Is Obamacare a Conservative Law?

On Saturday, the New York Times published an op-ed by J.D. Kleinke in which Kleinke argues that Obamacare is a conservative approach to the health care system's failings and has a right-wing pedigree. The piece wouldn't be remarkable if not for the fact that Kleinke is a fellow at the American Enterprise Institute -- one of the premier conservative think tanks in Washington.

Predictably, Kleinke's piece has been received with outrage by some on the right. Dean Clancy, a health policy analyst at the conservative organization Freedomworks, rejects Kleinke's thesis entirely, and asks if AEI is "fully committed to the side of freedom." The Cato Institute's Michael Cannon calls Kleinke's piece "nutty," and challenges the premise that Obamacare is fashioned after right-wing ideas. James Capretta, an AEI colleague of Kleinke's AEI, writes that Kleinke "either doesn’t understand Obamacare and the conservative case against it, or has willfully distorted his descriptions of both to serve his case."

On the other side of the aisle, Don Taylor, a public policy professor at Duke, thinks that Kleinke is right, and that the right's opposition to Obamacare "has always been oversold on policy terms and has been mostly about politics." Taylor notes that some of the right's health experts, including Capretta, have put forward credible alternatives to Obamacare, but none that could clear the bar of passing both the House and getting 60 votes in the Senate. Since Taylor thinks the Republicans' plans of repeal (much less replace) are unlikely, he concludes the GOP will have no responsible choice but to accept the reality of Obamacare and cut a deal on lowering system-wide costs.

Separately, but relatedly, the right-of-center Reihan Salam argues in a Reuters piece that voters do face a choice regarding health care costs. One option is a McCain 2008-style reform that equalizes the tax treatment of employer-provided and individually-purchased insurance. The alternative, Salam writes, is to "wind up with stringent bureaucratic price controls as [Obamacare]’s subsidies prove unaffordable. In light of the conservative failure to actually make the case for a market-friendly solution, the latter outcome is looking ever more likely." So Taylor and Salam agree that the most likely outcome is cost-cutting through Obamacare, although they disagree about the wisdom of taking that path.