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Obamacare: A starting point for GOP revival

The Republicans, at least sentient ones, have figured out that talking in abstractions ( “free-market capitalism”) and slogans (“rule of law!”) may be soothing for fellow conservatives but largely falls on deaf ears in a wider electorate. Likewise, opposing tax increases, opposing Obamacare and opposing compromise aren’t going to capture the imagination or earn the respect of non-ideological voters. Any political hack can vote no on the “fiscal cliff,” oppose immigration reform and demand a repeal of Obamacare; none of those actions, however, will advance conservatism nor earn the GOP more support.

In place of bumper stickers and no votes, Republicans (the smarter ones) are working to devise an affirmative conservative agenda grounded in conservative principles but relevant to the lives of Americans. A fairer, simpler tax code that spurs economic growth; refashioned entitlements that improve care and slow the rise in health costs; a K-12 education system based on parental choice and school accountability; a higher education system that produces capable workers and not debt-laden unemployed young adults; and an immigration system that is fair and enforceable and serves the 21st-century economy  — this is where the action is and where conservative principles of equal opportunity, personal freedom and market economics can flourish.

There is no better example of the flip from slogans to thoughtfulness and from a negative to a positive agenda than Obamacare. Most Americans still don’t like it. It has huge implementation issues. The costs will likely soon outstrip even the mammoth taxes it entails. And it is a burden on employers and job creation. Plodding conservatives for the umpteenth time will push to repeal it. This useless endeavor will please a segment of the right-wing echo chamber, but it will not advance the conservative agenda nor help drive voters to Republicans.

The problem in the 2012 election was not that Mitt Romney didn’t seek to repeal Obamacare or that he had a state plan with one element  (an individual mandate with an exchange); it was that he refused to spell out in particular detail an alternative. James Capretta and Jeffrey Anderson make a compelling case in the Weekly Standard that Republicans must do this:

Beyond resisting and delaying the implementation of Obamacare, the most important thing for the GOP at this point is to develop and unite behind a practical replacement proposal​—​one that will actually solve the very real problems plaguing American health care. While Obamacare’s failings will undoubtedly further energize popular opposition in the years after its implementation, that opposition alone is unlikely to be strong enough to result in its full repeal in the absence of a plausible replacement. Americans want reform of some sort to address the issues of preexisting conditions, rapidly rising costs, and unstable and insecure insurance for tens of millions of their fellow citizens. Obamacare’s opponents can win this fight​—​but only if they’re willing to do the hard and often complex work of developing an alternative that offers solutions to these concerns without imposing Obamacare’s excessive costs and heavy-handed governmental controls.

They urge Republicans to try to first delay full implementation of Obamacare (which may happen anyway given 25 states’ refusal to set up state exchanges) and reap the benefit of $200 billion in savings. (“This would be a popular pitch for Republicans to make to the American people: ‘We will cut the deficit by $200 billion and will also keep you from having to live under Obamacare for another two years.’) But without an alternative, the duo correctly point out, there will be no groundswell of support to dump Obamacare and no effective scene setting for the 2014 and 2016 elections.

They suggest a variety of reforms, none of which require the mammoth bureaucracy and federal intrusion of Obamacare: address the preexisting condition issue (with high-risk pools, protection for those going from individual too employer plans; rework the tax code (“a replacement to Obamacare should provide a tax credit to households that don’t have access to tax-subsidized, employer-based coverage. Such a credit should be equal to about $2,500 for individuals or $5,000 for families and could only be used to offset the costs of health insurance premiums or deposited into a health savings account”); and move toward ending federal subsidies for unlimited care in favor of a defined contribution model in which individuals purchase insurance of their choice.

That is a lot of detail. But so is immigration reform. Sen. Marco Rubio (R-Fla.) seized the reins on the latter and in a short time created a groundswell in favor of comprehensive, staged immigration reform. The Republicans need a respected figure to do the same on health care, this time making common cause with governors (for whom Obamacare has become a nightmare). Unlike immigration reform, this is unlikely to be a bipartisan effort, but it can be an effective one. Whether legislation can pass during Obama’s tenure remains a long shot, but the development of an implementable alternative is critical for the Republicans on the ballot in 2014 and 2016 and for the conservative movement as a whole. It is part and parcel of a GOP revival in which people, not abstractions, reality, not fantasy, and broad appeal, not echo-chamber plaudits, should be the focus.