Ponnuru & Levin in WSJ
November 14, 2013 3 Comments
Ramesh Ponnuru and Yuval Levin plead with elected Republicans to adopt a health reform reform strategy and to press the case given the problems in the ACA rollout. As I recently wrote, liberals should hope they succeed in getting elected Republicans to commit to some details because of old problems (uneven Medicaid expansion) and new ones (healthcare.gov):
I think that all of these intellectuals realize that the Republican party is the only way for their ideas to reach legislative fruition, and they know that eventually the Party will have to be for something in health reform. And I believe they are quietly working towards making this case within the Republican Party. The entire country, but especially Liberals/Progressives who know that more must be done on health reform, should be rooting for them to succeed.
Best thing and worst thing about what Ramesh and Yuval propose.
- Best. Advocating for financing via tax credits a guaranteed level of catastrophic coverage (I may be generously interpreting), with extra financing for low income persons. This is a plausible conservative approach, and if were advocated legislatively, I can imagine a health reform deal emerging. If Ramesh and Yuval went a step further and advocated a default insurance option as Reihan Salam has advocated all the better. The notion of buying (non dual/LT disabled) Medicaid beneficiaries into the private market is something I have advocated (over 2 years ago) in my book for both long run policy and political reasons, and it makes even more sense to consider this now as compared to the default uneven Medicaid expansion we now see. Arkansas has been innovative on this private option.
- Worst. High risk pools. Segregating the sickest people into the same risk pool, if your intent is to actually provide them with care/insurance, is the worst somewhat popular idea of which I know. They need to be in the biggest risk pool possible, if you are going to insist on them receiving health insurance. I just don’t see evidence they can work long run.
I wrote in December of 2010 that both sides needed a health reform deal. It is all the more true today. The missing piece to a possible deal are the details of a Republican alternative. I hope elected Republicans listen to Ramesh and Yuval and get down to the hard work of telling the country what they are for.