A mere 48 months after the law was introduced, with just two weeks until one of its main provisions takes effect, Republicans Wednesday finally offered their alternative to the Affordable Care Act.
Except it’s not really an alternative. Understanding why can help clarify the U.S.’s seemingly endless debate about health care.
The GOP bill would give tax deductions to buy health insurance, expand tax-free health savings accounts and limit insurance premiums for people with pre-existing conditions. What it wouldn’t do is expand coverage to the same number of uninsured Americans – about 25 million – as Obamacare.
The most important achievement of the Affordable Care Act is that the law attains something like universal health care in the United States, closing an embarrassing and indefensible gap between it and every other developed country.
That means any plan billed as an alternative has to meet one definitional threshold, and only one: covering a similar number of Americans. The documents Republicans released are conspicuously silent on how many additional Americans would be covered.
Until now, the Republican strategy has been to pretend that an alternative to Obamacare exists without saying what it is. Wednesday’s proposal is the logical culmination of that cynical strategy.
Republicans can continue to argue that ensuring universal health care is not a proper role for government, and try to persuade voters to agree with them. Their obstacle here is that the Affordable Care Act has been validated not only by the U.S. Supreme Court but also by the re-election of the president who signed it.
Alternatively, Republicans can come up with another way for the government to provide universal health care. Or they can concede that Obamacare is the best way to do so, and move on.