The Pitfalls of “Ignore and Deplore”

The Republican Health Care Dilemma

Republicans and health care are like peanut butter and ketchup. They don’t go well together. The issue is so far from the ethos of the Grand Ol’ Party that it’s members never wanted to confront it in the first place… not in the 1990s, not in 2008 and — as we see with the Senate’s failure to bring a bill to a vote - I’m quite sure they’d rather not deal with it now.

The Obama administration forced Republicans, and the country, to face the painful issue of health care. But bereft of constructive political or policy suggestions, the GOP threw a seven-year anti Obamacare temper tantrum. Their strategy, if you call it that, was to sell a lowest common denominator message to their base, policy be damned. I call it, the “ignore and deplore” strategy.
 
The ignore part was straightforward. Republicans simply refused to participate in health reform. They snubbed President Obama’s repeated efforts to engage them in the process. They conveniently forgot that the Affordable Care Act is based on Republican ideas put into practice by a Republican governor. And they disregarded the 161 Republican amendments that the Senate Health, Education, Labor and Pension Committee made to the legislation. To top it off, they wasted their almost decade-long opportunity to craft a workable healthcare plan of their own. By divorcing themselves from responsibility of health reform, Republicans let Democrats take the political risk and added nothing of value to the process. 
 
Then came the deplore strategy, which was based more on soundbites than facts. Republicans and their Fox News foot soldiers poisoned public opinion by capitalizing on emotions about health care. Any and every reform was maligned in the strongest possible terms with words like “death,” and “killing”. It would not have mattered if Ronald Reagan wrote the bill himself. Even today, unrelated, unintended or unaddressed consequences of Obamacare are held as proof of its outright failure. It’s like blaming vaccines for causing autism. It has wide appeal to large swaths of America looking for easy answers to difficult problems. But it’s just not true. 
 
 From a short-term political standpoint, “ignore and deplore” was relatively successful, until now. 
 
With control of Congress and the Presidency, the GOP is exposed like a naked emperor. Their voters demand repeal of Obamacare, expect not to lose health coverage, and even insist on cheaper and better insurance. In Republican voters’ minds, woes about unemployment or low wages will disappear as soon as Obamacare goes away. These unrealistic demands are the long term result of a strategy that fed them more bluster than truth.

Meanwhile many of these same constituents genuinely benefit from Obamacare. The Medicaid expansion, the prohibition of denying coverage for people with pre-existing conditions and the tax credits for private insurance are real, tangible results of the law that they’ve been told is killing them. For all its ills (and there are many), 20 million more people have insurance since Obamacare took effect.

So, Republican members of Congress have a choice. Do they forsake the health of their voters to fulfill a political prerogative of repealing Obamacare? If yes, they risk backlash from millions of angry people who’ve lost health care. Or do they do what’s best and find ways to improve the law as it exists now, perhaps even by working with Democrats? This route also leads to backlash, only this time from frothing conservatives demanding Obamacare blood.

Nevertheless, after nine years of ignore and deplore, the political risk now falls squarely on Republican shoulders. Such is the dilemma of GOP health care politics in 2017. It’s sneakily delightful for people like me to watch them try to squirm their way out of this corner — a corner into which they’ve backed themselves.