One of the significant political setbacks during former President Donald Trump’s initial years in office revolved around the Republican Party’s handling of healthcare. While overshadowed later by the Trump administration’s responses to the pandemic, impeachments, and the events of January 6, it remains a crucial point to reflect upon.
Despite vehemently opposing the Affordable Care Act and vowing to “repeal and replace Obamacare,” Trump supported a rushed and disorderly Republican initiative to dismantle the healthcare law.
Confidence in the GOP’s healthcare plan waned, revealing a lack of readiness. Following the final dismissal by the late Sen. John McCain in the summer of 2017, the party largely retreated from the issue.
This was an error. Healthcare spending accounts for roughly 18% of the national GDP, weighing heavily on the minds and budgets of American families. Failure to proactively address healthcare issues could lead to voter repercussions, as evident in the 2018 midterms when Democrats capitalized on this void.
Trump recently hinted at a return to the fight against Obamacare via a TruthSocial post, highlighting the rising costs and inadequacies of the system. However, responses from senators representing diverse parts of the Republican coalition, including Susan Collins, Bill Cassidy, and J.D. Vance, reveal little enthusiasm among elected Republicans to revisit this battle.
Despite GOP fragmentation, discussions on enhancing the US healthcare system are occurring quietly, away from the glare of cable news. Thinkers like Avik Roy from the Foundation for Research on Equal Opportunity and Ed Dolan from the libertarian-oriented Niskanen Center are shifting the conversation away from Obamacare repeal towards developing future strategies – a pivot the GOP should embrace.
Two tracks are emerging for a Republican healthcare approach beyond mere rhetoric of “repeal and replace.” One track aligns with a 21st-century version of supply-side thinking, aiming to enhance consumer choices by increasing healthcare options. This strategy, rooted in classic conservative principles and market appreciation, calls for repealing policies hindering a supply-side approach.
High healthcare service costs result from anti-competitive behaviors by hospitals, drug makers, physicians, and health systems, favoring profits over fair competition. Policies like “Certificate of Need” laws limit competition and impede market efficiency, a relic that needs dismantling across more states.
Further impediments arise from fears of a physician surplus, curbing medical school enrollments, and lobbying by medical associations against broader roles for nurses and physician assistants.
Policymakers must advocate for greater competition by empowering skilled nurses and physician assistants while exploring increased medical school seats and easing entry barriers for foreign medical professionals.
Additionally, the Affordable Care Act accelerated hospital consolidations and anti-competitive behavior. Republicans, traditionally aligned with big business, are now critical of these entities’ stance on Covid-19 policies and culture wars.
Supporting bipartisan efforts to investigate merger effects should garner Republican support, even among the politically risk-averse.
The second track of Republican healthcare policy aims for a longer-term vision. Younger and more adaptable Republicans are seeking family-friendly healthcare solutions, recognizing that healthcare complexities and costs persist despite insurance coverage.
Simplifying the healthcare experience, especially billing and customer service, demands more assertive regulation—a stance that challenges the healthcare industry’s interests, posing a hurdle for many elected Republicans.
Despite challenges from status quo biases and influential industry groups, there’s a growing realization among younger conservatives that healthcare needs to be more accessible and understandable for American families.
Revamping America’s convoluted healthcare system requires significant reform, but political resistance, as seen with the Affordable Care Act, suggests a prolonged journey ahead.
For Republicans, reverting to mere Obamacare repeal rhetoric will likely result in political setbacks. Addressing healthcare challenges and offering viable solutions will be pivotal in alleviating the burden of healthcare for individuals and families.
