Ryan, Republicans Aim Big with Obamacare Replacement

House speaker Paul Ryan said Wednesday that the House GOP's new Obamacare replacement is focused more on quality than quantity.

That's true, as far as the substance goes. But as far as the number of proposals in the health care package is concerned, quantity doesn't take second place to anything.

The comprehensive platform released as part of Ryan's "A Better Way" agenda unifies several Republican priorities from recent years with a couple of popular Affordable Care Act carryovers. It counters a central Democratic critique of the GOP—that its only health-care idea has been to eliminate the president's health-care law—and aims to encourage a competitive insurance market that suppresses costs and ups the quality of care.

"And that starts with giving you a choice. Instead of forcing you to buy a plan that Washington bureaucrats have mass-produced, we're going to repeal those mandates and let you pick a plan that works for you," Ryan said at the American Enterprise Institute. "We're saying, don't force people to buy insurance. Make insurance companies compete for our business."

Such a market-oriented focus begins with a repeal of Obamacare, as well as some familiar Republican ideas: allowing insurance sales across state lines and expanding access to personal health savings accounts, which consumers could use at their discretion to obtain care. But the Obamacare replacement provides some direct alternatives to what the law offers: Instead of a premium-support subsidy to purchase government-approved insurance, for example, the GOP program would provide a refundable tax credit to help individuals without access to job-based insurance receive coverage. The credit is age-adjusted and favors older individuals, and it would grow over time.