Republicans want to repeal ObamaCare -- but maybe they'd keep some of it

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Despite pledges by Republicans to take down ObamaCare, some still indicate there are parts in the president's controversial health care overhaul that could be preserved if the party ever got its wish of repealing the law.

Since the beginning, conservatives in Congress have been extremely vocal about their dislike of Obama's signature domestic policy achievement.

Yet, as demonstrated by a recent proposal from House conservatives, they say they wouldn't just repeal the law -- they would replace it with one of their own.

It wouldn't be ObamaCare. But there could be some similarities, items that despite the widespread public mistrust of the law have bipartisan support. Some combination of subsidies to help people buy insurance and consumer protections to help the sickest get care are recurring themes in any health plan, from either party.

Michael Gerson, former speechwriter for President George W. Bush, on Friday urged Republicans to start thinking along those lines -- of what kind of health care policy they could create, as opposed to simply how they'd tear down the existing one.

In a theoretical post-ObamaCare period, he argued in The Washington Post, a Republican plan should offer a universal credit to anyone who's not covered by a large employer. It should include protections for those without insurance from "catastrophic expenses."

Both ideas would be scaled-back versions of the subsidies and consumer protections currently offered in ObamaCare. The difference, Gerson writes, is that "Obamacare creates a powerful regulatory mechanism (the exchanges) that mandates comprehensive coverage" among other changes.
"Conservatives do not (or should not) oppose Obamacare because they want fewer Americans to receive health care," he wrote. "But making this clear requires an alternative that covers more people at a lower cost, without all the regulations, taxes and mandates of the current system."

Indeed, prior GOP pushes at health care reform show an overlap in ideas between the parties, and some now say that parts of ObamaCare would most likely show up in a Republican-penned plan.

"There is the politics of the moment -- whatever is out there will be attacked -- but if you take a step back, you see that there is a history of Republicans supporting ideologies parallel to what you see in the Affordable Care Act," David Kendall, a senior fellow for health and fiscal policy at Third Way, told

The law is not so dissimilar, Kendall said, to versions Republicans have pushed in the past, including a universal plan President Richard Nixon offered up at the end of his term.

According to a May 2012 Kaiser Health poll, popular provisions of ObamaCare favored by both parties include letting children stay on their parents' plans until they turn 26 and providing subsidies on a sliding scale to those who can't afford insurance.

Recently, Republican Study Committee Chairman Rep. Steve Scalise, R-La., called his party's counter-proposal a 180-degree turn from ObamaCare but a closer look shows some similarities.

The American Health Care Reform Act would use some long-standing conservative ideas for health care, like letting people buy insurance across state lines -- but also give tax deductions, as opposed to subsidies, to help purchase insurance.

The bill would not include what is perhaps the least popular element of ObamaCare - the mandate on almost everyone to obtain insurance.

"By default, the Republicans will have to use some of the things in the ACA," Kendall said. "They might repackage it but it would offer the same basic choices, subsidies to make coverage affordable and offer some guarantees."

One of the biggest selling points in ObamaCare -- as well as in the GOP proposal -- is the coverage of adults with pre-existing conditions. Under the ACA, insurers won't be able to turn down consumers who have a history of medical problems or charge them more for coverage.

Among the most hyped and hated parts of ObamaCare have been the exchanges, which are a centerpiece of the health reform plan. The exchanges are marketplaces where the uninsured go to purchase insurance. The rollout of the main exchange websites, though, has been plagued by problems since their launch on Oct. 1.

The experience would likely leave Republicans hesitant to try to recreate them if they ever were in a position to try their own plan. For now, though, the latest budget fight proved Republicans do not have the numbers or the leverage to repeal -- or replace -- ObamaCare at this point, and may have to wait until 2016 for their next shot at changing the balance of power.