Louisiana Gov. Bobby Jindal isn’t leading in the polls like Scott Walker. He hasn’t raised as much money as Jeb Bush. He isn’t as celebrated a speaker as Ted Cruz or Marco Rubio. He doesn’t have a loyal libertarian following like Rand Paul or an evangelical base like Mike Huckabee.
If Jindal plays his cards right, however, he could wind up getting the Republican Party to think more seriously about Obamacare.
Yes, Jindal’s lines about radical Islam and assimilation tend to get the most media coverage. But Jindal is at the center of an ongoing internal GOP struggle over the Affordable Care Act.
Every Republican politician says they want to get rid of Obamcare. Some are even willing to risk a government shutdown to try to defund it. But the GOP’s whole message has long been “repeal and replace.”
Republicans are deeply divided on the question of how to replace Obamacare, and the truth is some don’t really care to repeal it. (RELATED: The Blueprint For Ending Obamacare)
Jindal brought this debate to the stage of the Conservative Political Action Conference, a D.C.-area event billed as the nation’s largest gathering of conservative activists.
“We must repeal every single word of Obamacare,” he said in his speech. “All of it. It was built on broken promises.”
Pretty standard stuff — until you get to his criticism of fellow Republicans. “Republicans are about to wave the white flag of surrender on Obamacare, and I’m here to tell them, we won’t stand for that,” he said. “It is time for them to govern the way they campaigned and get rid of Obamacare.”
“I don’t know about you, but I don’t remember during those campaign ads last November, I don’t remember them saying we’re just going to repeal the easy parts of Obamacare,” Jindal said, continuing to twist the knife. “This election wasn’t about getting a nicer office for Sen. Mitch McConnell, it wasn’t about keeping a bigger office for Speaker John Boehner, this election was about taking our country back and it starts by repealing Obamacare.”
Jindal has a point. Many times, Republicans will say they want to repeal Obamacare but keep the ban on denying applicants with preexisting conditions. Or the part where you can stay on your parents’ health insurance until you are 26. Or the Medicaid expansion. Or maybe even the Obamacare premium subsidies.
When Mitch McConnell debated his Democratic challenger last year, he implied that Kentucky should keep its health care exchange after Obamacare is repealed.
“[C]onservatives need to focus on truly conservative health reforms — and not merely a slightly-less-liberal plan,” Jindal wrote in a letter to Congress earlier this month.
So what’s Jindal’s plan? He would fully repeal Obamacare, including popular provisions like the preexisting conditions ban. Instead he’d give the states $100 billion to try to design health care programs that will cover riskier patients.
Jindal would scrap the employer tax preference and allow individuals to purchase health insurance with pre-tax dollars. He would cap Medicaid spending, move toward Paul Ryan’s premium support model for Medicare and allow the sale of health insurance across state lines.
The goal would be to build a genuine free market in health care, focused on cutting costs first. Jindal and his supporters argue that this is better than getting in a bidding war with the Democrats over how many people will be covered, a contest in which the Republicans can always be outspent.
Jindal’s plan has an obvious drawback: it would be disruptive to existing health care arrangements, failing the “if you like your plan/doctor, you can keep your plan/doctor” test responsible for much of the backlash against Obamacare. (Jindal argues that this is not the case, but there are good reasons to think otherwise.)
If Jindal’s Obamacare alternative doesn’t cover as many people and doesn’t offer deductions big enough to replace the lost subsidies, that could create powerful obstacles to the health care law ever actually being repealed.
How competitive should Republican replacement plans be with Obamacare on coverage? That’s a key question in the conservative health care debate.
The upcoming Supreme Court case that has could cost millions their subsidies has finally gotten Republicans thinking about these questions. Jindal is taking the next step and representing the party’s right flank.
W. James Antle III is managing editor of The Daily Caller and author of the book Devouring Freedom: Can Big Government Ever Be Stopped? Follow him on Twitter.