I recently wrote about the unconstitutional alternative to Obamacare rolled out by Republicans late last month, pointing out as soon as GOP leadership uttered the word “replace,” it was clear Republicans had no intention on taking a constitutional route.

Even worse, the plan presented by Rep. Paul Ryan turned out to be nothing more than a Republican version of the same old unconstitutional insertion of the federal government into American’s healthcare that we got from the Dems.

The next day, Reason.com writer Peter Suderman published a column echoing many of the same concerns.

“As it turns out, the health care policy that Republicans might pursue looks, well, a lot like Obamacare—except, possibly, worse.”

The Republican plan does “repeal” Obamacare. Additionally, it replaces it with a plan featuring many of the central components of the Affordable Care Act. including preexisting coverage rules, subsidies for the purchase of insurance and even an (implicit) mandate. Suderman explains how the Republican proposal would force Americans into the federal healthcare program with a nudge instead of a shove.

“The GOP plan would also create a kind of an insurance mandate. While there’s no rule requiring people to maintain coverage or pay a fine, the existence of tax credits ends up pulling everyone into the system anyway, by essentially declaring that everyone who does not maintain qualifying coverage has to pay more in taxes.”

Granted, the Republican proposal does have some positives, including expansion of health savings accounts. But it still looks and smells a lot like the massive federal intervention in healthcare we go with the Democrats, the only difference being it comes with a GOP spin. Suderman makes a poignant observation.

But what this plan, as with the plans released by GOP presidential candidates last summer, demonstrates most is an inability to move substantially beyond the framework established by the Affordable Care Act.

The Republican plan to repeal and replace Obamacare, then, is to repeal the law and replace it with something that isn’t an exact Obamacare clone, but works from many of the same principles, modified to Republican preferences. Maybe that’s not too surprising, given that Obamacare was, after all, based on a Republican idea.

In any case, it’s clear that Republicans have become trapped by Obamacare, their policy imaginations and political inclinations limited by the president’s health law and the world it has created.

In other words if you were expecting some Republicans to ride into Washington and save you from Obamacare, that was your first mistake. We can’t expect D.C. to ever undo something once it’s been put in place. Federal programs never go away. They only grow and morph into even bigger boondoggles. Republican promises to repeal Obamacare were a farce from the beginning – empty promises meant to garner votes and contributions. Nothing more.

When James Madison told us how to fight overreaching federal power, he didn’t recommend waiting until the next election and hoping the opposing party will fix things. His strategy involved state action, including a refusal to cooperate with officers of the Union.

If you want to loosen the federal government’s grip on healthcare, the only viable strategy involves attacking it from the state level.

Mike Maharrey

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