Maine’s Republican candidates for governor, senator and Congress have made one thing very clear: Aside from familiar sound bites and vague promises, there is no Republican plan to make health care more affordable and easier to access.

That’s shocking when you consider that we pay more per capita for health care than any developed country, and our health outcomes are worse. Every single person will need care at some point in his life, and very few will have enough cash on hand to pay for it.

Republican candidates have run against health care reform for the last four election cycles. They have promised to repeal Obamacare, but have not offered much for a state like Maine, with its aging population and high health care costs. By now, we would expect to see concrete plans designed to target our specific needs.

Shawn Moody, the Republican nominee for governor, says he knows about health care costs because his business pays more than $1 million in premiums. But he doesn’t seem to know why they are so high.

HEALTH CARE A RIGHT?

As a group, people with private health insurance in Maine are older and less healthy than people who live elsewhere. Older people are more likely to have chronic conditions that need to be managed to prevent health catastrophes.

But when Moody says health care is not a human right; or when he puts impediments ahead of expanding eligibility for Medicaid to 70,000 Maine people; or when he says people on the program should lose coverage if they don’t meet certain job hunting demands, he is saying that more people should go without coverage. Instead of being treated by a doctor for a chronic condition like hypertension, they will be showing up in emergency rooms with heart attacks or strokes. And if they are uninsured, the cost of their health emergency will be blended into the rates paid by people with insurance.

Universal coverage won’t automatically lower costs, but it does stop the cost from shifting onto private insurance, which has created the burden employers like Moody struggle with. Making more people go without routine care would just make it worse.

Second District Rep. Bruce Poliquin claims to have a 14-point plan that would “fix our broken health care system,” but last year he voted for a bill that would have broken it even more. The bill would have eliminated insurance subsidies for millions of people to pay for tax cuts for individuals with incomes over $200,000 a year. It would have turned Medicaid into a block grant for states. The buying power of the federal share would shrink over time as inflation pushed up health costs. And the bill Poliquin supported would have allowed insurance companies to charge older customers as much as five times more than younger patients.

PRE-EXISTING CONDITIONS

Poliquin claims that the bill would have protected people with pre-existing conditions, but that doesn’t pass the straight-face test. The bill would have allowed states to apply for waivers that would let insurance companies hike the price for people with pre-existing conditions, effectively making insurance unavailable. Whether they refuse to sell plans to people with troubling health histories, or price them so high no one can afford it, the result is the same.

Republican U.S. Senate candidate Eric Brakey offers the libertarian’s all-purpose solution for every problem, which is eliminating regulations and letting people bargain for their health care in a free market.

This sounds good, but it doesn’t stand up to any scrutiny. You can shop for a car, you can shop for a house, you can go across town to get a better deal on groceries, but there is no free market for health care.

When people get sick they need it, and they don’t have the time or the specialized knowledge to make informed decisions. Regulations are annoying, but they are necessary to make sure that the care available at the moment that you need it will meet some basic standard.

Health care reform should be a top priority for any candidate for any office. The Affordable Care Act has succeeded in increasing coverage and slowing the increase in costs. But it has come nowhere near solving the most serious problems with access and affordability.

Neither party should sit out this debate. After eight years of running against Obamacare, it’s time for Republicans to get serious about this crucial issue.