EDITORIAL: Not what the voters ordered

March 20--A recent poll of 1st Congressional District voters suggests they aren't nearly as eager to repeal Obamacare as House Speaker Paul Ryan might believe, at least if the replacement involves millions of people losing their health care coverage.

Only 37 percent of 1st Congressional District voters said they support the Republican health care plan, compared to 46 percent who oppose it (16 percent are not sure). The poll was conducted by a Ryan opposition group and for that reason must be treated skeptically, though it was conducted scientifically and by a reputable firm, Public Policy Polling. The results weren't decidedly anti-Ryan, either, as the poll showed more voters had a favorable opinion of Ryan, 49 percent, than viewed him unfavorably, 44 percent.

Many Republicans reading the 2018 tea leaves believe they must deliver on six years of promising to "repeal and replace" or risk a bloodbath at the polls on Election Day, but this assumes they won't face a larger disaster if they implement something worse than Obamacare.

Perhaps the biggest problem with the Republican replacement plan is not that it fails to advance either conservative or liberal aims--it's simply impractical. It would shift some costs from the federal government to those least able to afford health care but without substantially driving down costs for the rest, while substantially increasing costs for some, older Americans in particular.

In a column Saturday, Sam Wilson, director of AARP Wisconsin, notes that the Republican proposal would hit hardest people in their 50s and 60s. Their insurance premiums could rise as much as $8,400 a year, which could force many older Americans into buying catastrophic insurance plans with gigantic deductibles when what they really need is comprehensive health care.

Ryan has long touted himself as a devotee to free market principles, but the Republican proposal seems like a case of political expediency. It sidesteps conservative calls to refashion health care into a consumer-driven enterprise, and instead of injecting transparency into the health care process, it would keep in place a monopolistic system catering to the wants of large health insurance companies and health care providers, ultimately leaving these two entities in control of deciding which services to provide and cover and at what price.

The Republican plan largely preserves Obamacare, except that it eliminates safety nets for many people, either by reducing subsidies or cutting off the most vulnerable from critical services, such as women's reproductive health care at Planned Parenthood. The proposal's greatest attribute, reducing the deficit by $337 billion over 10 years, is a hollow victory because the reduction comes from curtailing access to health care, not by creating a more dynamic marketplace.

For directing so much ire at Obamacare the past six years, Republicans have devised a solution that does surprisingly little to truly reform the health care system. If the poll of 1st Congressional District voters is any kind of indication, Republicans shouldn't assume their voters are fixated on repealing Obamacare. What comes next, after Obamacare, will prove just as important.

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