Republican Presidential Contenders Offer Substantive Obamacare Replacement Plans

As the 2016 presidential campaign ventures on, Republicans and Democrats candidates are facing, what many consider, the nightmare of Obamacare. Two Republican presidential candidates, Marco Rubio and Scott Walker, have created healthcare plans that would entirely replace Obamacare.

Healthcare policy expert James Capretta compares and contrasts the two candidates plans in National Review:

Governor Walker’s plan is very good because it is both workable as policy and realistic politically. It has five key features: Retention of Employer Coverage, Tax Credits for Households without Access to Employer-Sponsored Insurance, Continuous Coverage Protection, Expansion of Health Savings Accounts, Medicaid Reform. …

Senator Rubio’s plan is similar to the Walker plan. That’s not surprising because both candidates want to replace Obamacare with a plan built on decentralized, market-driven reforms. The Rubio plan would also provide a refundable tax credit for health insurance and would shift regulatory authority from the federal government to the states.

But the Rubio plan differs from Walker’s approach in certain ways as well. It would gradually phase out (over ten years) the tax preference for employer-paid health-insurance premiums in favor of a universal tax credit that would be made available to all Americans, whether or not they have access to a job-based option. This approach is “fair” in the sense that it would ensure that all Americans were treated identically in terms of the tax treatment of health insurance. However, it is more vulnerable to political attack than the Walker approach because it would create some uncertainty about the continued viability of existing employer plans. For that reason, it seems likely that the Walker approach to tax credits would hold up better over time, especially when the inevitable attacks come from Obamacare’s defenders.

The Rubio plan would also help people who have expensive preexisting conditions by giving them direct government subsidies instead of limiting what insurers can charge to people with continuous coverage. On this issue, too, Walker’s approach might be more attractive to voters because it does not depend on continued appropriations for high-risk pools, which have been chronically underfunded in the past.

These differences are important but shouldn’t be overemphasized. Both plans are clearly informed by the same general perspective, which is that health care in the United States will be better, of higher quality, and less costly if decisions over the allocation of scarce resources are moved from the federal government to consumers, employers, and the states.

Read Capretta’s full analysis at National Review.