About the Author

James C. Capretta

James C. Capretta

New Atlantis Contributing Editor James C. Capretta is an expert on health care and entitlement policy, with years of experience in both the executive and legislative branches of government. E-mail: jcapretta@aei.org.


James C. Capretta’s Latest New Atlantis Articles

 Health Care with a Conscience” (Fall 2008) 

 Health Care 2008: A Political Primer” (Spring 2008) 

 The Clipboard of the Future” (Winter 2008)


 More on James C. Capretta

Text Patterns - by Alan JacobsFuturisms - Critiquing the project to reengineer humanity

Tuesday, February 14, 2012

The President’s Plan: Higher Taxes, Deep Defense Cuts, and the Entitlement Status Quo 

I have a new column up at e21 on why the president’s new budget proposal is more of the same. Here’s a snippet:

For a brief moment, it seemed that the president wanted to take on this challenge and pursue just such an agenda. In 2010, he appointed the Bowles-Simpson commission to come up with a comprehensive budget plan to restore long-term solvency to the government. Not surprisingly, the plan approved by that commission called for serious tax and entitlement reforms as well as deep cuts in every corner of the federal budget.

But instead of embracing the Bowles-Simpson plan, the president changed course and chose to ignore entirely the recommendations of the panel he had initiated to great fanfare. The president then spent all of 2011 attacking the GOP’s version of long-term budget reform instead of offering a serious plan of his own, thus making it all but impossible for a bipartisan consensus to form in Congress. The president’s 2013 budget plan fits this pattern, providing stark contrasts with the GOP at the expense of real progress.

You can read the full article here.

posted by James C. Capretta | 4:19 pm
Tags: budget
File As: Health Care

Thursday, February 9, 2012

On the Contraceptives Controversy 

I spoke on a panel yesterday at the Catholic Information Center in Washington, D.C., about the controversy brewing over the Obama administration’s requirement that church employers cover contraception (among other services deemed preventive) in the health care plans they provide to their employees. The video of that event is available from C-SPAN here.

posted by James C. Capretta | 5:11 pm
Tags: religious exemption, Obamacare, contraception
File As: Health Care

Thursday, February 2, 2012

Two (Relatively) Recent Public Events 

On December 16, 2011, I participated in a public forum at the Brookings Institution entitled “Controlling Medicare Costs: Is Premium Support the Answer?” The event was kicked off by a presentation from former New Mexico Senator Pete Domenici (my old boss from the years I spent on the staff of the Senate Budget Committee) and former Clinton administration Budget Director Alice Rivlin, on the specific premium support plan they have proposed as part of the deficit reduction initiative of the Bipartisan Policy Center. I participated in a panel discussion that followed their presentation, which featured the views of both opponents and proponents of premium support in the Medicare context. My remarks were based in large part on the views I expressed in a companion paper, also commissioned by Brookings (available here). A full description of the event, and a full video recording of it are available here.

And this week, I had the pleasure of moderating a public forum, sponsored by e21, on Capitol Hill featuring introductory remarks from Wyoming Senator John Barrasso and a presentation from University of Minnesota Law Professor Daniel Schwarcz on why employers are likely to dump their unhealthy workers into the Patient Protection and Affordable Care Act’s state exchanges. Professor Schwarcz’s presentation drew on his findings from a law journal article he recently co-authored (available here). The full details regarding the event, as well as a full video recording of it, are available here.

posted by James C. Capretta | 11:48 am
Tags: premium support
File As: Health Care

Monday, January 30, 2012

A Clash of Conscience 

I have a new column up at National Review Online on the Obama administration’s recent refusal to grant a religious exemption for institutions that wish not to be required to pay for contraception and abortifacients:

The central purpose of Obamacare — and the reason it was and is so strenuously opposed by so many Americans — is to transfer all of the critical decisions about how American health care operates to the federal government. Despite what the president contends, it is a federal takeover. The federal bureaucracy is now in the driver’s seat.

And, with the federal government now calling all of the shots, it is a foregone conclusion that a decidedly secularist and utilitarian point of view will be pervasive in everything that is done. It is simply beyond the capacity of the modern federal government to even consider arguments questioning the wisdom of governmental policies promoting free and abundant contraception. Indeed, it is an article of faith in the modern bureaucratic context that pushing such “prevention” measures onto the American public is one more step on the long march to a more just and humane society.

This is the environment in which we live. The hard truth is that the federal government cannot be trusted today with these kinds of decisions, and there’s no prospect of that changing anytime soon. That’s a big reason why Obamacare should never have been allowed to pass in the first place. Just the sight of Catholic leaders’ being forced to go begging before federal officials ought to be enough to convince most Americans that handing over so much power over such sensitive matters to the federal government was a terrible, terrible mistake.

Read more here.

posted by James C. Capretta | 11:24 am
Tags: religious exemption, Obamacare
File As: Health Care

Wednesday, January 25, 2012

On the State of the Union Speech 

Over at National Review Online, I have a brief take on last night’s State of the Union speech. And at economics21, a lengthier response:

It was no real surprise that during last night’s state of the union address the president hit on the same populist themes he has been pounding since Labor Day, which essentially come down to this: the nation’s economic troubles — anemic job growth today, massive federal borrowing and debt accumulation, and stagnant wage growth for the middle class — can all be traced to public policies which deliver excessive economic gains to the rich at the expense of everyone else. In other words, if only the Republicans were willing to tax the rich, all would be well....

But what President Obama didn’t explain last evening — indeed, has never really explained — is how a tax hike on higher income households will help the struggling middle class. Because it’s not at all obvious it would.

You can read the whole column here.

posted by James C. Capretta | 2:19 pm
Tags: State of the Union
File As: Health Care

Monday, January 23, 2012

Inside the Obamacare Spin Zone 

Over at National Review Online, I have a new column up looking inside the Obama administration’s claims about progress at the state level implementing the “health exchanges” meant to form much of the new health care system:

According to the administration’s spin, some 28 states are “on their way” toward establishing the exchanges, so everything is apparently well under control. In other words, nothing to worry about here. Full speed ahead! 

But is that really what’s going on here?

Because, even if one were to accept the White House’s accounting (which one shouldn’t), that would mean that 22 states — roughly 40 percent of the country — are not “on their way” toward erecting the Obamacare exchanges. Isn’t that a problem? Further, upon closer inspection, it’s clear that many of the 28 states that are supposedly “on their way” really aren’t “on their way.”

You can read the full column here.

posted by James C. Capretta | 6:43 pm
Tags: Obamacare, health exchanges
File As: Health Care

Tuesday, January 17, 2012

Yes, NPR, Repealing Obamacare is Possible 

NPR this morning ran a segment on the supposed difficulties that might be involved in repealing Obamacare. Folks who are interested in this question might want to check out a piece I wrote for NRO back in October 2011 laying out the steps involved in using a reconciliation bill in 2013 to repeal Obamacare (assuming Republicans keep control of the House, pick up a majority in the Senate, and take the White House). As the NPR reporter noted, some parts of Obamacare have already gone into effect, and repealers would have to decide which of those to keep intact. But the most significant and expensive components of the legislation certainly could and should be repealed in 2013.

posted by James C. Capretta | 5:53 pm
Tags: repeal, replace, reconciliation
File As: Health Care

Thursday, January 5, 2012

More on Premium Support 

I have a new column up at National Review Online on premium support and controlling health care costs:

There are many reasons to be grateful for the introduction of the Medicare “premium support” plan by Democratic senator Ron Wyden and Republican House Budget Committee chairman Paul Ryan.

In some respects, it represents an improvement over the design of previous versions of premium support. Whereas the original Ryan plan offered seniors a subsidy based on a predetermined formula, the Wyden-Ryan plan relies on competitive bidding for setting the government’s contribution rate. Competitive bidding has the potential to cut costs even more than a predetermined index, because an index tends to lock in today’s wasteful spending. Of course, Wyden-Ryan also very usefully shook up the political debate over premium support, making it much more difficult for Democrats to demonize the concept.

But perhaps the most useful byproduct of the Wyden-Ryan plan has been the clarifying effect it has had on the debate over how to slow the rise of health-care costs.

The full article is available here.

posted by James C. Capretta | 12:45 pm
Tags: Medicare reform, premium support
File As: Health Care

Thursday, December 22, 2011

A Look Back at 2011: Congress and White House Edition 

I have a new column up at e21, looking back at the major policy struggles of the last year:

2011 began with great uncertainty and anticipation. How would the new House majority, propelled into office with the energy from the emergent Tea Party movement, share power with a Democratic White House and Senate? And what would it all mean for economic and fiscal policy?

Now that 2011 is nearing an end, it’s safe to say that this particular political marriage — arranged to some extent by the voters who pulled the lever both for Barack Obama in 2008 and then for conservative Republican congressional candidates in 2010 — has been a rocky one, to put it mildly. Over the course of the past year, the news has been dominated by a series of high-level budget negotiations that were initiated by both sides with great fanfare and much hope for historic and game-changing breakthroughs, and that ended instead as spectacular, headline-grabbing failures....

You can read the whole column here.

posted by James C. Capretta | 1:11 pm
File As: Health Care

Friday, December 16, 2011

Premium Support in the new Medicare proposal 

I have an article up at National Review Online on the new Medicare proposal:

The release of the Medicare-reform proposal cosponsored by Democratic senator Ron Wyden and GOP House Budget Committee Chairman Paul Ryan is a milestone event in the long-running struggle for sensible entitlement reform....

The Wyden-Ryan proposal has ... brought to the surface an important issue of how “premium support” is designed. The version that Ryan released in April 2011, and which passed the House as part of the GOP’s budget plan, would have given seniors a subsidy each year based on a predetermined government formula. The new version would instead set the government contribution based on bids from the competing plans, including the “public option” of traditional “fee for service” Medicare. Setting aside the public option for a moment, moving toward competitive bidding is actually an improvement over the previous version. Most analysts agree that the potential for cost-cutting in Medicare is immense. With a government-set formula for payments, there is a danger that excessive costs get locked into the payment stream. With competitive bidding, there is much greater potential for deep cost-cutting, as plans that find new ways to deliver more for less can attract enrollment with low premiums.

You can read the whole piece here.

posted by James C. Capretta | 4:26 pm
Tags: Medicare reform, premium support
File As: Health Care

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