The Republican health care wars have begun.
Wisconsin Governor Scott Walker's roll-out of an Obamacare replacement plan Tuesday prompted a scathing attack by rival presidential candidate and Louisiana Governor Bobby Jindal, who labeled it "Obamacare lite."
"In a health care plan that is light on specifics, Governor Walker endorsed the fundamental underpinning of Obamacare—the notion that America needs another entitlement program," Jindal said in a statement.
Inside the world of Republican politics, few insults are more aggressive than accusing a fellow tribesman of supporting anything similar to Obamacare, which despite its origins in conservative policy circles is now widely seen on the right as the pinnacle of what's wrong with Washington.
On Tuesday, Walker said in a speech in Minnesota he'd send legislation to Congress on his first day as president "that will once and for all repeal Obamacare entirely and replace it in a way that puts patients and their families back in charge of their health care decisions."
"This gives them a way to get an affordable healthcare plan," he said, referring to the age-based refundable tax credits at the heart of his plan, for people who aren't eligible for employer-provided insurance or Medicare. They range from $900 per year for a person under 17 to $3,000 for a person above 50.
Unlike Walker's plan, Obamacare provides insurance tax credits to people based primarily on income—between 133 percent and 400 percent of the federal poverty level—with the aim of helping lower-income people afford coverage. Republicans have widely panned the 2010 law's tax-credit scheme as an entitlement, and Jindal extends the same logic to Walker's plan.
"In Governor Walker’s plan, a new entitlement is created for every single American human being from the time they are born right up until they grow old and become eligible for Medicare," Jindal said. "It is frankly shocking that a Republican candidate for President would author a cradle to grave plan like this."
Jindal's critique exposes a major fault line within the Republican Party, namely that the staunchest conservatives in Congress don't believe the the government should subsidize health insurance. It's one reason why congressional Republicans have failed for five years to unify behind an Obamacare replacement plan.
Walker's Obamacare replacement is being welcomed by some conservatives. Influential conservative policy wonk Yuval Levin wrote in National Review that Walker's plan is "the most substantively and politically serious conservative health care reform we have yet seen from a presidential candidate."
'The gentleman from Louisiana protesteth too much'
Jindal's plan for national health care reform, unveiled in April 2014, proposes a $100 billion federal cash infusion over a decade for state-based high-risk pools and replaces the tax exclusion on employer-provided insurance with a standard deduction. In the past, Jindal has spoken favorably about the idea of refundable tax credits.
AshLee Strong, a spokeswoman for the Walker campaign, said the Wisconsinite's plan was "getting rave reviews from the conservative movement" and defended it against Jindal's attack. "The refundable health care tax credits the governor includes have been supported by many conservatives because they put health care decision making in the hands of the American people where it belongs," she said.
Dean Clancy, a former vice president for public policy at the tea party group FreedomWorks, wasn't impressed by either plan. "I would say the gentleman from Louisiana protesteth too much," he said, arguing that Jindal's plan "is only a little bit less DC-centric" than Walker's.
"There's not much difference in principle between Walker's tax credits and Jindal's standard deduction. Both are entitlements, and both, at the end of the day, share a lot of DNA with Obamacare," Clancy said. "I'm still waiting for a candidate who wants to follow the Constitution and send health care back to the states and private sector, lock, stock, barrel."