Conservatives Take on 'Credibility Gap' on Health Care, Push Localized Reform
WASHINGTON, D.C. — On Wednesday, conservative policy leaders met with reporters at the Heritage Foundation to discuss the framework for Republican health care reform. The policy experts admitted that Republicans start with a "credibility gap" on health care, but argued that limited government approaches will better achieve the goals of driving down costs, providing more options, and helping the most vulnerable obtain health insurance.
"There is a credibility gap," Grace-Marie Turner, president of the Galen Institute, admitted to PJ Media in the briefing. "I think the reason conservatives are in that gap is because they spent so much time talking about these little levers that they would pull from a government perspective, and not enough time talking about goals."
Marie Fishpaw, director of domestic policy studies at the Heritage Foundation, explained why the Republican attempts to repeal the Affordable Care Act (Obamacare) failed in 2017.
"What they did in 2017 lacked a clear direction of what they were trying to accomplish beyond fulfilling a campaign purpose," Fishpaw said. "Americans still care a lot about healthcare. They have clearly defined hopes and fears. They fear that they or someone they love will get sick and lose access to being able to see a doctor when they need it, and they fear longer wait times, higher costs."
"They want lower costs, they want more choices," the Heritage scholar explained. "They want personalized health care that’s designed to treat your conditions based on your particular needs."
"Has Obamacare accomplished those goals? In my view no," Fishpaw added. Mentioning Democrat efforts to push a government-run expansion of health care — "Medicare for All" — she warned, "I actually think it would make everything they fear come true if we go in a big-government direction."
That does not mean reform isn't necessary, however. "I also think just patching over a broken system isn’t going to cut it either," she insisted.
In order to bridge the "credibility gap," Turner directly addressed the key goals of health care reform and explained how the Health Care Choices Proposal presented by the Health Policy Consensus Group would accomplish those goals.
"So we’re saying here are the goals that this would accomplish: lower prices, more choices, and coverage for those who are vulnerable," the Galen Institute president said.
The Health Policy Consensus Group started in the 1990s as a response to the challenges of President Bill Clinton's health care reform proposal. After Congress failed to pass health care reform in 2017, the group came back together.
The group includes over 100 scholars with many associated nonprofit organizations, including the Galen Institute, the Heritage Foundation, the 60 Plus Association, Americans for Prosperity, the Family Research Council, Students for Life, the Ethics and Public Policy Center, Independent Women's Forum, the American Enterprise Institute, the Mackinac Center for Public Policy, and more.
The group's Health Care Choices Proposal would cut Obamacare mandates, allowing states to innovate. It would redirect subsidies through direct block grants to the states, with provisions that 50 percent of the grants should go to helping people buy private health insurance and another 50 percent going to low-income people (these categories would overlap). These block grants would run through the Children's Health Insurance Program (CHIP), and such funds could not be used for abortion.
The choices proposal "takes a federalist approach to moving power and control over the health sector away from Washington to the states and ultimately to individuals," Turner argued. "Health care is not just state-driven, it's local-driven."
She noted that elements of the choices proposal made it into President Donald Trump's 2019 budget.
Both Turner and Fishpaw attacked Obamacare. Turner noted that if people with chronic conditions join the regular pool with everyone else, "they drive up premiums. As we've seen, these pools are sicker under the ACA. This forces everyone in those markets to cross-subsidize people with those highest health care costs."
Fishpaw attacked Obamacare as "a nice hand-out for big insurance," and slammed Medicare for All as "just empowering big government."
One of the reporters asked the Heritage scholar about the liberal talking point that Obamacare was a conservative idea — originally pushed by the Heritage Foundation.
"If you look at the components of the ACA, those were not components that Heritage advocated for," Fishpaw said. "Heritage has consistently opposed both the ACA and the individual components of it, including the individual mandate, since it was first on the table."
Both scholars emphasized that the Health Care Choices Proposal began outside of government. "This is the first time in a long time that a proposal has been developed on the outside," Turner said.
"This wasn't something that came from on high," Fishpaw said. "This was something that grassroots organizations bubbling up asked, 'how can we get this right?'"
Republicans still have a long way to go on health care, but they should not surrender this issue to the Democrats. Democrats took the House of Representatives last year partially by campaigning on health care. Republicans need to do more than just repealing Obamacare, and the Health Policy Consensus Group has made good strides in creating policy for them to campaign on. Trump has already started incorporating it into his plans, and the group's proposal could become a strong 2020 issue.
Follow Tyler O'Neil, the author of this article, on Twitter at @Tyler2ONeil.