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The elusive GOP alternative on health care

Associated Press

The Washington Post's Jennifer Rubin doesn't criticize congressional Republicans often, but last week, she called congressional GOP leaders "weak" when it comes to offering detailed policy proposals, especially in one notable area. "Where is the market-based health-care plan?" she asked, adding, "Without it, [Republicans] weaken their own case against Obamacare and give the president the opportunity to say they've got no alternative."

The Associated Press also picked up on the absence of a GOP health care plan the other day.

Three years after campaigning on a vow to ''repeal and replace'' President Barack Obama's health care law, House Republicans have yet to advance an alternative for the system they have voted more than three dozen times to abolish in whole or in part.

Officially, the effort is ''in progress'' -- and has been since Jan. 19, 2011, according to, a leadership-run website.

But internal divisions, disagreement about political tactics and Obama's 2012 re-election add up to uncertainty over whether Republicans will vote on a plan of their own before the 2014 elections, or if not by then, perhaps before the president leaves office, more than six years after the original promise.

The AP quoted Rep. Fred Upton (R-Mich.) saying his caucus will "have a replacement bill ready" just as soon as they're done destroying the Affordable Care Act -- which is to say, never.

Rep. Steve Israel (D-N.Y.), the DCCC chairman this cycle, added, ''Every voter knows what Republicans are against. They don't know what they're for'' on health care.

And while I'm generally sympathetic to that argument, it's not entirely correct. Most of the political world has forgotten about this, but in the summer of 2009, congressional Republicans swore that they would produce their own health care reform plan and present it to the public for scrutiny.

In November 2009, GOP leaders actually delivered on this promise and released the Official Republican Health Care Plan. Why doesn't this sound familiar to you? Because it was a spectacularly awful proposal that even GOP lawmakers hoped you wouldn't hear about.

As we talked about a year ago, congressional Republicans missed a series of self-imposed deadlines in 2009, before throwing together a half-hearted joke -- the GOP "policy" largely ignored the uninsured, did nothing for those with pre-existing conditions, and offered nothing for those worried about losing coverage when it's needed most.

We learned shortly after the Republican plan was defeated that the proposal included provisions that mirrored "the suggestions put forth by the lobbying entity of the private insurance industry way back in December 2008." Imagine that.

As Matt Yglesias noted at the time, the Republican approach to reform sought to create a system that "works better for people who don't need health care services, and much worse for people who actually are sick or who become sick in the future. It's basically a health un-insurance policy." And as ThinkProgress added in 2009, the CBO crunched the numbers and found that the Republican alternative would leave "about 52 million" Americans without access to basic medical care.

Pressed for some kind of alternative to Obamacare, this was the best congressional Republicans could do.

And here's the punch line: in July 2012, Tom Brokaw asked House Majority Leader Eric Cantor (R-Va.), "[W]hen will we see a Republican plan that would replace more meritoriously the Obamacare plan that you're so unhappy with?" Cantor replied, "Tom, you knew back in 2009 when the Obamacare bill was being considered on the House floor, we put forward our alternative. So to sit here and say we don't have a replacement is not correct."

In other words, the demonstrably ridiculous reform "plan" that Republicans were embarrassed by in 2009 was still considered Eric Cantor's go-to replacement for Obamacare as recently as a year ago.

So the point isn't that GOP lawmakers can't come up with a health care plan; the point is they can't come up with a good health care plan.

And why not? Because to address a problem like this one -- a dysfunctional health care system that costs too much and covers too few -- requires government spending and government regulation. There's just no way around this simple truth. So Republicans have faced a straightforward question for the last several years: do they (a) address a national problem that prevents millions of Americans from receiving affordable health care and literally bankrupts countless American families; or (b) stay inside their ideological comfort zone.

Take a wild guess which option they prefer.