You Call This A Plan?
The Republican plan to “repeal and replace Obamacare” bears a striking resemblance to a dog chasing a car. Every day, for seven years, they’ve sprinted after the car. Ohhhh, they hate the car! The car whips up such a rage within them! And now, after years of effort, they finally caught the car — and they have no idea what to do now.
Inauspicious beginnings
From the moment of Donald Trump’s electoral victory, Republicans were giddy to have the opportunity to repeal the Affordable Care Act. President Trump threw a wrench in the gears when he indicated that he wanted a replacement to come at the same time as the repeal. One would think that this would be an easy enough proposal — after all, “repeal and replace” has been the Republican talking point since the passage of the ACA. So of course they’d have a replacement ready, right?
Well…no.
As it turns out, Republicans had no replacement plan. Not “We’ve got the basics sketched out, now we need to work on some details” — no plan at all. House Republicans voted 54 times to repeal the ACA, and it never seemed to occur to them to articulate the “replace” part of that pledge. This may be a sign of how pessimistic they were about Donald Trump’s electoral chances. Or maybe the problem is more deeply rooted. When a party is built as a well-oiled obstruction machine, they lose sight of how to govern when they get the chance.
Shrouded in secrecy
As House Republicans got to work on their bill, it became obvious that they didn’t want people to see it. Only a select few Representatives got a look at the bill. This was rather hilariously capped off by Rand Paul grandstanding outside of a basement door demanding to see the bill (which, as it turned out, wasn’t there.) We talk often about how Trump’s off-the-cuff remarks betray a lack of preparation, but this problem is not isolated to the President. With each passing day, it’s becoming clearer that this is a problem with a Republican party that has forgotten how to govern.
The grand reveal
Finally, the House bill has been revealed. The New York Times has a good rundown of what the bill would change. What’s the response to this master plan? Well…everybody kind of hates it. The left hates it, obviously. Medical and insurance professionals hate it. Powerful senior citizen lobbies such as the AARP hate it. Rather than endorse the bill, the White House referred to it as a “work in progress.” Kellyanne Conway pushed back against a Fox News anchor calling the bill Trumpcare:
It looks like the only people who do like the bill are House Republicans. Enough GOP Senators have expressed opposition to the bill to make passage through that chamber very difficult. Mike Lee and Rand Paul have both come out against the bill from the right, the latter referring to it as “Obamacare lite.” Moderate Republicans in the Senate have also come out in opposition from the center, saying that the changes made to subsidies and the Medicaid expansion would hurt people in their state. The bill faces the same problems in the House, as both the 32-member Freedom Caucus and some House moderates have expressed opposition.
Assuming that Democrats vote as a bloc, this bill could be defeated with 21 defections from House Republicans or with 3 defections from Senate Republicans. So far, it looks like both chambers have enough disgruntled Republicans to kill it. This problem is exacerbated by conservative lobbying groups standing in opposition to the repeal plan.
Backed into a corner
I understand that there are difficulties in drafting a bill that would please every faction of the party. But one would think a bill could be drafted to please at least one faction of the party.
This intra-party squabbling demonstrates something which I have long suspected: Republicans don’t know how to create a market-based healthcare reform that’s better than the ACA. Since they’ll never embrace single-payer, they’re backed into the corner of opposing the status quo without being able to provide a desirable alternative. If the left is smart, they’ll use this failure to launch as an opportunity to inject single-payer into the mainstream political discourse. As Republicans search for a market-based reform to a market-based healthcare system, the left should point out that these problems disappear under a single-payer system. Will such a thing pass in the next four years? Of course not — but at least when Our Side captures the government, we’ll have a plan.
