But there is another way to make exchanges viable, one that should be prominently on the table at Blair House: offer a tax break. Some Republicans like Tom Coburn of Oklahoma and Paul Ryan of Wisconsin propose a refundable tax credit for buying insurance. This can be linked to exchanges.I think this is a good idea. I think the whole idea would be even better if the tax exchange idea was dropped, plus the Congress said both that there would no longer be mandates for what must be in a policy at either the national or state levels and that there could no longer be restrictions on buying insurance from companies across state lines.
Since employer-provided health insurance has a huge tax advantage, the only way a market is going to develop outside employer-mediated insurance is to level the tax field with a proper tax incentive. It also happens to be fair, since a growing number of people work for themselves and hence are discriminated against in being forced to pay higher taxes compared to those who benefit from the employer health insurance tax break.
With a significant – say $3,000 a person – and permanent tax cut, exchanges have a chance of attracting enough customers. Justice and economic logic both demand this tax break.
Please don't any body point out that this tax credit idea sounds a lot like a "voucher" for health insurance. If Democrats notice this they just might be afraid that if vouchers worked for health insurance they would probably work for education as well.