by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Instead of a repeat of 2017, Republicans would be better off trying to move current law gradually in a more preferred direction. The overall goal should be market-driven health care with secure insurance for all Americans. The GOP should not ignore the effects of their proposals on overall insurance enrollment. Put another way, Republicans should not want to be the party that increased the number of Americans without health insurance by 10 or 20 million people. To the contrary, Republicans should embrace reforms that lead to more enrollment in health insurance than would have occurred under the ACA, even after repeal of the individual mandate.
There are elements of the ACA that can help Republicans achieve their goal of a more market-driven system. For all of their problems, the ACA’s exchanges are supposed to facilitate consumer choice and competition among insurance options. Moreover, the ACA established a system of income-tested credits to facilitate enrollment in private health insurance plans. Republicans can work to improve this framework, to make it less expensive with less burdensome government regulation, and to drive down costs for consumers and the federal government.