Back in March of 2014, I had the opportunity to tell the story of the Republican alternative to Obamacare ― that piece of legislation that would serve as the replacement in the constant vows of Republican legislators to “repeal and replace” the Affordable Care Act. Basically, it was five years of an endless cycle of proposing alternatives, tabling those alternatives, taking criticism for the lack of alternatives and then the grim renewal of this process ― accompanied by continued reminders that the GOP could not “be the party of no” and would not be able to “beat something with nothing.”
It was a chronicle of absurdity, which I termed “the public policy embodiment of Zeno’s dichotomy paradox” at the time. The Republican replacement ― that legendary quantum artifact ― was always coming but never arriving, and the sureness of this non-eventuality was, for those five years, as constant and as certain as death and taxes.
Three years later, this is as true as ever.
Of course, there have been some changes since we arbitrarily closed this chapter back in 2014. Changes in congressional leadership have brought changes in priorities and tactics. For a brief, mad moment, Republicans were able to shelter in the hope that a U.S. Supreme Court decision might kill the act ― removing the worry that their legislative fingerprints would be found on the corpse, absolving them of the blame for the disruption.
Throughout the last three years, Republican legislators grew markedly less eager to write replacement bills only to see them languish, unremarked upon, in committee. Instead, they’ve become attached to rudiments ― working groups, task forces, outlines and white papers ― assuring that they will always be able to talk up all the activity in which they are engaged without having to subject any of their work to scrutiny, or a vote. The urgent need to “repeal and replace” remains their cri de coeur. But over time, it became clear that they’d rather have that urgency ― and its animating force among the Republican base ― than a resolution.
It’s almost as if GOP legislators, knowing their congressional majorities were always going to be in decent enough shape, were planning to continue the work of useful demagoguery, with a new Democratic president as their foil.
But there was a bit of a plot twist, if you recall! The GOP won the White House, and it was now time to put up or shut up. You’d think that this would create favorable circumstances to finally repeal and replace Obamacare. I think that for a day or two, Republican lawmakers felt the same way.
Things haven’t gone as planned.
It’s almost as if wherever you point that thing, someone’s going to get hurt. But let’s not spoil the ending. Instead, we will pick up our history of the Republican alternative to Obamacare where we left off.
Rep. Renee Ellmers (R-N.C.) tells a Politico Health Care Breakfast Briefing that the “GOP plan to replace Obamacare may be a collection of different bills rather than a single omnibus package,” owing to the fact that Republicans had not yet “come together on a plan.”
Ellmers said getting Republicans to agree on one plan is like “herding cats” but that ultimately the party will examine “what has worked and what hasn’t worked” about Obamacare to devise a solution.
But one cat in particular was running fairly far afield from the rest of the herd: Sen. Ted Cruz (R-Texas), who, in an appearance on ABC News’ “This Week,” said that the GOP was going to “repeal the controversial health care law in 2017.”
Republicans didn’t want to hear about it from Cruz. Days later, The Washington Post’s Robert Costa reported that “House Republican leaders” were “adopting an agreed-upon approach to fixing the nation’s health-care system, in part to draw contrast” with Obamacare. The new plan contained “an expansion of high-risk insurance pools, promotion of health savings accounts, and inducements for small businesses to purchase coverage together,” as well as “guaranteed renewability” and “the ability to buy insurance across state lines.” In short, the same ingredients as many other Republican alternatives to Obamacare that had died in committee.
According to simultaneous reports in Politico, “the dirty secret about the House Republicans’ efforts” was that they had not even “decided if they will hold a vote.”
Sure enough, a few days into April, House Republicans announced that they were “delaying the rollout of their alternative proposal to Obamacare,” with House Majority Whip Kevin McCarthy of California citing the difficulty of “trying to get it all together.” But hours later, it was reported that the monumental task was being taken up by Sen. Marco Rubio (R-Fla.) and Rep. Paul Ryan (R-Wis.). “I don’t have anything to announce today,” said Rubio, when asked about it.
A GAME-CHANGING IDEA EMERGES: “We need to have a positive alternative,” said Rep. Tom Price (R-Ga.).
House Republicans returned from a two-week recess with a renewed repeal-and-replace itch, with House Majority Leader Eric Cantor releasing a strategy memo that gave reforming “our healthcare system by replacing Obamacare with policies that improve patient choice, access to doctors and hospitals and lower costs” a priority for the weeks to come. The Hill subsequently reported that conservatives in the House were determined to “press their leaders ... to move on an Obamacare replacement bill before the August recess.” It was a cunning plan!
According to several GOP lawmakers, members of the conservative-leaning Republican Study Committee (RSC) plan to wear lapel pins to the weekly conference meeting that state, “HR 3121, There’s a Better Way” as a sign of support for moving a bill that is co-sponsored by 130 House Republicans.
Rep. Phil Roe (R-Tenn.), the lead sponsor of H.R. 3121, the “American Health Care Reform Act of 2013,” told The Hill that RSC members will “all wear little pins to conference [this] week … to push our leadership to bring this bill up or [another] bill up.”
HR 3121 was referred to committee, and nothing came of it. It’s unknown what became of the lapel pins. By the end of the month, Republicans conscious of the looming midterms began to “retreat” from their “all-out assault” on Obamacare, “talking about the health-care law in more nuanced terms” and, in some instances, running on “fixing” the law rather than repealing it.
On June 4, The Associated Press’ Erica Werner reported that, while House Republicans were as “united as ever in their election year opposition to Obamacare,” they were “increasingly divided over their promise to vote this year on an alternative.” Cantor’s spokesman Doug Heye, however, voiced confidence, saying, “Majority Leader Cantor continues to work towards bold legislative solutions to replace Obamacare.” Which was all well and good, except Cantor was competing in a Virginia primary on June 10, and ... well, this happened:
House Majority Leader Eric Cantor’s shocking primary loss Tuesday night all but kills any chance of the House voting on an Obamacare replacement bill this year.
The prospects of Republicans rallying around a replacement policy and scheduling a vote was already an uphill endeavor — one that few expected to actually happen. After all, the House GOP had been trying to agree to a plan for several years already.
But the loss of the House leader who was most closely allied with the lawmakers seeking a vote is probably an insurmountable obstacle.
Whoops! And just as Cantor was going to mount what would have certainly been a game-changing bus tour as well!
Cantor’s ouster led to the elevation of Rep. Steve Scalise (R-La.) to the role of House majority whip, deemed by House Republicans to be “good news for ultimately getting a replacement measure to the floor.” Still, a gloomy road loomed for the replacement crafters. “You know, the discussions about Obamacare and what the replacement bill would look like continue,” said House Speaker John Boehner (R-Ohio). “We’re trying to build consensus around one plan. Not there yet.”
But by August, no replacement bill was in sight ― and Republicans were deep in contemplation about what they would do if they retook control of the Senate after the midterm election. Their plan: Repeal Obamacare in a “series of votes,” watch President Barack Obama veto those bills and then scratch their heads a lot.
In an interview with The New York Times, Sen. Rand Paul (R-Ky.) suggested that after the president vetoed their repeal bills, those crafting an alternative could coalesce around the kinds of ideas that Obama might not veto: “If we won, I think you would see a vote for repeal, and I would vote to repeal the whole thing. I have a feeling [Obama] won’t sign that. Then you start trying to see what he will sign.”
A GAME-CHANGING IDEA EMERGES: “We need to change our mentality,” prescribed Sen. John Cornyn (R-Texas). “Because we have been in the minority, some people are used to saying no. We need to find something we can say yes to, something that advances our agenda.”
Sen. Rob Portman (R-Ohio), echoing Rand Paul, said that Republicans would definitely vote to repeal Obamacare if they retook the Senate. “I suspect we will vote to repeal early to put on record the fact that we Republicans think it was a bad policy,” Portman said, evidently not sufficiently convinced that the GOP had made its position on the law as clear as it should have. Almost as an afterthought, Portman said that having a replacement plan might be a nice thing, saying, “I think we should.”
Meanwhile, many of Portman’s would-be Senate colleagues were campaigning at cross-purposes ― playing down their desire to repeal Obamacare outright while touting replacement plans that did not, strictly speaking, exist.
Undaunted, the GOP’s Senate nominee in Virginia, Ed Gillespie, rolled out a preview of his alternative-to-Obamacare plan in Williamsburg. Like all GOP alternative plans, it included tax credits for insurance consumers, the ability to buy plans across state lines, medical savings accounts, new tort reform measures as well as “as-yet-undefined protections for people with pre-existing conditions.” Beyond that, it included Gillespie not going “into much detail.” Gillespie’s plan hit a snag when he did not win the election.
Remember back in April, how Ryan and Rubio were hard at work with a Republican alternative to Obamacare? Well, let’s check in with The Tampa Bay Times’ Alex Leary, who sought out to report on the details of their progress: “Without more detail, it’s difficult to assess the scope and implications of the legislation. Rubio’s office indicated Monday that things were still coming together.” OK!
Having taken control of the Senate, the GOP turned its eyes to its Obamacare replacement plan ― except that, according to newly minted Senate Majority Leader Mitch McConnell, that plan was, once again, back in the larval stage. As Reuters’ Richard Cowan reported:
The senior Senate Republican on Tuesday raised the possibility of Congress writing comprehensive healthcare legislation if the Supreme Court next year strikes down a subsidy provision of Obamacare.
Raised the possibility of writing a plan? Well, unfortunately for McConnell, the King v. Burwell case ended when the Supreme Court upheld the subsidies. But that’s a bit of a spoiler alert.
A GAME-CHANGING IDEA EMERGES: Author Philip Klein: “If the justices invalidate those subsidies, Republicans must have a free-market alternative waiting in the wings. Otherwise, there will be tremendous pressure on Congress to pass a ‘fix’ allowing existing benefits to continue. Obamacare will be entrenched before Republicans even get a chance to retake the White House. The time to stop that is now.”
As the new year dawned, GOP legislators were still eyeing the possibility that the Supreme Court might end up being Obamacare’s death knell. If the Obamacare subsidy system was gutted by a court majority, the viability of the health law would be badly imperiled. As Politico reported, “The GOP wants to be ready.” After nearly six years of getting ready to prepare to get ready to replace the bill, the time was finally ripe (again).
And so, Republican lawmakers flew into action, preparing legislation that would repeal Obamacare by “instructing relevant committees” to finally buckle down and write that Obamacare replacement. Meanwhile, other Republican leaders were banding together to form their own “task force” ― a move that was hailed as their “most serious attempt this far to develop their health care package.” Surely this would be the last time they restarted this process!
A GAME-CHANGING IDEA EMERGES: “What the King case does is gives us an opportunity and a reason to come to a consensus sooner so, when we get the ruling of the Supreme Court in June, we are then prepared to say, ‘Here is what is better for the American people in terms of affordability, quality and choice,’” said Sen. John Barrasso (R-Wyo.), chairman of the Senate Republican Policy Committee.
Progress at last? As The Hill reported in February’s first week, Sens. Orrin Hatch (R-Utah), Fred Upton (R-Mich.) and Richard Burr (R-N.C.) revealed an “outline” of a “plan” to the public. But, as usual, there was a lack of consensus: “The plan — released the same week that the House cast its first vote of the year to repeal ObamaCare — will compete with several other replacement options as the GOP tries to coalesce around a response to a looming Supreme Court decision that could dismantle the law.” (Confusingly, Upton was also a member of the aforementioned “task force” that was supposed to be preparing the plan around which consensus was to form.)
Burr would later say that the GOP might not be able to come to an agreement on a replacement plan until 2017. But Paul Ryan wasn’t having it, insisting that the GOP plan would be revealed in March. “I don’t want to reinvent the wheel,” Ryan proclaimed. Which is too bad, because that’s something they might have been able to accomplish by now.
Remember how back in January, Sen. Barrasso was telling people that the GOP had to be “prepared to say, ‘Here is what is better for the American people’” by the time the Supreme Court ruled? Well, funny thing:
One day before Supreme Court was scheduled to hear oral arguments in King v. Burwell, TPM asked Senate Majority Leader Mitch McConnell (R-KY) at his weekly Capitol press conference if the GOP would have bill ready to mitigate the potential health care crisis.
The short answer: We’re working on it, but won’t commit to anything.
Ah, well. But the good news was that now that the effort to replace Obamacare was entering its seventh year, “the search for a replacement by Republican lawmakers [was] finally gaining momentum,” according to The New York Times. As oft-quoted Republican economic adviser Douglas Holtz-Eakin enthused, “There’s an untapped discussion out there.... It’s coming.”
Also coming: a defined time-frame. As Talking Points Memo reported:
The Senate Republican budget released Wednesday inches forward with an Obamacare replacement by putting in place a process for key committees to craft one. A very small step but a notable one that sets a self-imposed deadline.
That deadline? July 31, 2015. Boom. But what about specifics? “There are no specifics ― yet.” Ah.
Then, suddenly, at the end of April, The Hill reported that “the most conservative members [were] putting the final touches on a new Obamacare replacement plan.” Ahead of schedule, even! Most important, this plan would be out before the King v. Burwell decision, so it was probably prepared for all contingencies, right?
The plan will not specifically say how the GOP should respond to the King v. Burwell case, which threatens to erase healthcare subsidies for 7.5 million people in 34 states.
Republican Study Committee Chair Rep. Bill Flores has this to say about their efforts:
“If we start building toward a shore, but we don’t know what that shore is, then the bridge might not work very well,” the Texas Republican said. “The alternative tells you what the other shore looks like.”
Wait, are you guys in boats or something?
Meanwhile, Rep. Tom Price introduced his alternative plan, HR 2300 ― better known as the Empowering Patients First Act ― a name borrowed from two other bills he’d failed to advance. HR 2300 was referred to committee, and nothing ever came of it.
As the day of the Supreme Court’s decision approached, GOP lawmakers’ feet of clay returned ― and with them came the calls to kick the can down the road as far as a replacement plan went. Rep. Ryan, reminded by “Fox News Sunday” host Chris Wallace that his colleagues had “still not come up with a coherent plan” to replace Obamacare, “responded by noting that there had been GOP alternatives when the Affordable Care Act was passed in 2010 and said that his party will have a replacement plan sometime in the next administration.” Congressional leaders echoed this not long afterward. As The Huffington Post’s Jeff Young reported, Rep. Charles Boustany of Louisiana said that House Republicans were content to “tee up” the task for “the next president.”
In The National Review, Sen. Ben Sasse (R-Neb.) outlined a vision that would make it the responsibility of Republican presidential nominees to come up with the plan:
Beginning now, presidential contenders must present a constructive vision for health-care reform. It should be a minimum requirement that any candidate worthy of consideration must have a coherent plan for the voters. The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017. If Republicans fail to offer compelling alternatives to Obamacare in the 2016 campaign, we will lose — and we will deserve it.
(Funny thing about that, actually!)
So, do you remember how back in March, Senate Republicans had set an end-of-July deadline for the unveiling of the GOP alternative to Obamacare? Well, as Politico reported, “Republican lawmakers and staffers [in the Senate] say that the July 24 deadline doesn’t really mean anything.” “I don’t have a time to give you,” said Mitch McConnell. “We’ve got a lot to do,” added Sen. John Cornyn. While many members of the House felt put out by the news, their leaders quickly fell in line. “It’s not a hard and fast deadline,” said House Majority Leader Kevin McCarthy (R-Calif.), who added, “I don’t think there’s a reason why we have to hurry. So you will see something later.”
No reason to hurry, reiterated Sen. John Thune (R-S.D.): “I think if we use reconciliation for Obamacare, I don’t know if there’s any particular rush to doing it. You know that’s an issue that’s going to be around for a while. It’s not going away.”
A GAME-CHANGING IDEA EMERGES: Wisconsin Gov. Scott Walker: “We must repeal Obamacare in its entirety as soon as possible. But we can’t stop there. The president’s policies must be replaced with a plan that will send power back to people and the states.”
Former Florida governor and presidential aspirant (he was actually considered by many to be the front-runner around this time!) Jeb Bush tells Fox Business Network’s Maria Bartiromo that his own Obamacare alternative is imminent. That plan, he says, will be a “consumer-driven system” that includes “low-premium, catastrophic coverage where it’s portable,” as well as offering consumers “more than one choice” so that they are “empowered to make decisions zzzzzzzzzzzzzzz (falls asleep).”
If you recall, back in July of 2014, John Boehner was telling reporters that Republicans were “trying to build consensus around one plan.”
And then in January, Sen. Barrasso, anticipating the ruling in the King v. Burwell case, was saying, “What the King case does is gives us an opportunity and a reason to come to a consensus sooner so, when we get the ruling of the Supreme Court in June, we are then prepared to say, ‘Here is what is better for the American people in terms of affordability, quality and choice.”
And then, later that month, Senate Republicans set themselves an end-of-July deadline ― which they blew through.
But now it’s October, so, what’s up? The Hill reports: “Consensus emerging in GOP on how to replace Obamacare.”
Emerging, eh? Reset the stopwatch!
Cue the sirens! On Dec. 3, House Speaker Ryan emerges from his chamber of solitude to tell reporters, “We think this problem is so urgent that next year, we are going to unveil a plan to replace every word of Obamacare.”
Four days later, The Hill reports:
“We need to have an alternative, and that’s something that I’m going to be pushing our congressional committees to develop and to roll out in 2016,” Ryan said during an interview with a Wisconsin radio station. “I don’t have an exact timeline. I don’t want to be, you know, the dictator of the House. I’m the Speaker of the House.”
So not as urgent as all that. Meanwhile, The Hill goes on to report that “Congressional Republicans are also planning a retreat next month in Baltimore, where input on the plan can be gathered.” This despite the fact that whenever Republicans get together, they come up with the same plan with the same elements and then fail to do anything with it legislatively. Why is that? Well, as The Hill mentions:
Developing a full replacement plan will also force Republicans to confront trade-offs like how to pay for the plan.
So that is why.
Another new year kicked off, another immediate return to activity masquerading as achievement ― pursued with the temporary fervor of all New Year’s resolutions. We begin with some breathless reporting from Fox News:
Within hours of reconvening Tuesday, the GOP-led Congress will finally act to fulfill a 2010 promise to repeal and replace ObamaCare.
The effort is set to begin Tuesday afternoon when the House Rules Committee meets on the repeal measure, with a full debate and vote as early as Tuesday. With the Republican-led Senate having already passed its version, GOP congressional leaders will send the measure to President Obama, daring him to veto it.
Daring him! But, is this really much of a “dare,” per se?
Obama will undoubtedly veto the measure to undo his signature health care law, and Congress has nowhere near the votes to override a presidential veto.
Whew! Real seat-of-the-pants stuff right there! But this time out, they actually managed to send a bill to the president’s desk ― though, weirdly enough, it also called for the blocking of federal funds for Planned Parenthood. It’s almost as if Republicans were worried Obama wouldn’t veto it. Hey, Mr. President, we put some more veto-bait in this thing. Just wanted you to notice!
It was also announced that the “GOP Doctors Caucus” was going to “work on its own Obamacare replacement bill.” But the meaning of the words “its own” were a bit strained. As Politico reported, this new bill combined “Rep. Tom Price’s Empowering Patients First Act and the Republican Study Committee’s American Health Care Reform Act, which it first introduced in fall 2013.” So, it was sort of like “The Eagles’ Greatest Hits” of Obamacare replacement bills.
But from there, GOP legislators once again demonstrated that their desire to buckle down and work on a replacement to Obamacare was a transient thing. “Senior House Republicans” told Politico on Jan. 7 that they weren’t planning “to hold votes on many of the agenda items the party plan[ned] to unveil ― such as a health care plan to replace Obamacare.” But when Obama eventually and predictably vetoed the repeal bill sent to him one week later, Paul Ryan responded with a hot-blooded vow to create a “patient-centered health system.”
But his House colleagues weren’t feeling it, according to The New York Times:
But the only area where House and Senate Republicans promised legislation was appropriations. It was unclear, for instance, whether Republicans will actually present a plan to replace the current health care law that has been their central policy punching bag since they took over the House.
Republican leaders in the House and Senate demurred on whether they would write and vote on a bill this year.
A GAME-CHANGING IDEA EMERGES: According to a report from CQ Now health care reporter Melissa Attias, Rep. Tom Price said that it was incumbent on Republicans to “pursue [an] Obamacare alternative” and that he was anticipating the House “bringing a package of solutions forward this year.”
GOP legislators literally just rebooted the same plan they spent the entire past calendar failing to follow. A vow to finally put something together? Check. Multi-committee “task force” assignments? Check. A July deadline? Yep! You had to give the Republicans credit: They had, by this time, gotten really good at this part of replacing Obamacare.
News about the GOP’s multi-pronged, multi-tracked process of promising to deliver a Republican alternative to Obamacare once again reached the simmer stage, and along with it came a heady promise: The alternative would be arriving ahead of schedule. Which is an amusing thing to say about something that’s been late in arriving for years.
As The Hill reported, a “group of senior House Republicans” emerged to “promise to deliver proof that the party [was] making headway in its six-year struggle to replace Obamacare.”
”Give us a little time, another month or so,” House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) told reporters this week. “I think we’ll be pretty close to a Republican alternative.”
None of which sounded like a concrete plan to either replace Obamacare or a concrete plan to provide proof that anyone was “making headway” in the “struggle” to come up with a concrete plan. Upton described his group as being in “listening mode.” To whom were they listening? “You name it ― the world.”
However, subsequent reporting indicated that this House task force had hit on one idea: a “healthcare backpack,” which would include a “health insurance plan, a health savings account, and easy access to … medical records.”
Meanwhile, The New York Times’ Jennifer Steinhauer, in reporting on the “parallel campaign” that Speaker Ryan was running alongside the presidential primary, captured Ryan making this vow:
For example, if the Republican nominee does not provide an alternative to the Affordable Care Act ― something Republicans have failed to do since it passed in 2010 ― Mr. Ryan intends to do so.
Strong words! As The Hill noted: “Coming up with a plan to replace Obamacare has been an aim of the Republican Party for so long that it’s become a laugh line even in conservative circles.”
The Hill reported that the GOP was finally poised to release an Obamacare alternative into the wild. It would not, however, be a piece of legislation. Rather, it would be “more of a broad outline” or “a white paper that is less detailed than legislation would be.” The release of this outline/white paper would be “part of a broader effort from Ryan to show that House Republicans have policy solutions.”
According to The Hill, that white paper would contain a lot of what we’d come by now to expect from a GOP plan, including “a tax credit to help people afford insurance and a cap on the current exclusion of employer-based health insurance plans from taxation.”
What it would not contain, however, was “specific dollar figures on some of its core provisions,” because that would help “[put] off some of the difficult tradeoffs and [preempt] lines of attack that would be raised with a specific and detailed plan.”
A subsequent report from The Morning Consult offered further details:
“Including numbers for growth rate in premium support and tax credits would allow Democrats to calculate how much more seniors and low-to-moderate income working people would have to pay for health care,” said Ed Lorenzen, a senior advisor at the Committee for a Responsible Federal Budget. It would be “most problematic for internal Republican conference politics if there was enough detail for CBO to provide a cost estimate [and] the net savings would be drastically less than their budget assumed, which would cause heartburn for the Freedom Caucus.”
Replacing Obamacare sure wasn’t getting any easier!
A GAME-CHANGING IDEA EMERGES: “It’ll be terminated and replaced with something,” said Donald Trump on Obamacare.
Trump continued to talk up the tremendousness of the eventual Obamacare replacement: “Plans you don’t even know about are going to be devised.”
And now, “Hype and Expectations Before and After an Election,” a play in five tweets:
For just about the entirety of the Affordable Care Act’s life, congressional Republicans have known that with Obama in the White House, any effort to repeal and/or replace his signature piece of legislation was guaranteed to come to naught. And yet that never impeded them in crafting the perception that they were hard at work coming up with a replacement and eager to present the fruits of their labors. When it came to meeting deadlines, GOP lawmakers were a profound failure, but that never stopped them from setting them all the same ― and when they did so, it was always within a tight time horizon.
So, without the choke-point of a presidential veto to fret about, you’d think they’d finally crank this get-rid-of-Obamacare machine into high gear. But you’d be wrong ― and amusingly so. As Politico reported:
Congressional Republicans are setting up their own, self-imposed deadline to make good on their vow to replace the Affordable Care Act. With buy-in from Donald Trump’s transition team, GOP leaders on both sides of the Capitol are coalescing around a plan to vote to repeal the law in early 2017 — but delay the effective date for that repeal for as long as three years.
That’s right: Winning the election simply led to new innovations in balking ― now with the “repeal” part of the deal stuck in some long-term limbo. Per Politico: “The idea is to satisfy conservative critics who want President Obama’s signature initiative gone now, but reassure Americans that Republicans won’t upend the entire health care system without a viable alternative that preserves the law’s popular provisions.”
As it turns out, that’s a pretty hard nut to crack: getting rid of Obamacare while simultaneously retaining all of its popular features. Delaying the repeal itself would require GOP lawmakers to provide a backstop, in the form of a financial bailout, to hospitals and insurers whose bottom lines would be roiled in the uncertain market created by the Republican legislators’ own uncertainty. This conundrum was nicely summed up by New York Magazine’s Jonathan Chait:
Republicans can certainly patch up the exchanges and keep them going during a transition period. All it would require is halting their relentless efforts to blow up the law and start trying to make it work. (“They want to pump money back in to the insurers without appearing like they’re giving them a handout or bailing them out,” one insurance lobbyist explains.) But if they do this, then they’ll have essentially proven that they can fix Obamacare. And if they can fix it, why would they let it expire? Especially when the deadline for the replacement approaches and, inevitably, Republicans have still failed to produce a replacement?
It’s no wonder that in the hour of their greatest success, Republican lawmakers found themselves “arguing over how long it will take to phase-out Obamacare and are essentially nowhere on an Obamacare replacement” and contemplating a delay process that was, in some imaginings, timed to “avoid [the] 2020 election.”
A GAME-CHANGING IDEA EMERGES: “Repeal is not going to be as simple as some people might have thought,” said the Bipartisan Policy Center’s G. William Hoagland.
With President-elect Trump’s inauguration looming, it was like GOP lawmakers were only getting around to understanding what the Affordable Care Act did and the immense challenge that lay in front of them. As the Los Angeles Times’ Noam N. Levey reported, Republican legislators were seemingly only becoming aware of some of the factors in play, like the numerous Republican governors who had expanded Medicaid under the law’s auspices and how the overall rate of uninsured Americans had been brought to historic lows thanks to the tax revenues that underpinned Obamacare’s mechanics.
As The Huffington Post’s Jonathan Cohn reported Jan. 12, Senate Republicans took a first step, passing a “special budget resolution that instructs committees to write legislation stripping the health care law of its funding and spending provisions.” Still, it was generally held that this was among the easier steps in what promised to be an arduous process.
And the “repeal” part of the deal wasn’t nearly as complicated as the process of crafting a replacement. CNN reporter Phil Mattingly reported on Jan. 11 that Sen. Joe Manchin (D-W.V.) was talking up how a replacement bill would be at hand inside of two months, but subsequent reports only served to make one wonder where Manchin found this confidence.
Maybe what the Republicans needed was some guidance from their new president’s Twitter account:
“Republicans must be careful in that the Dems own the failed ObamaCare disaster, with its poor coverage and massive premium increases ... like the 116% hike in Arizona. Also, deductibles are so high that it is practically useless. Don’t let the Schumer clowns out of this web ... massive increases of ObamaCare will take place this year and Dems are to blame for the mess,” Trump wrote. “It will fall of its own weight - be careful!”
Oh, whoops, that was no help at all! Fortunately, things were stirring on Capitol Hill, according to HuffPost’s Matt Fuller:
On Thursday, Republicans held a two-and-a-half hour session on Obamacare that many lawmakers thought could produce those general agreements on a replacement. Instead, in the words of one member, “it was a farce.” Two other members characterized it as “pathetic.”
A pretty evergreen sentiment, if we’re being honest.
And so, let’s sum up where we are right now, on the matter of the Obamacare replacement, courtesy of HuffPost’s Jeff Young:
Senate Republicans have not yet begun to work in earnest on a replacement plan for the Affordable Care Act, Sen. Bob Corker (R-Tenn.) said on Tuesday.
It was a rare public admission of what has become obvious from the outside, as Republicans find both the politics and the substance of Obamacare repeal more difficult in practice than in rhetoric.
“To be honest, there’s not any real discussion taking place right now,” Corker told reporters in the Capitol.
Welp, there’s always next year!
Jason Linkins edits “Eat the Press” for The Huffington Post and co-hosts the HuffPost Politics podcast “So, That Happened.” Subscribe here, and listen to the latest episode below.
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