Wisconsin governor and vanilla pudding made flesh Scott Walker is going through a bit of a slump in his campaign for the White House. After a debate performance that had all the pop and energy of a funeral, Walker’s poll numbers took a dive, both nationally and in Iowa. Then he alienated fiscal conservatives and Tea Party types by signing off on a new taxpayer-funded stadium for the Milwaukee Bucks. Walker needs something new and exciting to drag him out of this rut, so this week he’s going to try to recapture the affections of his party by taking direct aim at the one thing conservatives and Republicans hate most: Obamacare.
On Friday, National Review published an op-ed by Walker in which he ran through all the boilerplate Republican criticisms of the Affordable Care Act and also promised that he’ll reveal his Obamacare replacement plan this week. The grand unveiling is apparently going to happen Tuesday at a speech in Minnesota. We don’t have the details yet, but going by what Walker wrote in his op-ed, it sure seems like he’ll be pitching some variety of the Republican healthcare unicorn: a plan that covers more people than Obamacare, costs less than Obamacare, has no mandates and regulates no one.
In the op-ed, Walker writes that his health plan will not do many of the things that Obamcare does: he rails against “too much government interference” and “mandates that harm workers, businesses, and the economy.” He complains that Obamacare “taxed and regulated innovation out of the health-care industry" and inveighs against “out-of-control premium increases” (using Heritage Foundation data for a handful of states). “In recent years,” he writes, “hundreds of thousands of workers may have seen their hours cut thanks to Obamacare’s destructive incentives.” May have! That’s a slippery bit of weasel-wording – Walker can’t demonstrate that this happened (because it hasn’t) so he just puts it out there as a frightening possibility.
The thing to understand about Obamacare is that it engages with the reality that reforming the healthcare system requires a series of trade-offs. Americans above a certain income threshold are now mandated to purchase insurance, but to help meet this mandate they are provided subsidies. Insurers must abide by certain regulations – they are no longer allowed to deny coverage to the sick – but the individual mandate helps cover those costs by impelling healthy people to purchase plans.
Walker doesn’t seem interested in this reality. Instead he’s talking about eliminating mandates and eliminating regulations while boosting coverage and “lower[ing] the burden on taxpayers.” Basically, he’s promising all good things and nothing bad. He endorses coverage for preexisting conditions but rejects Obamacare’s approach of simply requiring insurers to cover them. I’m anxious to see what alternative he has in mind, though I suspect it’s the go-to Republican fallback of federally subsidized high-risk pools in each state (an idea that tends to meet resistance from conservatives when they hear how well-funded those pools have to be in order to work).
This desire to produce healthcare legislation that meets every item on the conservative wish list is an all-too-common feature of Republican policymaking – or rather, lack of policymaking, given that the party has conspicuously failed to craft a piece of legislation that satisfies all these competing needs.
So what can we expect from Walker on Tuesday? I tend to take a cynical view of these things, so my guess is that he’ll serve up yet another rearrangement of what is now the familiar smattering of Republican health policy ideas: selling insurance across state lines, tort reform, health savings accounts, and, yes, high-risk pools. We can also expect Walker to propose some ill-considered “reforms” to Medicaid. He adheres to the mistaken assumption that people are on Medicaid because they either can’t find a job or refuse to work, and he supports block-granting the program, which would drastically slash Medicaid’s overall budget.
But whatever Walker ends up proposing, at least he’ll have a plan. Ask the other Republican candidates what they intend to do after they repeal Obamacare, and chances are excellent you’ll hear a variation of “something.” Donald Trump has an idea for “something terrific.” Jeb Bush envisions “something that doesn’t suppress wages and kill jobs.” Walker is at least threatening to get specific, and even if he stays true to his terminally dull nature and blurps up a bland mish-mash of Republican health policy proposals, he’ll nonetheless be ahead of the pack.