A Theoretical Obamacare Alternative Isn't Good Enough for Some Republicans

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If America had a dollar for every time a Republican mentioned their upcoming vote on a GOP Obamacare alternative, we could probably fund a single payer system. Republican lawmakers are once again calling for a vote on an alternative, even though all of the factors working against them are still in play: there are too many ideas, the GOPcare still looks too much like Obamacare and, more importantly, Republicans would rather run on a theoretical alternative than a real one. Just ask Mitch McConnell. 

According to The Wall Street Journal, members of the large conservative wing of the House, the Republican Study Committee, will ask House leaders on Thursday to move forward with their bill, which has the support of 130 GOP representatives. The RSC bill is just one of four major proposals that the party has been debating, as the Washington Post noted in March. The RSC plan would "boost federal support for state high-risk pools aimed at helping cover those with existing conditions and overhaul medical liability laws," and also tax employer plans (and offer tax breaks to consumers). 

The goal is to vote on something before the August recess, giving lawmakers a chance to go home and campaign on the alternative. But the RSC plan is only one of several plans floating around and, more importantly, it's not that good. The medical liability/malpractice reforms Republicans have supported in the past were recently ruled unconstitutional by a Florida court, and high-risk pools aren't as good at insuring people as banning pre-existing condition screening.

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A bigger problem might be that the GOP's best chance for covering a lot of people might be to resemble Obamacare as much as possible. "As far as repeal and replace goes, the problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act," a congressional GOP health aide told Talking Points Memo last month

And even if the GOP could agree on a plan and vote on it, they'd have to campaign on it. In the last week, Sen. Mitch McConnell has become a great example of what that looks like: he wants to repeal Obamacare, but he also wants the hundreds of thousands of Kentuckians who just joined Medicaid — some, but not all, thanks to Obamacare — to keep their insurance. In his attempt to meet both goals he's come off ridiculously, first saying that his push to repeal Obamacare wouldn't effect his state's Obamacare exchange. McConnell's campaign then wrote to the Washington Post that Kentucky could keep people enrolled in expanded Medicaid, even if the extra funding was repealed. "The federal government does allow states flexibility in setting requirements and Kentucky could be able to keep many of the newly enrolled in the program if we decided to,” McConnell's spokesperson wrote.

The Medicaid expansion pays 100 percent of the costs for new enrollees. Regular Medicaid pays much less percent, and the odds of states losing Obamacare funding but still being able to afford their new enrollees is slim. But McConnell, like many Republicans, wants to campaign on an idea: somehow there must be a way to repeal Obamacare without repealing millions of health plans. They just haven't quite figured it out.

This article is from the archive of our partner The Wire.