Party Like It’s 1989

Obamacare parties like it’s 1989…the Republican Party, that is.

You see, the premise of Obamacare, or the Affordable Care Act (ACA), is that everyone should have access to health care, and to accomplish this it requires 1) that insurers offer coverage to anyone regardless of health status and 2) everyone be required to have health insurance.  Somewhat ironically, these are the exact same premises of the 140-page plan for national healthcare reform that was laid out in 1989 and again in 1993 by the conservative Heritage Foundation.  At that time, this plan for reform was supported by a whole host of conservatives like Newt Gingrich, Orrin Hatch, and Chuck Grassley, all who vehemently oppose “Obamacare” today.

Anybody who has followed the health care reform debate has probably heard this story before but it bears repeating, especially in light of yet another recent round of attacks from opponents, because it illustrates how middle of the road the ACA actually is.  

The Heritage Foundation originally released its plan in 1989 as momentum for health care reform was growing.  Health insurance coverage had been dropping steadily for years while costs were going up steeply and there was a rising chorus of Democrats and liberals pushing for a national health insurance system similar to Canada’s.  It’s worth noting that this was back in the good old days when health care accounted for a paltry 11% of national spending or $2,000 per person per year, “more than the per capita GNP of many countries” as the Heritage Foundation put it.  Today, by comparison, about 18% of our GDP, over $8,600 per person per year (!!!!) is spent on health care.  If the Heritage Foundation described health care as “on the critical list and needs intensive care” back then, one can only imagine how it feels about it today. 

Fearing a move toward “socialized medicine,” growth of government, and rationing of care, the Heritage Foundation proposed a plan that would have required all American households to maintain at least a basic level of health insurance coverage while providing tax subsidies to low- and middle-income families who would have had trouble affording the insurance.  One of the expected impacts of the insurance requirement was a more robust individual, non-group market where health insurance companies would be forced to compete for consumer business which would help control costs.  The plan even included a provision to permit family health insurance plans to cover “non-traditional” dependents such as children over the age of 18 living away from home, for example kids in college. 

If you’re at all familiar with the basics of Obamacare, you’ll immediately recognize how nearly identical the cornerstones of the Heritage Plan are.  Granted, there are differences in the plans, the biggest being the Heritage Foundation’s stance against an employer mandate.  However, few of those who oppose Obamacare yet previously supported the Heritage Plan are claiming to do so on the basis of the employer mandate.

The principles of the Heritage Plan even had strong bipartisan support as recently as 2009, in the form of the Healthy Americans Act.  Formally known as the Wyden-Bennett Act, the Healthy Americans Act was first proposed in 2007 by Senators Wyden (D-Oregon) and Bennett (R-Utah) and was essentially a mirror image of the Heritage Plan, individual mandate and all.  In 2009, this bill had bipartisan support with 12 co-sponsors in the Senate, including seven Democrats and five Republicans.

In essence, a plan that was created specifically as the conservative alternative to a socialized medicine reform and was touted as pro-consumer/pro-business a few years ago is now being derided by many of the same people as socialist and anti-business. 

That’s politics for you.  Unfortunately, in this case, politics means the health and well-being of our citizens.  

UPDATE:  Wonkblog over at the Washington Post ran a similar blog on July 26th comparing a number of Republican plans to Obamacare over the years, including a counter-proposal from House Finance Committee Chair Paul Ryan with many surprising similarities to the ACA.  Check it out here: “Republicans had a plan to replace Obamacare. It looked a lot like Obamacare.

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