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Tue., Sep. 30, 2014
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Healthy GOP ideas

The following editorial appears on Bloomberg View.

Louisiana Gov. Bobby Jindal proposed an alternative to Obamacare this week. His blueprint follows on a plan from Sens. Richard Burr, Tom Coburn and Orrin Hatch in January. And in the weeks ahead, more such Republican proposals are expected to emerge.

Why, four years after the Affordable Care Act was passed, are Republicans now offering alternatives? It may be thanks to enrollment on the new state and federal insurance exchanges, which has rooted the law more firmly into the U.S. health-care system: Now it's suddenly harder for opponents to denigrate it without suggesting what would be better.

Jindal's plan includes two excellent ideas. The first is to let nurse practitioners and other medical professionals practice to the full extent of their abilities. This would drive down costs. Jindal also proposes ending the tax exclusion for employer- sponsored health insurance, an accident of history that encourages higher consumption of health care and makes it more expensive. Jindal wants to replace it with a tax deduction for all health insurance.

It would signal the end to the widespread practice of obtaining insurance at work. The status quo is peculiarly unfair. Americans with employer insurance get the benefit of a tax break while those who buy policies on their own do not.

The proposal from Burr and his colleagues also deals with the tax exclusion, but in another way - by limiting it to 65 percent of the cost of an average health plan. That, too, would be a big change, and it deserves consideration as a way to reduce spending.

Another good idea from Burr and company is to automatically enroll in health-insurance plans any Americans who are eligible for premium tax credits. With more than 30 million Americans projected to lack insurance even with Obamacare, further ideas to bring them into the market are needed.

Understandably, Democrats in Congress recoil at the suggestion that Obamacare should be repealed. But they shouldn't tune out Republican ideas to improve the law. Health care reform is a work in progress. Costs remain too high. And too many Americans still can't afford care. Good ideas for improving the law should be welcomed wherever they come from.


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