A Brief History of Health Care Reform, à la GOP

In a word, visionless.

1994: GOP stops Hillarycare (with pivotal help from centrist Dems).

1996: GOP passes Dems’ HIPAA bill.

1997: GOP passes Dems’ SCHIP bill (though thankfully not Dems’ Medicare-for-kids plan).

1997: GOP cuts Medicare spending (BBA-97).

1998-2002: GOP increases Medicare spending (BBA-97 givebacks).

1998-2002: GOP stops Dem priorities: Patients Bill of Rights (PBOR), Rx reimportation, Medicare Rx benefit.

2003: GOP passes Dems’ Medicare Rx benefit (albeit in a superior form) and passes HSAs (an actual gain!).

2010: GOP fails to stop Dems’ ACA bill, which is the evil child of Hillarycare and Romneycare and includes a massive, unnecessary Medicaid expansion plus parts of the old PBOR plus IPAB (bureaucratic rationing) plus costly and unnecessary mandates like under-26, guaranteed issue, and community rating (price controls) plus a passel of Hillarycare’s ugly step-siblings like the CLASS Act and the Cadillac tax. In short, the Year of Disaster.

2010: GOP retakes the House, campaigning on repeal-and-replace.

2012: GOP repeals the CLASS Act (with help from Dems, who concede it’s unworkable).

2014: GOP retakes the Senate, campaigning on repeal-and-replace.

2016: GOP retakes the White House, campaigning on repeal-and-replace.

2017: GOP fails to repeal-and-replace, and appears to lose enthusiasm for doing so. While it does manage to repeal the ACA’s individual mandate and IPAB, and postpone the Cadillac tax, it fails to repeal Obamacare’s insurance mandates or do anything to reduce health care costs. Also no progress on efforts to expand HSAs, or promote direct-payment, or protect insurance alternatives like health care sharing and direct primary care. The Year of Inexplicable Failure.

2018: ???

Dean Clancy, a former senior official in Congress and the White House, writes on U.S. health reform, budget, and constitutional issues. Follow him at deanclancy.com or on twitter @deanclancy.