Despite the president's assertions that GOP critics of Obamacare haven't offered anything better, Republicans have in fact put forward alternatives aimed at not only repealing the flawed law but also fixing many of its shortcomings.
In the House, the Republican Study Committee has put together the latest and most comprehensive version of a GOP healthcare plan. The American Health Care Reform Act, introduced in September, now has 108 co-sponsors.
The proposal flips Obamacare's focus on a vast role for the federal government in overseeing the nation's healthcare system to a free-market approach, including tax deductions geared at giving consumers the ability to purchase their own health insurance, and tort reform aimed at lessening costs to medical providers.
The plan leans on ideas previously proposed by Republicans, including allowing competition from insurance providers across state lines, creating pools for small businesses that keep rates down, and allowing the federal government to contribute to high-risk insurance pools in the states, bolstering support for those with pre-existing conditions.
"Most people know we're against the president's healthcare law, but I think they want to see what we stand for," Rep. Steve Scalise, a Louisiana Republican who chairs the Republican Study Committee, said at an event sponsored in November by The Washington Free Beacon.
During the government shutdown battle, President Barack Obama said Republicans were trying to repeal the Affordable Care Act without offering any alternatives.
Republicans "used to say, 'Well, we're going to replace it with something better.' There's not even a pretense now that they're going to replace it with something better," Obama said at a White House press conference in August.
"I've been hearing about this whole replacement thing for two years," he said. "Now I just don't hear about it because basically they don't have an agenda to provide health insurance to people at affordable rates."
But lawmakers who are in the study committee aren't the only ones pitching a Republican alternative. Rep. Paul Ryan of Wisconsin, Sen. Tom Coburn of Oklahoma, and Rep. Tom Price of Georgia all have floated their own versions of a Republican healthcare plan, with similar themes drawn from ideas across several years of policy research by a host of think tanks.
A comprehensive and detailed proposal also was offered by Republican Sen. John McCain of Arizona during his 2008 presidential bid against Obama. The McCain plan was estimated to cover about 21 million new people, while about 26 million were expected to get coverage under the Obama plan.
Conservative policy experts say the party needs to coalesce around a unified approach, noting that the lack of concentrated support has kept their ideas from advancing.
"The issue is not really whether there are plans. There have been enormous lists of proposals. On a scale of one to 10, you're talking about a 10 on the Richter scale," Robert Moffit, a senior fellow at the Center for Policy Innovation at the Heritage Foundation, told Newsmax.
"I think what has to happen is the leadership in Congress — representatives in the House and Senate — have got to coalesce around a comprehensive set of proposals," said Moffit, who served in the Reagan administration as deputy assistant secretary at the Department of Health and Human Services and is the former director of the Heritage Center for Health Policy studies.
"That doesn't mean they have to put everything in one bill. They have to have a whole series of initiatives where they have a coherent policy response to the problems of the country, and at the same time stop the permanent damage that is being done by the president's law," Moffit said.
"The reason why we ended up with the mess we ended up with, Obamacare, is because the Republicans would never get their act together on health policy," he said.
Heritage's plan, which it describes as "patient-centered" and "market-based," focuses on consumer choice, allowing individuals to pick and control insurance plans they could carry from job to job and through retirement, rather than pick from exchanges that limit choices.
Employers, Heritage suggests, should be encouraged to offer plans that are portable for employees, and consumers should receive an individual tax credit that they could use to help buy a policy.
Heritage supports offering consumers their choice of providers rather than a limited selection as offered under Obamacare, and creating high-risk pools for those with pre-existing medical conditions.
The foundation also supports allowing the purchase of policies across state lines, creating competition in the marketplace by eliminating barriers to interstate commerce, and allowing consumers to choose a provider no matter where the carrier might be.
"What we see now are these large geographical cartels," said Moffit. "We should break them down, create a huge national market, like life and auto insurance. With a large national market, you'd create large national pools — you might see 250,000 to a couple of million people in a national pool. When you get that kind of economies of scale, you get much lower administrative costs."
Republicans have put a slate of common-sense ideas
on the table, says Michael Tanner, a senior fellow who studies healthcare reform at the Cato Institute.
"I think the basic concept of a more consumer-based market is key . . . so individuals control more of their money and make more decisions, along with creating more competition, allowing purchases across state lines," Tanner told Newsmax.
"I think the basic ideas behind the Republican plans are not the problem," he said. "The fight for the Republicans is about the details.
"The problem on the Republican side isn't that there isn't a plan. There are a lot of different proposals and several different bills that have been introduced. What there isn't is a single plan," Tanner said. "Part of this is ideological, because there is not a consensus around details of those plans."
Unlike Democrats, who have rallied around Obama as president, "Republicans don't have a single leader," Tanner said. "It's not an election year, so you don't have a presidential candidate. You have a lot of folks who are jockeying around for their own stuff. Who speaks for the Republican Party?"
Without the bully pulpit of the White House, it is harder for Republicans to communicate their ideas on a complex issue, Tanner said.
Ideas for fixes to Obamacare are gaining momentum as Americans grow inpatient with the rollout and talk in turn about the 2014 midterm elections, in which Obamacare — and its massive problems — will be the top issue in congressional races that could change the balance of power.
"As a national issue," Tanner said, "it's going to be the No. 1 issue for Republicans across the country run on."
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