Deirdre Shesgreen

USA TODAY

What’s the worst thing that could happen if Republicans in Congress pass the House GOP Obamacare alternative?

Democrats could gain power after the next presidential election and enact a single-payer health care system. That’s the nightmare scenario envisioned by Mike Needham, CEO of Heritage Action, a powerful conservative advocacy group in Washington that's leading the charge against the GOP health plan unveiled by House Speaker Paul Ryan last week.

In a call with reporters on Monday, Needham blasted the GOP plan — called the American Health Care Act — as Obamacare by another name. He said the GOP plan includes tax credits that are virtually the same as the subsidies included in Obamacare, and the GOP’s provision allowing insurers to impose a 30% surcharge of those with a lapse in coverage is similar to Obamacare’s mandate requiring most Americans to purchase insurance.

“It leaves the fundamental architecture of Obamacare in place,” Needham said.

He said “the biggest fear I have” is that Republicans pass a bill preserving such elements of Obamacare, and then absorb the wrath of the electorate as health insurance costs continue to rise and competition continues to shrink.

Then "the same death spirals that are already starting to happen under Obamacare happen under a Republican replacement plan," he said. "And that in 2020 or 2024, the American people look at health care system that’s collapsing and vote a Democrat in who says the only answer is single-payer health care.”

Some liberal Democrats have embraced a single-payer system, or “Medicare for all,” which would provide universal coverage and replace private insurers with a federally administered fund that reimburses providers for health care services.

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