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

Wednesday, August 1, 2012

Talking About Replacing Obamacare 

Last month, I was very pleased to be invited to appear on Brian Lehrer’s radio show (public radio in NYC) to talk about an alternative vision for health care reform, one that is very different from the vision embodied in Obamacare. The invitation to appear on the show was prompted by the piece Bob Moffit and I wrote for National Affairs magazine, entitled “How to Replace Obamacare.” The discussion focused on the reforms that are necessary to build a functioning marketplace for health care in the United States.

In addition, the American Enterprise Institute (where I am a visiting fellow) recently asked me to record a series of brief video remarks outlining the major features of a replacement plan for Obamacare. Those remarks closely follow the points I made with Bob in our National Affairs piece. AEI has posted the recorded videos on its YouTube channel.

For those who might be interested, the radio show is available here, and the AEI videos are available here.

posted by James C. Capretta | 0:00 am
Tags: AEI, health care reform
File As: Health Care

Tuesday, July 31, 2012

Health Care Costs and Obamacare 

I have a new column at e21 rebutting Christine Romer’s latest defense of Obamacare’s cost control mechanisms:

Romer is right that rapidly rising health costs is the most serious threat to the nation’s long-term prosperity. Already, the rapid run-up in federal health entitlement spending is putting tremendous pressure on the federal budget. Between 1972 and 2011, federal spending on Medicare and Medicaid rose from 1.1 percent of GDP to 5.5 percent, according to the Congressional Budget Office (CBO). CBO’s latest projections indicate that spending on these programs, plus ObamaCare’s new entitlement spending, will push total health entitlement spending up to at least 8.4 percent of GDP by 2030. That’s a jump in spending of nearly 3 percentage points of GDP compared to today’s level — or the equivalent of another $500 billion in budget outlays.

But although Romer is right about the severity of the problem, she is dead wrong about ObamaCare’s role in addressing it. ObamaCare did not lay the foundation for sensible cost control, and did not partially ease budgetary pressures, as she asserts. Quite the contrary, ObamaCare will pour an ocean of gasoline on the health entitlement fire, and the supposed cost-control mechanisms are a mirage.

The rest of the column is here.

posted by James C. Capretta | 10:57 am
Tags: Obamacare, cost control
File As: Health Care

Tuesday, July 17, 2012

The Mandate After the Court 

My colleague Yuval Levin and I have co-authored a new article for National Review Online about how the Roberts decision will affect Obamacare:

In the wake of the Roberts decision, participation in Obamacare’s insurance scheme is optional. Rather than a requirement to buy coverage backed with a penalty for violators, the law now offers Americans two equally lawful and legitimate options: buy expensive insurance (which Obamacare will make all the more expensive), or pay a modest (and still largely unenforceable) tax and just buy insurance for the same price later if you need it. Presented as a choice, not a command, this provision will invite a straightforward comparison, and for many Americans the choice it would pose would be a very easy one. 

You can read the rest of the article here

posted by James C. Capretta | 12:03 pm
Tags: Supreme Court, Yuval Levin
File As: Health Care

Thursday, June 28, 2012

Obamacare as “Play or Pay” 

I have a new post up at National Review Online on how today's Supreme Court decision raises some interesting questions about how Obamacare will operate in the real world:

The Congressional Budget Office (CBO) and others have suggested that the presumed mandatory obligation to buy health insurance would be a very powerful motivator for those who today choose to remain uninsured to purchase coverage, even though the “penalty” they must pay is generally far less than the premiums for even bare-bones health insurance. In other words, the CBO assumes these people will go along with the program because everyone else is going along with it and, well, it’s the “right thing to do.”

This was always a dubious assumption, as it presumes people will act against their own self interests. But it would seem even less plausible now because the Supreme Court, in its language today, has made it clear that the mandate cannot be viewed as a mandate at all; it’s just an optional tax that citizens can pay in lieu of securing health insurance.

You can read the rest of the article here.

posted by James C. Capretta | 7:28 pm
Tags: individual mandate
File As: Health Care

Thursday, June 28, 2012

SCOTUS Post-Mortem 

I have a column up at e21 on what today's Supreme Court ruling means for the future of Obamacare, and what opponents of that plan need to do to repeal and replace it:

Still, there’s no question that today’s ruling provides a boost to the administration and to the long-term prospects of ObamaCare. The future of ObamaCare now rests in the political and legislative arena -- perhaps appropriately, as that is where the fate of most important policy matters should be settled. ObamaCare opponents should be optimistic, because the public remains firmly opposed to the law, but also determined, because it won’t be easy.

You can read the rest of the article here.

posted by James C. Capretta | 4:30 pm
Tags: Supreme Court, Obamacare
File As: Health Care

Wednesday, June 27, 2012

All the President’s Mandate Positions  

I have a new column up at National Review Online on Obama’s history of flip-flops on the individual mandate:

Without the mandate, the Obama plan would not be considered a “universal coverage” plan in Democratic circles, as analysts, including those at the Congressional Budget Office, would expect large numbers of Americans to decline to sign up for coverage in a voluntary system. Party elites and activists would regard this as a major, perhaps even fatal, flaw. Nothing in the Democratic catechism is more sacred than the goal of “universal coverage” in health care.

So Senator Obama was taking a risk in not toeing the party line. But it was a calculated risk. He knew from polling data that, despite its popularity among party elites and left-leaning health-care analysts, the individual mandate was far less popular among Democratic primary voters. Here was a policy difference with Senator Clinton that he could exploit to his advantage in the primaries.

You can read the rest of the article here.

posted by James C. Capretta | 3:00 pm
Tags: individual mandate
File As: Health Care

Thursday, June 21, 2012

Obamacare’s Failings Go Well Beyond the Individual Mandate and Medicaid 

I have a new issue brief at the Heritage Foundation on four of the worst problems with Obamacare that are not under review by the Supreme Court. Here’s one:

Obamacare will exacerbate the nation’s already alarming entitlement spending and debt crises. Already, the dramatic rise in spending on Medicare and Medicaid is pushing the federal budget to the breaking point. Obamacare makes the problem much worse by creating two new additional entitlement programs in the form of a massive Medicaid expansion and a new premium credit entitlement for households with incomes between 138 percent and 400 percent of the federal poverty level. These two entitlement expansions are expected to add a minimum of 35 million Americans to the entitlement rolls when phased in, at an expense of more than $200 billion annually by the end of the decade.

You can read the rest of the article here.

posted by James C. Capretta | 12:45 pm
Tags: Obamacare, Supreme Court
File As: Health Care

Friday, June 15, 2012

The Case for Romney’s Health Care Plan in USA Today 

I have an Op-Ed today in USA Today, offering an opposing viewpoint to their editorial:

This week, former Massachusetts governor Mitt Romney began to describe the kind of health care reform plan he would implement if he is elected president. It's the right vision, and it's very different from President Obama's.

The president's 2010 law is based on a government-centric approach to health care reform. The federal government, already heavily involved in regulating the health sector through Medicare and Medicaid, will have near-total control over all important decisions under the new law, including what's covered by insurance, where people go to access their coverage, and how doctors and hospitals should organize themselves.

Gov. Romney has a different focus....

You can read the rest of the piece here. (Note that their editors chose the title.)

posted by James C. Capretta | 12:25 pm
Tags: Obamacare, Mitt Romney
File As: Health Care

Thursday, June 14, 2012

Supreme Suspense: Getting Ready for the Big Obamacare Decision 

I have a new column up at e21 on how conservatives should be prepared for whatever the Supreme Court decision on Obamacare turns out to be:

...it’s possible to boil down the various scenarios to a handful that capture the most likely outcomes, and to examine the implications of those scenarios through both a policy and a political lens. Indeed, for those who have spent the past three years opposing ObamaCare, it’s critically important to be prepared for all eventualities because what the key players in this drama say and do in the days after the Court issues its decision could be just as important as the decision itself to the future of ObamaCare and American health care.

Scenario 1: The Court Upholds ObamaCare. What if the Court doesn’t strike down any provisions of ObamaCare? This is the scenario conservatives are loath to consider but ignore at their peril. It is certainly possible that the Court will find ObamaCare within the bounds of existing constitutional law, despite the many flaws in the administration’s legal defense that were exposed during oral arguments. If that happens, it will be seen as a severe blow to the ObamaCare opposition because so many conservatives have invested so much energy in the two-year-long legal case....

You can read the rest of the article here.

posted by James C. Capretta | 3:28 pm
Tags: Obamacare, Supreme Court
File As: Health Care

Thursday, June 7, 2012

It’s Obama’s Economy 

I have a new article at National Review Online showing why Paul Krugman is wrong to blame the Republicans for the state of the economy:

No doubt it would be impressive if the president managed to convince the electorate that three years’ worth of anemic job creation is all the GOP’s fault. And certainly one can’t blame Krugman for making the suggestion (desperate political times call for desperate political evasions). But the odds of this working for President Obama are near zero.

For starters, there’s the problem of who has actually been in charge of economic policy since 2009. The president came into office with commanding Democratic majorities in the House and Senate. He could have done anything he wanted during those years, without even consulting with Republicans. And, in fact, he did do pretty much anything he wanted in those years, in spite of GOP objections. Which is why, as Douglas Holtz-Eakin has already noted, we got the $800 billion stimulus spending plan, very substantial spending increases in the 2009 and 2010 appropriations processes, Dodd-Frank, the auto bailout, a state- and local-government bailout bill, Cash for Clunkers, and much else — not to mention the huge tax hikes, including tax hikes on labor, contained in Obamacare. This was the president’s activist economic agenda, and it’s all been implemented or is in the process of being implemented. The fact that it hasn’t worked to spur a robust economic recovery is no one’s fault but the president’s.

You can read the rest of the article here.

posted by James C. Capretta | 6:22 pm
Tags: President Obama, Paul Krugman
File As: Health Care

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