“Republicans have proposed dozens of (health care) solutions designed to help control costs and improve quality.”
— Sen. Ron Johnson, R-Wis., Nov. 17 in the weekly Republican address
As Republicans continue to score points bashing the early struggles of President Barack Obama’s health care law, the common refrain from Democrats is to claim their GOP counterparts lack an alternative. It has fit neatly into their characterization of Republicans as the party of “no.”
For their part, Republicans have consistently said that’s not the case.
“Throughout the health care debate, Republicans have proposed dozens of solutions designed to help control costs and improve quality — without surrendering control of your personal health care decisions to nameless bureaucrats in Washington,” U.S. Sen. Ron Johnson, R-Wis., said during the Republican national address Nov. 17.
The question of how Republicans would replace Obamacare has come up before, and it will remain a major part of the argument over the law’s future throughout the 2014 midterms. There’s a big difference between no solutions, as Democrats surmise, and dozens, as Johnson claims. So who is right? We decided to investigate.
How we got here
We asked Johnson’s office to provide evidence of the “dozens of solutions” Republicans have put forth. His staff sent us a list of 24 Republican proposals released over the years, starting with President George W. Bush’s call for health reforms in 2007.
At this point, let’s pause for some important political and parliamentary realities.
In 2009 and 2010 when the health care law worked its way through Congress and onto Obama’s desk, Republicans were in the minority in both the Senate and House. During the initial debate, Republicans circulated many ideas and put forth many bills. None of them gained enough support within the GOP to become a clear conservative alternative to Obamacare, and even if they had, it was unlikely Democrats would go along.
Republicans had even less interest in capitulating with Democrats and working with them on the Affordable Care Act. Not a single Republican voted for the final version.
We reviewed the list of legislation Johnson’s office sent us. With a handful of exceptions, the bills are partial or full retreads of each other and share similar ideas. Some actually include provisions of Obamacare, such as allowing young people to stay on their parents’ plans or making it harder for insurance companies to drop people with pre-existing conditions.
Johnson’s camp said the Republican senator doesn’t necessarily support all the proposals, but they show that Republicans have been active players in the debate.
We reviewed Johnson’s list of 24 proposals. We found the ideas in them tend to fall along the following six lines: tax incentives, allowing insurance companies to sell policies across state lines, changes in tort law, health savings accounts, creation of high-risk pools and allowing trade associations and small businesses to buy insurance as a group. (PolitiFact goes into greater detail about each of these approaches online at www.politifact.com/truth-o-meter/statements/2013/nov/26/ron-johnson/johnson-said-republicans-have-proposed-dozens-solu/.)
While some of these proposals could shift the cost curve down, nothing we came across would directly affect quality of care, as Johnson claimed. We ran the list by a panel of experts as well, and many of them agreed.
“Johnson may be exaggerating a bit numerically, but the more important point is that the Republican plans would do next to nothing to improve quality, extend coverage or control spending growth,” said Henry Aaron, a health policy expert at the Brookings Institute.
William Dow, a professor of health care economics and head of the University of California-Berkeley Division of Health Policy and Management, largely agreed. “There is little here that would improve quality,” he said. “Some could have minor effects on controlling costs.”
Our ruling
Johnson said, “Republicans have proposed dozens of solutions designed to help control costs and improve quality” of health care in the United States. Republicans have circulated quite a few bills and ideas over the years, but there is almost nothing in most of the GOP proposals that directly addresses quality of care.
As far as costs, most of the proposals have winners and losers. Some of the bills would make health care more affordable for certain individuals, and changes in tort law and the expansion of health savings accounts could bend the cost curve down slightly. Elements of Johnson’s claim are at least partially accurate, but in the aggregate, the plans are far from substantial. We rate his statement Half True.
