(Bloomberg View) — When it comes to health-care policy, Republicans are known more by what they oppose than by what they support.
Americans are familiar with the Republicans’ fierce resistance to policies proposed by the Bill Clinton administration in 1993 and 1994, and their continuing battle against the Patient Protection and Affordable Care Act (PPACA) — Obamacare.
Outside the small Washington policy community, however, few Americans know what Republicans would do to fix the nation’s health-care system. That must change in 2015 — or it may never change at all.
See also: PPACA contains possible PPACA 2.0 provision.
Republicans already have a broad consensus on what they want: to give consumers greater control over health-care spending and, as a result, the incentive to seek the most effective bang for their medical buck. A freer, more responsive market would, over time, improve consumer choice, increase quality and reduce costs — just as it does in other sectors.
Trouble is, the party’s broad consensus breaks down over precisely how much government intervention is necessary to realize those goals. The philosophical differences lead to policy conflicts.
For instance, many Republicans support allowing individuals to buy health insurance with pretax dollars, whether they purchase it on their own or through their employers. Creating a standard tax deduction for this wouldn’t require new spending, but it would have limited value to low-income consumers who have little or no income-tax liability.
That’s why other Republicans support providing age- or income-based refundable tax credits, which would provide a set amount of money for purchasing health insurance — even to those who don’t owe taxes. Such credits would better expand coverage, but they would also cost more.