If folks who watched Thursday night’s Republican presidential debate were expecting the candidates to tell us what they’d do to replace Obamacare if they could get rid of it, those folks would have been disappointed.
In fact, the 10 candidates who are currently leading the polls said so little about health care during their two hours on stage that one has to wonder if they’ve given any thought to an Obamacare alternative. They haven’t.
The only ones who uttered more than a sound bite about health care were Ohio Gov. John Kasich, who explained why he expanded his state’s Medicaid program with Obamacare money, and Donald Trump, who claimed that even though he’d said good things about the single payers systems in Canada and Scotland, he preferred a “private system” for the U.S. “without the artificial lines around every state.”
Wisconsin Gov. Scott Walker, former Arkansas Gov. Mike Huckabee and Sen. Marco Rubio all noted that they would work to repeal the Affordable Care Act, but made no mention of what they would replace it with. Huckabee contended that the Social Security program had been “robbed” to pay for Obamacare, but he didn’t offer an explanation.
Trump’s mention of artificial lines around states apparently was a reference to the fact that many health insurers sell coverage in only one state. Ever since the Affordable Care Act was signed into law five years ago, many Republicans have said that one of the first things they’d do if they ruled Washington would be to allow insurers to sell policies across state lines.
It sounds like a swell idea, and inevitably leads to suspicion that the federal government is somehow making it impossible for insurance companies to do that. But that’s not the case. Obamacare actually contains a provision that would facilitate the sale of coverage across state lines. Starting next January, in fact, states can form compacts with each other to encourage insurers to sell their policies in multiple states.
What the GOP seems to want to do is the opposite of what the party normally espouses: that the federal government should stay out of the states’ affairs as much as possible. What Republicans apparently desire is to have the federal government force the states into allowing insurers licensed elsewhere to sell whatever they want to sell in every state—regardless of the individual states’ laws and regulations. A lot of state lawmakers and regulators don’t like that idea at all. It essentially would take away their ability to set their own standards for insurance company solvency as well as for the adequacy of the plans out-of-state insurers might want to sell.