NCPA - National Center for Policy Analysis


August 17, 2009

Two interesting GOP proposals, so far not adopted by party leaders, have been offered from opposite ends of the Republican ideological spectrum -- conservative and moderate.  They differ in one major way.  Conservatives would end employer-based health care, while moderates would keep it.  But both are aimed at using free-market competition to lower costs and make private insurance more affordable to businesses and individuals, says Morton Kondracke, executive editor of Roll Call, the newspaper of Capitol Hill.

The conservative health care proposal has been offered in the House by Rep. Paul Ryan (Wis.) and in the Senate by Richard Burr (N.C.) and Tom Coburn (Okla.).  The moderate plan has been proposed by Reps. Mark Kirk (Ill.) and Charlie Dent (Pa.) and reportedly will form the basis of a full-blown GOP alternative developed by the GOP Health Care Solutions Group headed by Rep. Roy Blunt (Mo.), but not yet unveiled.

  • The Ryan-Burr proposal would allow employees to opt out of their employer-based insurance plan and get a $5,000-per-family tax credit to buy health insurance or pay medical bills.
  • It would also allow individuals and businesses to form pools and buy insurance anywhere in the country, not just in the state where they live.
  • This will greatly expand the choices of coverage available to consumers and will also encourage broader competition and diversity among insurers, says Ryan.
  • Along with practically every other plan, Democratic and Republican, the conservative plan would require insurance companies to offer insurance regardless of a person's pre-existing medical condition.


  • Kirk and Dent's Medical Rights and Reform Act is designed to lower the cost of insurance policies through legal reform -- which will reduce the expensive practice of "defensive medicine" -- and also create interstate pools.
  • The average cost of insurance in states like California, which have limits on medical malpractice awards and allow large-scale pooling, is less than half that in lawyer-friendly states like New Jersey, says Kirk.

Both the conservative and moderate plans would allow low-income Medicaid patients to get vouchers to buy private insurance and encourage states to experiment with insurance market reforms, says Kondracke.

Source: Mort Kondracke, "GOP has health care ideas. Why not fight for them?" Jewish World Review, August 14, 2009.

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