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Jeb Bush’s Plan to Repeal and Replace Obamacare Offers Both ‘Tricks’ and ‘Treats’

The opinions expressed by columnists are their own and do not necessarily represent the views of

Republican presidential candidate and former Florida Gov. Jeb Bush took to Twitter on Oct. 15 to tout his newly released policy outline for repealing and replacing the Affordable Care Act (ACA). Like many of the other policy proposals offered by Bush, his plan to send Obamacare to the grave includes both ‘tricks’ and ‘treats’ that will leave conservatives in his party unsatisfied.


Bush’s proposal includes a number of goodies for free-market health care advocates. First, Bush aims to end some of ACA’s highly unpopular mandates. “No employer mandate, no employee mandate, no mandated benefits,” promised Bush to a crowd of supporters in Iowa.

Second, Bush would hand back much of the regulatory power to the states, allowing each one to determine for itself the best way to tackle local health care concerns, including giving states the power to keep existing health insurance exchanges or remove them entirely. The plan also promises to put caps on federal payments to the states.

Third, Bush would help individuals without employer-based health insurance purchase health insurance plans by providing tax credits based on age—as opposed to an income-based credit—and expanding contribution limits for health savings accounts (HSAs) up to $6,550 for individuals, which Bush says could be used to cover growing out-of-pocket expenses. This would effectively double the current limit placed on HSAs today.

Fourth, the proposal, in vague terms, promises to enhance innovation, alter or replace regulations imposed on the health care industry by the Food and Drug Administration, “facilitate transparency on costs and outcomes,” and limit damages in medical malpractice lawsuits. Bush also wants to allow small businesses to make tax-free contributions to individual, portable plans given to their workers.


Bush says the focus of his plan is to help every American afford, at the very least, a catastrophic health insurance plan and then let individuals (or their employers) determine how much more they would like to pay for additional benefits, a model many conservatives have espoused over the past six years.

Although Bush’s repeal and replace effort offers many positive reforms of the ghoulish Obamacare system that has kicked millions of Americans out of health insurance plans they liked and created countless regulatory nightmares that have kept small business owners up at night, there are many parts of Bush’s proposal that will likely frighten away conservative Republicans still looking to rally around one nominee in a crowded field of presidential contenders.

Bush’s plan would retain several important Obamacare provisions, including allowing children to remain on a parent’s health insurance plan until age 26. Bush would also keep Obamacare’s coverage guarantee provision for Americans with pre-existing conditions.

One part of Bush’s health care reform platform that’s sure to receive pushback from many conservatives is his plan to cap the value of the deduction allowed for high-quality employer-based insurance plans, a move many analysts say will have a similar effect as the Cadillac tax, one part of Obamacare virtually all Republicans and many Democrats now oppose. However, Bush’s cap is higher than the current, highly unpopular Cadillac tax threshold. The cap for individual plans would be $12,000, and the cap would be $30,000 for families.


Bush’s plan deserves praise for promoting innovation, removing onerous Obamacare regulations, and putting more power into the hands of states—precisely where it should be. However, Bush’s health care reform proposal still leaves a lot to be desired.

Bush’s proposal doesn’t appear to offer the ability to purchase health insurance across state lines, one of the most popular conservative reform ideas that’s already been suggested by many of his GOP competitors, including Sen. Marco Rubio (R-Fla.) and Louisiana Gov. Bobby Jindal (R). Bush’s plan also fails to address the significant shortage of primary care doctors or the exploding debt held by medical students, both of which greatly contribute to rising health care costs.

Perhaps most importantly, Bush’s focus on government-created health insurance tax breaks is, as Jindal once said about similar proposals, “Obamacare lite.”

Although Bush’s plan does limit the role of the federal government in the health care industry compared to the monstrous, Frankenstein system put into place under the Affordable Care Act, it still maintains a great deal of centralized power for bureaucrats in Washington, DC, and it’s not difficult to imagine how Bush’s system could easily be transformed by future presidents into a system that closely resembles the disastrous one in place today.


Successful health care reform would fully embrace free-market principles, and Bush’s plan falls well short of that. It’s an improvement over Obama’s failed system, but it’s still a government-focused plan that refuses to exorcise the big-government demons that have prevented the United States from entering an era of unprecedented innovation that is well within the nation’s reach—but only if zombie bureaucrats and regulators get out of the way.


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