Now, however, Kentucky senator Rand Paul may have come up with a proposal that could offer a way out of the political corner Republicans have been painting themselves into. From the start, Paul has argued against proposals to set a sunset date for Obamacare today and come up with a replacement later. Paul wants to repeal Obamacare root and branch, of course, but he also wants Republicans to offer a replacement plan on day one. Democrats may block it, but then the political fallout will be on them.
Paul’s proposal draws liberally from the best ideas in other Republican plans, while avoiding many of the pitfalls that make some of those plans unworkable. He would, for example, dramatically expand health savings accounts (HSAs). HSAs shift control of health‐care spending from employers to employees. Paul’s expansion would allow much larger tax‐free contributions to these accounts, and would allow them to be used for a wider variety of health‐related expenses, including insurance premiums. That would mean that you — not your boss — would be able to choose your insurance plan. Expanded HSAs would also mean increased portability for health insurance. Because you could use your HSA to pay your premium, you wouldn’t be as likely to lose your insurance if you changed or lost your job.
This would replace many of the subsidies in Obamacare without the dangers of government‐designated insurance inherent in some of the tax‐credit proposals that some Republicans have backed. (If the government offers a credit for insurance, it has to define what insurance qualifies for the credit.)