The Health Reforms the G.O.P. Should Embrace (but Probably Won’t)

By backing a flimsy, state-initiated lawsuit to throw out the entirety of the Affordable Care Act, President Trump has made himself and Republican candidates in 2020 vulnerable to attacks that they want to take health insurance away from millions of people.

The president compounded the problem by saying Republicans are going to become the party of health care without having any plan, let alone a coherent proposal that would produce better results and could get through Congress. Republicans are now deeply divided on what should be done, and the president is no help in setting a course for the party.

Yet not all is lost on the issue for Republicans. Many Democrats, by rushing toward a single-payer Medicare for All plan, are being pulled along by ideological yearnings instead of practical realities. Medicare for All would upend all current public and private insurance arrangements, including employer coverage for about 180 million people. Further, even the sponsors admit these plans would require significant middle-class tax increases.

What that means is that the door is open for a responsible Republican plan to improve the nation’s mixed public-private health system. If the party’s leaders were so inclined, they could take advantage of the Democratic overreach by embracing reforms that would build upon what exists and make it work better. Such a conservative reform plan would look something like this: