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November 22, 2013 4:54 PM Republicans and Health Insurance Exchanges

By Ed Kilgore

Ezra Klein reminds us today in a more comprehensive way than we’ve seen so far that the Republican caterwauling about complex government-run private insurance exchanges and the disruption of existing insurance plans disguises the fact that their own health reform plans involve both, perhaps to an even greater extent than Obamacare. Exchanges were central to a 2009 plan jointly sponsored by Reps. Paul Ryan and Devin Nunes, and Sens. Tom Coburn and Richard Burr. And they’re also integral to Ryan’s famous Medicare plan:

Unlike the individual mandate — a conservative idea that became a profound threat to freedom the moment it passed into law with Democratic votes — insurance exchanges haven’t been disowned by Republicans. They remain at the core of Republican plans to reform Medicare. Ryan’s 2014 budget even keeps the clunky name: “Beginning in 2024, for those workers born in 1959 or later, Medicare would offer them a choice of private plans competing alongside the traditional fee-for-service option on a new Medicare Exchange.”

Worse yet, every Republican health reform plan, dating back to those proposed by George W. Bush and by 2008 GOP nominee John McCain, focuses heavily on abolishing the current tax subsidy for employer-sponsored insurance, which would very deliberately disrupt existing insurance plans more than fifty Obamacares. And by pushing many tens of millions of Americans into the individual insurance markets, Republican plans make some sort of government-run exchanges absolutely essential in order to maintain collective purchasing power.

But hey, I guess the Ted Cruz health reform plan, due any day now, will solve all these problems and avoid all these massive acts of hypocrisy.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

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