Scott Walker’s Health Care Plan Relies on Tax Credits to Buy Coverage

“Repeal and replace” has been a mantra for Republicans when discussing President Obama’s health law. On Tuesday, Gov. Scott Walker, the Republican presidential candidate from Wisconsin, offered some details on how he would replace the Affordable Care Act if he is elected.

Mr. Walker’s plan makes a full repeal of the law his top priority, then proposes a system of tax credits that would allow Americans who do not get health insurance through their employers to purchase individual plans. The credits would be based on age, and consumers could then decide what plan to purchase, if they opt to buy health insurance at all.

“On my very first day as president of the United States, I will send legislation to the Congress to once and for all repeal Obamacare entirely,” Mr. Walker said in a speech in Minnesota.

Repealing the Affordable Care Act has been a rallying cry for Republicans since it was enacted without their support in 2010. Mr. Walker’s detailed critique of the law and his plan to replace it by lowering taxes and offering consumers more freedom comes as he has been struggling in recent polls after a tepid debate performance.

Despite continuing resistance to the law, dismantling it would likely be a big challenge for a Republican president. The Obama administration said this month that the number of people without health insurance had continued to decline, dropping by 15.8 million, or a third, since 2013. Meanwhile, studies have shown that the law has helped to keep insurance premiums in check.

“If this vague grab-bag of conservative wish-list items is the best health plan the G.O.P. can come up with for the largest economy on earth, it’s the clearest signal yet that Republicans like Scott Walker are out of ideas and out of touch,” said Eric Walker, a spokesman for the Democratic National Committee.

Senator Marco Rubio shed some light on his own health care reform policy this week. The Republican from Florida would also promote tax credits as a way to make insurance affordable and create federally backed “high risk pools” in states so that the sick can buy insurance at reasonable prices.

In Wisconsin, Mr. Walker has been a staunch opponent of the Affordable Care Act and has resisted taking federal funds to expand Medicaid in the state. A report last year faulted him for costing Wisconsin $500 million in lost savings because of his opposition to the law, but the governor maintained that such reliance on federal money would have been a mistake.

“We believe confidently going forward this federal government is likely to renege from its promises on Medicaid to the states,” he said last summer. “And we won’t be exposed to that.”

Mr. Walker vows to do away with the Affordable Care Act’s requirement that Americans purchase health insurance. Instead, his plan would seek to limit insurance premiums by opening the market so that consumers can shop for plans across state lines, thus intensifying competition among insurance companies.

The proposal also calls for reforms to Medicaid and improvements to health savings accounts that would give patients more pretax money to pay their health bills.

“You’re going to do more to manage your health care, and your health, not just your health care, if you have control over the those dollars,” Mr. Walker said. “It’s all about freedom.”

Mr. Walker also tries to address the issue of covering people with pre-existing conditions, which was one of the most important reforms in the Affordable Care Act because of the prohibitive prices sick people often faced when trying to purchase health plans. He promises “additional reforms to insurance coverage laws” that would prevent companies from discriminating against people who find themselves ill and without health insurance. Federal funds would be distributed to the states to help people with these conditions buy coverage.

Many of Mr. Walker’s proposals on overhauling the health care system have been mainstays for Republicans over the years, and his plan offers little insight into how its costs or effect on the economy would compare with Obamacare. But pointing to the success of Wisconsin’s BadgerCare program for the poor, Mr. Walker said he was confident that a similar structure could work across the United States.

“My plan would roll back the damage done by Obamacare and when compared to the realities that existed before Obamacare, would not add to the deficit,” he said.