But now, Republicans have all of Congress. If they want to replace Obamacare, they can. And on Wednesday, they took a step in that direction. With little fanfare, Sens. Orrin Hatch of Utah, Richard Burr of North Carolina, and Rep. Fred Upton of Michigan unveiled their blueprint for Republican health reform. Called the “Patient Choice, Affordability, Responsibility and Empowerment Act,” it is mostly identical to an outline released last year by Hatch, Burr, and now-retired Sen. Tom Coburn.
The consequences of the proposal are straightforward: By ending Obamacare in its entirety and placing limits on Medicaid, it would eliminate insurance for millions of Americans and make it harder for middle- and working-class people to purchase coverage. And while it’s described as a plan to save money, the truth is that it accomplishes this by reducing care for the poor and raising costs on everyone else.
In other words, this isn’t a plan to achieve universal coverage. That’s simply not a Republican goal, and it’s part of the reason it has proven politically difficult to craft an alternative. We don’t think everyone should have health insurance just isn’t an appealing message. Which gets to something important about this whole enterprise: The CARE Act is a blueprint. There is no legislation to score or any bill to debate. It’s just a package of ideas—one approach for when, or if, the party decides to pass a genuine alternative to Obamacare.
Put differently, it’s probably a dead letter.