Obamacare supporters may be too busy celebrating the seven million enrollment number to have noticed, but Louisiana Gov. Bobby Jindal has released a plan to repeal and replace the law. Jindal’s plan doesn’t aim for universal coverage, which distinguishes it from some plans supported by some conservative wonks, but rather to reduce costs first and foremost. As Wonkblog explains, Jindal’s vision blends standard Republican health care ideas with others that have a bit more bipartisan support. Core provisions include block-granting money to the states to run their own Medicaid programs, extending the tax deduction employers get to all individuals, and premium support, which would give elderly Americans a subsidy to buy coverage from private insurers.Jindal’s is the second major ACA replacement idea we’ve seen, after the one advanced by Senators Tom Coburn, Orrin Hatch, and Richard Burr. Both show that at least some in the GOP realize that their party cannot just coast to victory on a “repeal Obamacare” platform. The proposals come not a moment to soon, as Ross Douthat points out:
We do know that there won’t be an immediate political unraveling, and that we aren’t headed for the kind of extremely-low-enrollment scenario that seemed conceivable just a few months ago, or the possible world where cancellations had ended up outstripping enrollment, creating a net decline in the number of insured. And knowing that much has significant implications for our politics. It means that the kind of welfare-state embedding described above is taking place on a significant scale, that a large constituency will be served by Obamacare (through Medicaid as well as the exchanges) in 2016 and beyond, and that any kind of conservative alternative will have to confront the reality that the kind of tinkering-around-the-edges alternatives to Obamacare that many Republicans have supported to date would end up stripping coverage from millions of newly-insured Americans.
The longer Obamacare is in place, the more important it will be for Republicans to coalesce around a compelling alternative to the ACA. With two plans out there now, the GOP is still in the very beginning stages of the kind of policy ferment that could lead to that kind of consensus. But the sooner it gets there, the better it will do.