Let's play a game: I'll describe a healthcare bill to you. Then you tell me if I'm describing President Barack Obama's Affordable Care Act or the budget released this week by Representative Paul Ryan. The insurance markets in both plans are essentially identical. And for good reason. The Affordable Care Act was based on two decades of Republican thinking about healthcare. The basic structure was first proposed by the conservative Heritage Foundation in 1989, first written into a bill by Senate Republicans in 1993, and first passed into law by a Republican governor by the name of Mitt Romney in 2005.