While Pascal-Emmanuel Gobry hails Governor Scott Walker for taking “the right approach” to replacing Obamacare, Jonathan Chait dismisses Walker’s proposal as being merely a “skeletal description of [a] plan-like concept”. How to reconcile such disparate views? Let’s have PEG and JC debate!
First, PEG’s defense of Walker:
Walker has opted for a version of the plan proposed by conservative reformers, such as James Capretta, that offers a refundable tax credit to buy health insurance. The key thing is that the credit is refundable, meaning low-income Americans who max out their tax liability with the credit get a check from the government to buy health insurance. This means that everyone can buy it. Walker's plan also offers a tax credit for getting a health savings account,probably the single most important thing we can do to get progress in the American health care system. The plan also proposes to reform Medicaid, something that is badly needed because it ill-serves the poor…By allowing people to buy the health care plan they want, and to control more of their spending, [Walker’s plan] will increase competition in the health care system and therefore spur innovation and reduce costs. Equally important, it will ensure almost all Americans are covered.
Would Mr. Chait care to respond? Yes, he would, taking on not just Walker but also Marco Rubio:
Walker and Rubio are fairly clear about their plans for regulating the insurance market. They want to go back to the pre-Obamacare, deregulated system. They’d eliminate the requirements that insurance plans cover essential benefits, and let them charge higher prices to sicker customers. That’s good for people who have very limited medical needs (as long as they never obtain a serious medical condition, or have a family with somebody with a serious medical condition). It’s bad for people who have, or ever will have, higher medical needs.":"
Both Walker and Rubio promise to take care of people with preexisting conditions by creating separate “high-risk pools.” That is a special kind of insurance market for people with expensive medical conditions. As you may have guessed, insurance for people with expensive medical needs is, well, expensive. Making that insurance affordable therefore requires lots of subsidies from the government. Where would Walker and Rubio get the money for that? They don’t say.
Both the Rubio and Walker planlike concepts share a basic structure and an extreme lack of detail. Walker’s document is a few pages padded out with ample white space. Rubio’s op-ed, which repeats the talking points of another op-ed from a few months ago, contains even less information.
Closing thoughts from M. Gobry?
[Walker’s plan is] also the right approach politically, and a very good sign for American politics writ large. That Scott Walker, aka Mr. Median Republican, is adopting reform conservative ideas shows these ideas are winning. Three cheers for that!
Following PEG's Gallic cheerleading, Mr. Chait gets the last words:
[Republicans] will not finance real insurance for the people who have gotten it under Obamacare, nor will they face up to the actual costs they’re willing to impose on people. The party is doctrinally opposed to every available method to make insurance available to people who can’t afford it. They have spent six years promising to come up with an alternative plan, and they haven’t done it, because they can’t.
Jonathan Chait very generously doesn’t even mention the enormous costs that would be involved, at this point, in having insurance companies and medical providers undo all sorts of changes they’ve made in order to comply with Obamacare. As for PEG’s belief that Walker’s plan is “the right approach politically”: try telling that to all the Americans who, after finally getting affordable healthcare coverage, are going to have to deal once again with an unregulated insurance industry that will be free to sell substandard policies (aka crap) and to discriminate based on age, gender, and pre-existing medical conditions.
If you’re not persuaded by Mr. Chait (or by me), please feel free to consult the always informative Sarah Kliff (at Vox).3 Ms. Kliff has carefully examined Scott Walker's plan, and her verdict is (I’m paraphrasing, of course): Walker’s plan sucks, unless you’re Taylor Swift.