Tevi Troy & Jeff Anderson
By proposing a health-care bill of their own, Senate Republicans can throw the extraordinary weaknesses of the Democratic bills into stark relief. In the wake of the Congressional Budget Office’s recent scoring of aspects of the House Republican bill, there is now an opening for Republicans to provide a clear contrast with the proposed Democratic overhaul.
The Democratic bills are polling badly, even though they’ve been running largely unopposed in the eyes of most Americans. But continuing to let them run without competition would be a major political error, in both the short and long term. Republicans need to show how health-care reform should be done, improving on the unsustainable status quo while reflecting the political realities of the moment.
The House Republican bill, while imperfect and incomplete, provides a roadmap to victory. Even the New York Times recognizes as much, writing that “a ‘cheaper’ alternative” (the Times puts it in quotes) could scuttle the passage of the proposed Democratic agenda. The Wall Street Journal strikes a similar theme, writing that in the aftermath of the New Jersey and Virginia gubernatorial elections, Republicans “have an opening” to “give obviously anxious voters an alternative.”
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The Democrats are attempting to decrease the number of uninsured through mandates and requirements — at the tradeoff of raising costs. Americans recognize this. As a recent poll in the
Economist shows — by the overwhelming margin of 50 to 9 percent — Americans think they would personally have to pay more if the Democrats pass a bill.
That is why the CBO’s evaluation of the House Republican alternative is so encouraging. The Republican approach is to focus on lowering costs, which in turn would make coverage easier to afford — and the CBO says this approach would succeed. It estimates that the Republican bill would lower Americans’ insurance premiums — by 5 to 8 percent in the small-group market, up to 3 percent in the large-group market, and 7 to 10 percent in the individual market — while increasing the number of insured by 3 million.
The House Republican bill also has an obvious weakness, as the
New York Times and
Washington Post were quick to note. While it would reduce the number of uninsured by far more
per dollar spent than the Democratic bills would, it would not lower the
total number of uninsured by nearly as much.
But the CBO score for the House GOP bill was also extremely positive in another way: It said that the bill would reduce deficits by $68 billion. This, in tandem with the verdict that the bill would lower premiums, provides a prime opportunity for Senate Republicans to advance a proposal that does a better job of reducing the number of uninsured.
Here’s how: Senate Republicans should take the House Republican bill and add a $2,000 per person ($4,000 per family) tax credit —
refundable,
advanceable, and usable only to buy insurance — for those without employer-based
health coverage. Currently, those who buy health insurance on the open market have to buy it with income that’s already had taxes taken out of it, while those who get insurance through their employer get it tax-free. This inequality is unfair, and it makes no sense when trying to solve the problem of the uninsured.