A front-page story in Saturday’s Washington Post discussing Republican candidates’ positions on the Affordable Care Act included a curious quote from Rep. Steve Israel, chairman of House Democrats’ campaign committee, who said that Republicans are “promising fixes but won’t be specific.”
Actually, many conservatives have outlined numerous alternatives to Obamacare. Republicans in the House have written at least 200 separate bills showing their ideas on health care, large and small. My own organization, America Next, released its blueprint for health reform earlier this year.
Conversely, the comparatively small universe of “fixes” advocated by supporters of the health legislation omit major fiscal details. Here are three examples:
In a March Politico op-ed, several Democratic senators (and one independent, Sen. Angus King) proposed allowing the broader sale of low-cost, high-deductible health plans, whose availability is currently limited under the ACA. The senators also advocated expanding the law’s tax credits for small business—making them available to more firms and for longer periods—and further diluting the ACA’s employer mandate on businesses, which already has been delayed twice.
Former President Bill Clinton last year called for fixing a provision that disqualifies families for insurance subsidies if one member of the family can get “affordable” health coverage from an employer.
Others have discussed repealing a provision in the law that would slow the growth in premium subsidies beginning in 2019.
Most of these “fixes” come with price tags—and potentially large ones at that. A 2011 study by the Employment Policies Institute found that fixing the affordability definition, as President Clinton proposed, could increase spending by nearly $50 billion per year.
Supporters of the Affordable Care Act suggesting modifications have a duty to explain whether and how any spending increases would be paid for—through tax increases or other spending reductions. Because proposing new federal spending without a way to pay for it could put Democrats—and taxpayers—in, well, a bit of a fix.
This post was originally published at the Wall Street Journal Think Tank blog.