In this March 15, 2014 file photo,a volunteer health care...

In this March 15, 2014 file photo,a volunteer health care worker wears a t-shirt, getting people to sign up for the new health care programs, in Miami. Credit: AP / J Pat Carter

It’s easy to understand why President Donald Trump’s staunchest working-class supporters are confused about the Grand Old Party’s gridlocked plans to repeal and replace Obamacare.

They just discovered they’ll be the biggest losers in the dueling House and Senate GOP plans that would reward the rich while shafting the hard-working folks who played by the rules, won the election for Trump — and may lose the health insurance they got through the Affordable Care Act.

So today, I’m inviting these Americans to walk back and become reporters for a few minutes — just long enough to rediscover the real options as I covered them.

Because frankly — and this may surprise some faithful readers! — the conservative Republican alternative to what the liberal Democrats were proposing made a lot of sense to me when I first reported on it.

So hop into my time machine and let’s go!

It is March 5, 1992, and we’re interviewing the policy think tankers at the new, impressive Heritage Foundation headquarters on Capitol Hill. They have handed us copies of “Heritage Talking Points: A Policy Maker’s Guide to the Health Care Crisis.” We’ve turned to “Part II: The Heritage Consumer Choice Health Plan.”

Heritage’s experts were mainly concerned about finding a common-sense alternative to the single-payer approach favored by Sen. Ted Kennedy (D-Mass.), which they summarized as: “The government becomes the monopoly provider of health care financing. It fixes a budget for health care and allocates money to hospitals, and it sets physician fees.”

Instead, Heritage is proposing “The Consumer Choice Approach” which states: “Americans are allowed to choose the health care plan they want.”

In order to cover patients with pre-existing conditions (whose health care is most costly), Heritage’s proposal states, in big bold-faced letters, that all households will be mandated to purchase some form of health insurance: “Require all households to purchase at least a basic package of insurance, unless they are covered by Medicaid, Medicare, or other government health programs.”

It adds: “All heads of households would be required by law to obtain at least a basic health plan specified by Congress.” A “refundable credit system partially would offset the cost of such a plan for most Americans.”

Well — I see a number of you Trump voters just raised your hands. Yes? I’ll repeat your question for the others. You’re asking: Isn’t this the same mandate President Trump and every Republican who ran against him have attacked as one of the worst things about Obamacare? Well, yes it is.

And yes, as a matter of consistency in policy, the attack makes no sense. Heritage’s 1992 plan proposed a mandate. And because of that, about a decade later, Massachusetts’ Republican Gov. Mitt Romney proposed mandated coverage in his Romneycare plan that worked well for years. Putting hypocrisy aside, Republican politicians knew it was much easier to make you hate Obamacare by playing attack politics. So they pretended a mandate requiring everyone to buy some form of health insurance was suddenly evil — even though the mandate idea was hatched and nurtured in Washington’s most famous conservative think tank.

It was only because of its mandate that the Heritage document could list among its “Advantages of the Heritage Plan” the following: “Every American family would have access to affordable and adequate health care. Americans no longer would lose coverage when they changed jobs. Costs would be controlled effectively and efficiently. The Heritage plan is budget neutral.”

When Obamacare was taken off paper and put into practice, it turned out to have unrelated flaws that desperately need fixing. But politicians of all persuasions believe “Let’s Fix Obamacare” would be a lousy bumper-strip.

So Republicans chose to play the political-hate game, conning you into hating and fearing Obamacare. And many of you fell for it.

Democrats chose to play the admit-no-wrongs game. They didn’t have the guts to propose practical compromise solutions for fixing Obamacare. So they mainly ignored the flaws we all could see.

And my news media colleagues chose their own safe and easy path. They mainly covered the health care food-fight — and didn’t risk the hard work of uncovering boring compromise solutions. Oh sure, a policy solution might rescue your family. But reading a story about it might cause you to miss the excitement of being lied to and deceived. You might even switch to a media outlet that was only telling you the lies and spin you love to hear.

So everyone played the game by playing it safe. Which is how we got into the mess we are stuck in today.

Martin Schram, an op-ed columnist for Tribune News Service, is a veteran Washington journalist, author and TV documentary executive.


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