Why Won’t Republicans Help Reform Obamacare?

The obvious answer is that Obama created it – and they’re that petty. But it is based in many parts on a moderate Republican idea – the kind of market-friendly, private-sector-based reforms that George H W Bush and Mitt Romney backed (not to speak of Heritage, which has gone from providing some of the core features of the ACA to screaming like a rabid wolf at the moon). The ACA is much more conservative than Nixon’s healthcare vision or Clinton’s. Beutler notes the many ways the GOP could usefully fix some of the inevitable problems that will emerge:

We could reduce the impact of cross-subsidization on young, healthy people by making subsidies more generous or stretching the age band or loosening minimum essential coverage standards or some combination of the three.

Barro is on the same page:

Adrianna McIntyre calculates that there are about 7 million Americans aged 18-64 who have incomes over 400% of [Federal Poverty Level (FPL)] and who are uninsured or insured through the individual market. That’s less than 3% of the population. Of these, just 1.5 million are 35 or younger; the older members of the group are not as likely to be made worse off by new insurance rules.

If Republicans were interested in working with Democrats to improve Obamacare and reduce the economic distortions it creates, they could fix this group’s problem.

For example, they could restrict the value of the tax exclusion for employer-provided coverage (shrinking a needless tax benefit for rich people like Sen. Ted Cruz) and use the savings to extend the subsidy range above the 400% of FPL mark.Reforms like this, needless to say, are not high on the Republican policy agenda.

Jonathan Bernstein calls the GOP a “post-policy” party:

It’s not just failure to, say, draft an alternative to the Affordable Care Act. It’s also about refusing to distinguish between aspects of the Affordable Care Act they really hate and those which they only mildly dislike (or, if they were really honest, those they actually support). Even if you want to compromise, it’s almost impossible for negotiations to work (what Greg called “the normal give and take of governing”) if you can’t make those kind of decisions.

They’re just increasingly uninterested in governing. But the GOP’s golden era under Reagan followed a burst of intellectual, wonkish energy at the granular level. Just think of what Policy Review used to put out. There was so much interest in policy you were almost overwhelmed by rightwing wonkishness. Now? Pure rhetorical vacuity. The decline and fall of Heritage is a micro-cosm of a macro-implosion of constructive, reformist conservative thought and analysis.