first word was “no.”

That may seem deliciously appropriate for those who know that I extoll the virtues of limited government.

Deserved or not, the Republican Party has a reputation as being the “Party of No.”

The moniker is not always unwelcome. Sometimes saying no is necessary — like when every Republican in the House and Senate voted against the Affordable Care Act.

But in the wake of the law’s horrendous deficiencies, opposition to Obamacare — in the form of one repeal bill after another, or efforts to stall implementation at the state level — is no longer enough.

Those who have called the law a “disaster” are not guilty of hyperbole. Nearing four years since its passage, the health care law has fundamentally changed the way the health insurance market works, such that returning to the status quo is no longer an option.

With the employer mandate delayed, small-business policy cancellations on the horizon and a litany of other complications expected to surface in the coming months and years, the worst is yet to come.

What’s more is that the promise of universal coverage has been virtually vaporized. A recent survey of insurers found that as little as 11 percent of individuals who enrolled in exchanges were previously uninsured.

The law’s failures are widely acknowledged, making the opportunity for Republicans to present a plan nothing short of epic. To the frustration of conservatives such as me, they have failed to coalesce around a single, functional alternative.

This is, at least in part, because wholesale, government-mandated reform is anathema to many Republicans, who tend to use a more targeted, free-market approach to fixing things.

The problem isn’t a lack of ideas, either. Indeed, there are at least half a dozen substantive GOP plans worthy of consideration. The Ryan-Coburn plan is one. The Republican Study Committee released another comprehensive proposal in September. Several think tanks have offered suggestions, as well. But none has captured enough support or attention to seem viable or marketable to an American public now so wholly disillusioned with the government.

House Speaker John Boehner recently acknowledged his party’s truancy on the issue.

“It’s important for us as a party, especially in an election year, to tell the people what you’re for,” Boehner said. In the coming weeks, the party leadership is expected to unveil an ambitious agenda, which it has said will include a Republican health-care alternative.

But what will it look like?

John Goodman, president of the National Center for Policy Analysis in Dallas, says that in order to work, Republican reform must be simple, understandable and workable. Further, it must focus on basic concepts: choice, fairness, jobs — themes that resonate with Americans and policies that won’t require tens of thousands of pages of regulations to implement.

The two greatest challenges will likely be these: First, Republicans will need to overcome the gravitational pull of the intraparty factions that have divided them in recent months. A unified party passed Obamacare in the first place: Republicans will need every “yea” in their own party, and then some, to pass an alternative.

Second, and very important, they must be able to talk fluently about their proposal, using examples of real people that illustrate why their approach has merit.

Those of us who eagerly await the release of an alternative plan also hope that, unlike Obamacare, it will build a consensus among people who approach health care reform from different perspectives. In Goodman’s words: “No plan designed by those at the top can ever work unless people at the bottom have an economic incentive to make it work.”

If Republicans succeed, they will have earned a new nickname. My suggestion: “The Party of No, BUT…”

Cynthia M. Allen is a columnist for the Fort Worth Star-Telegram. Email her at cmallen@star-telegram.com.

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