ST. PAUL – Presidential candidate Scott Walker impressed a small crowd of local Republicans here Tuesday when he unveiled a proposed replacement for the Affordable Care Act-but with the crowded field of 17 major candidates, many voters are waiting to make up their minds.
Walker, the governor of neighboring Wisconsin, visited a Brooklyn Center factory to lay out the broad strokes of a health plan that repeals President Barack Obama's signature law but incorporates conservative spins on some of its key concepts.
For example, "Obamacare" provides tax subsidies to people without employer-sponsored insurance based on their income, with poorer people getting larger subsidies. Walker would keep tax subsidies for health plans, but base them on age, not income. Eligibles under 17 could receive $900 per year, rising to $1,200 for people 18-34, $2,100 for people 35-49 and maxing out at $3,000 for people 50-64. All those subsidies would be the same whether a person earns $25,000 or $250,000 per year.
The average tax subsidy received through Minnesota's MNsure health exchange last year was $185.48 per month for the roughly 40 percent of MNsure customers who received a subsidy. The remainder earned too much money to receive a tax subsidy. So far in 2015, about 55 percent of MNsure customers are receiving subsidies.
The Affordable Care Act requires insurance companies to cover people without regard for any pre-existing medical conditions.
Walker has a scaled back version of this proposal: insurers would have to cover preexisting conditions, but only as long as people didn't have any gaps in coverage. Walker would also provide subsidies to help people too poor to buy insurance get coverage for their pre-existing conditions.
"We're going to replace (the Affordable Care Act) in a way that puts patients and families back in charge of your health care decisions," Walker said at Cass Screw Machine Products, a Brooklyn Center factory.
The small crowd of Republicans gathered in the factory Tuesday liked what they heard.
"Obviously we need a lot of reforms in health care," said Arthur Kane of Buffalo. "He did a good job laying it out."
But Kane and fellow attendee Jesse Schelitzche both said they want to learn more about Walker's plan before they make up their minds. The Wisconsin governor's 15-page plan didn't include some of its specific details and numbers.
"Clearly there's more details that need to be discussed before we really, truly know what it's about," said Schelitzche, who owns a business in St. Louis Park.
Other elements of Walker's plan include more support for health savings accounts, letting Americans buy insurance plans from other states and replacing Medicaid, the joint state-federal program that provides health coverage for low-income Americans, with money for states to design their own plans.
The state grants would be smaller than current Medicaid funding-a key part of how Walker would pay for his plan. He wants to abolish all the tax increases that pay for the Affordable Care Act, which average more than $100 billion per year. Walker would offset that lost revenue by reductions in Medicaid payments and a tax on high-cost health plans.
Democrats quickly condemned Walker's proposal, saying it was a step backward that would take away people's health coverage.
"What Scott Walker offered this morning is a vague grab bag of conservative wish-list items, not a comprehensive health plan," said Ken Martin, the chair of the Minnesota Democratic-Farmer-Labor Party.
In his speech, Walker took aim not only at Democratic frontrunner Hillary Clinton, but also at Republican members of Congress.
"We were told by Republican leaders during the campaign last year that we just needed a Republican Senate to be elected to repeal Obamacare," Walker said. That happened, but "there's not a bill on the president's desk to repeal Obamacare."
Several of Walker's rivals for the Republican presidential nomination are Republican senators: Sen. Ted Cruz of Texas, Sen. Lindsey Graham of South Carolina, Sen. Rand Paul of Kentucky and Sen. Marco Rubio of Florida.
Walker argued that his experience in Wisconsin shows he'd get things done in Washington.
"In our case, we fought, we won, we got results," Walker said. "We did all that in a state that hasn't gone Republican for president since 1984."
Many of the attendees at Walker's speech said they're still undecided about which candidate to support-including his host Tuesday, Cass Screw Machine Products CEO Steve Wise. Wise said he likes Walker but that his favorite Republican candidate right now is Ohio Gov. John Kasich because of Kasich's focus on fiscal issues over social issues.
Schelitzche said he's looking to see which candidate can do the best job selling conservative messages.
"As we've seen with President Obama, his charisma is what convinced a lot of people, not just what he stood on," Schelitzche said. "Unfortunately, you do have to have somebody who's personable and who people can relate to."
Schelitzche said Walker passes that charisma test-at least, for a Minnesota voter.
"Being from Minnesota we might have a different opinion, because he's a Midwest guy and we like that aspect of it," he said. "We don't like the brash East Coast mentality-not to say that's not going to win."