Leavitt has been an outspoken proponent of creating insurance exchanges: Marketplaces where small businesses could shop for insurance plans. If you follow health policy, then you can guess why conservatives upset: The Affordable Care Act also calls for the creation of exchanges, as part of its scheme to make insurance available to all. Leavitt happens to have a financial stake in the creation of exchanges and he was an advocate for cap-and-trade while serving as administrator of the Environmental Protection Agency, also during the Bush Administration. The combination has drawn the ire of such prominent conservatives and libertarians as Ben Domenech, Philip Klein, and Michael Tanner. The editorial page of the conservative Washington Examiner called Leavitt's place in the Romney heirarchy a "red flag."
But why should exchanges arouse concern from conservatives? The point of creating an exchange is simply to create a buyer's club, so that individuals and small businesses can get the same kinds of group pricing that large businesses get. Utah happens to be one of two states that have functioning exchanges and, as Politico's Jason Millman notes, Leavitt has frequently referred to Utah's exchange as a good model. But it's far more minimalist than the one Romney's law created in Massachusetts or that the Affordable Care Act calls for other states to develop. The Utah exchange doesn't have all the regulations on insurers and it doesn't have the huge subsidies for people and businesses that can't pay for insurance on their own. It doesn't deliver universal coverage or anything close to it. It just lets small businesses pool their resources.
It doesn't matter precisely because the Republicans are now locked into and dedicated solely to the destruction of laws that have been passed, particularly (but not limited to by any means) President Obama's legacy. Replacing those laws are somebody else's problem, because that would be "governing". Republicans don't do that, they focus on "winning". It's worked rather well for them as of late, too. Not so well for the country, but hey.
The consensus was already eroding by the 1990s, when Newt Gingrich famously called for letting Medicare "wither on the vine." But the consensus still had power as recently as the last decade, when the Bush Administration created Medicare Part D. That program gave seniors prescription drug coverage, as liberals had long advocated, but it offered less generous benefits than liberals wanted and channeled coverage through private insurers rather than government. (It also didn't pay for itself, but that has frustrated liberals as much as, if not more than, it has conservatives.)
It's hard to imagine today's Republicans endorsing anything like Part D. And that's a significant shift. Conservatives never liked left-wing, government-run solutions to problems like unaffordable health care and climate change. These days they don't seem to like right-wing, market solutions, either.
It's an intellectually honest point of view, to which they are certainly entitled. But it does make you wonder. Do they like any solutions at all? Do they even think the problems are worth solving?
No, Jon, they do not. A government-based solution would prove that government works. Today's Republicans don't see a problem unless it's affecting corporate profits or power, then it's about "freedom". Then we get a solution where government helps them and it's called a "free-market" solution. That's it. The GOP cares about taking what they can from the treasury and leaving the rest of us to rot.
End of story.
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