Obama Care: Any Alternatives?

Without question, the biggest political news to splash across the headlines last week involved the amazing comeback of the Affordable Care Act (ACA). Despite the catastrophic roll-out of its signature e-commerce web site last autumn, the system handily surpassed its original 7 million enrollment target, while additional volume continues to roll in.

The biggest surprise of the week, though, may have involved the absence of any comprehensive alternative proposals from Republican opponents to the ACA. After all, with well over seven million Americans now obtaining health insurance through the online exchanges, a simple repeal of the law — without any alternative options whatsoever — would cause chaos in the health care sector.

Louisiana’s Republican Governor Bobby Jindal acknowledged the problem a few days ago, noting that “I think there are too many Republicans in this town thinking that we should just run against Obamacare … but I think that’s wrong.” Jindal proposed replacing the ACA with a collection of federal block grants, health care vouchers, tax deductions, and other government initiatives. But Jindal did not release any cost estimates, and failed to explain how he would pay for his proposals.

The primary challenge now facing the Republican Party is that such initiatives have been thoroughly debated — and repeatedly pilot tested — during the past several decades. But the pilot programs have never generated outstanding results, and thus the options have never drawn significant political support for widespread implementation.

In fact, to the chagrin of Republicans, the ACA remains the sole contemporary option for extending health coverage to millions of uninsured Americans across the nation. And according to the Congressional Budget Office, by the end of President Obama’s term in 2017, 28 million Americans will receive coverage through the health insurance exchanges (see Table B-3).

Even if the Republicans achieve sweeping victories in the 2016 Presidential and Congressional elections, it is difficult to believe that any President and legislature would ever simply repeal the ACA and cancel the health plans of 28 million Americans without offering any alternative options. Does this mean that Obama Care is now an irreplaceable cornerstone of the American health care sector?

If you were Reince Priebus, the Chairman of the Republican National Committee, would you support the development of a comprehensive national health program as an alternative to the ACA?

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