Why There's No Room for Compromise on Obamacare

Common ground has repeatedly proved illusory in the health care debate. Republican Sen. Lamar Alexander and Democratic Sen. Patty Murray have struck a bipartisan deal to stabilize Obamacare’s exchanges, but it is turning out to be no exception to this rule. There’s a lot more in it for liberals than conservatives to cheer, and Republicans are keeping their distance accordingly.

Conservatives are supposed to get two wins. The first is the creation of “copper” plans within the Obamacare exchanges. Moderate Democrats have championed this idea as a way for consumers to buy plans with lower premiums and higher deductibles than others available on the exchange. But because the plans would still be subject to Obamacare’s regulations, they would still be a far cry from the low-cost catastrophic plans that conservatives would like to see on the market.

(Related: Lamar Alexander Keeps the Individual Health Rescue Fight Alive)

The deal also gives states a little more flexibility — but constrains that flexibility in a way that makes it valueless. States would have to show that any policy changes they make would lead to a comparable number of people having the same kind of comprehensive coverage that Obamacare seeks to foster. But that’s not the kind of coverage conservatives want to make the focus of public policy.

What conservatives generally favor is helping consumers choose from a menu of options that includes low-cost plans that protect people from the risk of major expenses related to medical care. These low-cost plans would not, however, help them to pay for routine medical expenses. The copper plans are close to the reverse of this goal, since they would cover routine preventive care (thanks to Obamacare’s regulations), but have deductibles so high that they would not protect against major expenses.