The Republican Health Care Plan Emerges... Again

This week was my last cycle in a long, painful treatment for cancer using chemotherapy. Medicare saved my life-- no ifs, ands or buts about it. Medicare has been better insurance than the platinum standard insurance Warner Bros gave me as the president of one of their divisions-- not "as good"-- BETTER. Medicare-- other than Part D, the Republican Party prescription drug plan that is oriented towards their Big Pharma campaign donors, not towards patients like the rest of Medicare-- is a wondrous and blessed thing, something every American should be proud of and willing to fight for. We cannot let conservatives wreck Medicare. And we must make certain that Obamacare-- debilitated by hideous GOP-oriented compromises pushed by Blue Dogs and New Dems-- is absorbed into Medicare.

This week Budget Committee Republicans couldn't come to an agreement among themselves about even proposing their $3.8 trillion budget. Warmongers want to lard the budget up with more military spending-- without increasing revenue, which means, of course, further drastic cut backs on popular domestic programs, like Medicare and Social Security. Budget Chair Tom Price says he'll try to hammer out a compromise in his committee again today.

Writing for New York Magazine, Jonathan Chait reiterated-- if less famboyantly-- exactly what Alan Garyson had to say about the Republican Health Care plan during the original debate over Obamacare. There is no Republican Health Care plan for America beyond repealing the Affordable Care Act. "[T]he Republicans," he wrote, "do have a health-care plan: It is to repeal Obamacare and replace it with what we had before Obamacare... Patrick Brennan, one of the more reasonable types at National Review, objected the other day to the premise that the Republican plan is to repeal Obamacare and do nothing."

It’s true-- Representative Tom Price has a health-care plan. Of sorts. It’s a really sketchy plan that Price has not had scored by the Congressional Budget Office, which allows it to serve the purpose of letting Republicans cite it to refute the charge that they have no plan without being held accountable for its effects. This shows the primary obstacle to Republicans uniting around an Obamacare alternative. Reforming the health-care system is very tricky, and requires trade-offs. The Republican position on health care has relied almost entirely on the public’s status quo preference. Republicans have relentlessly attacked every discomfiting policy change in the Affordable Care Act and promised to change the system in ways people desire, without spelling out the very unpopular downside such changes would create.

The House budget illustrates the second obstacle to the adoption of a Republican health-care alternative. If Republicans wanted to replace Obamacare with Tom price’s health-care “plan,” they would include it in their budget. Tom Price probably has the clout to get his health-care plan onto the desk of the person in charge of writing the House Republican budget, who also happens to be Tom Price.

But the Price-authored budget ignores the Price health-care plan for the same reason the old Ryan budget ignored the Ryan poverty plan. It’s a thing Republicans want to say they’re for, but don’t want to make the sacrifices necessary to do it. The place where a party reconciles its competing priorities is its budget.

Now, the Republican budget does not actually reconcile its competing priorities. It is filled with smoke and mirrors. It won’t actually pony up the extra defense spending its hawks want, but it won’t deny their wishes, either, so the budget adds a one-year “emergency” defense hike, then whisks it away in subsequent years, even though nobody really thinks that would happen.

The biggest single gimmick is health care. Since Republicans are theologically committed to repealing every word of Obamacare, they have to repeal not only the law’s outlays, but also the tax hikes and spending cuts it uses to finance them. But they need those savings to pretend to cut the deficit. So the Republican budget claims to repeal them, and replace them with some other form of savings whose nature it won’t even hint at, let alone identify.

So their health-care plan is to repeal all of Obamacare, replace its savings with $1 trillion in magic money, and then spend zero on subsidizing health insurance for the millions of Americans who would become uninsured. If Republicans wanted to spend something on an Obamacare replacement-- tax credits, high risk pools, whatever-- they would need to set aside money for it. They chose not to. As hard as it is to design a health-care plan, designing one that cuts $1 trillion and spends nothing is really hard.

Indeed, even the existing budget fails to account for the party’s competing demands. It doesn’t set aside the extra defense spending that the hawks are angrily demanding. Nor does it account for the trillions in lost revenue that pretty much all the presidential candidates are promising. It’s pretty clear that, when it comes time to turn the Republican budget into reality, the first constituency with its hand out will be the tax-cutters, and the next one will be the defense hawks. There’s no way any money will be left over for health care. Republicans don’t even have the budget room to pay for the stuff they actually care about.

There's not much most of us can do about these Republican predators. But we can-- and must-- stop the conservative Democrats, the Blue Dogs and New Dems, who enable them. Do you recoil at the idea of voting for a Republican? You should have an identical instinct about the idea of voting for a Blue Dog or New Dem-- same anti-family, careerist garbage. We need more Alan Graysons and fewer Patrick Murphys, more Donna Edwards and fewer Chris Van Hollens, more Alex Laws and fewer Donald Norcrosses and more Chuy Garcia's and no Rahm Emanuels. And that is something can do something about!