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April 14, 2014 11:01 AM How Do You Repeal Obamacare Without “Fixing” It?

By Ed Kilgore

A favorite rant among our little wingnut friends is that evil Establishment RINOs are trying to “fix” Obamacare instead of repealing it, destroying it, and salting the earth in which its tender shoots once grew. Here’s the Commissar, Erick Erickson:

More and more Republicans inside the beltway are whispering that they can fix Obamacare. We’ve already seen House Republicans do it. They’ve started fixing Obamacare, claiming they are dismantling it. Really, they are making it more and more likely that Obamacare will, in some perverted form, stay.
Leading Republican intellectuals are trotting out columns and white papers on what to do to fix Obamacare — what to do to change Obamacare. While the base and the public still want Obamacare gone, the party in Washington has begun to think it possible to change it.

In anathematizing “columns and white papers” Erickson is presumably referring to the various “replacement” agendas, from Tom Coburn’s to Bobby Jindal’s to Avik Roy’s, that conservatives are offering so that voters won’t think they just want to go back to the pre-2010 status quo ante in health care policy. So far as I can tell, all of these proposals solemnly call for the full repeal of the Affordable Care Act as a condition precedent. So what the Right is actually objecting to is the inclusion in a Republican health care agenda of any of the features—however modified to be leaner and meaner—of Obamacare, such as purchasing exchanges or subsidies for low-income consumers or special provisions for people with pre-existing conditions.

It’s no great secret that prior to the enactment of the Affordable Care Act a lot of conservatives thought the status quo was too socialistic; indeed, many seemed to think (and still think) that even private health insurance is suspect because it detracts from individual responsibility for one’s own health. And indeed, “spreading risk” via private insurance carries the same alleged moral hazard as “spreading risk” via public programs. That’s why nearly every Republican health care proposal includes the Health Savings Account pet rock whereby individuals pay for routine care out-of-pocket, and many of them recommend replacement of tax incentives for employer-sponsored group insurance plans with incentives for individual plans.

So a lot of this talk about RINOs wanting to “fix” Obamacare is actually code for a determination to make sure freeloaders and loafers don’t benefit from the insurance premiums paid by virtuous people who either stay healthy or save their pennies to pay the doctor. It would be nice if people like Erickson would come right out and admit they want to take health care policy right back to the 1950s.

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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