Every time Republican candidates for president put forth their Obamacare repeal and replace plans it's like money in the bank for Democratic political ad makers. In their desperate need to appeal to Republican primary voters, candidates are giving Democrats the same kind of health care hammer that allowed Barack Obama to pummel John McCain into the ground in 2008.
This week Wisconsin Governor Scott Walker came out with a somewhat detailed repeal and replace plan, while Florida Senator Marco Rubio outlined a very similar piece in a Politico column. These plans follow the standard playbook of Republican proposals to reform health coverage, one that Republicans in Congress never actually move forward because they understand the political dynamite they would ignite.
The following are accurate claims that Democrats can make about the Walker plan. Most also appear to also apply to Rubio's, although his is such a sketchy description it's hard to be certain about all of them.
The Walker and Rubio plans would return to the days when insurance companies could deny coverage or charge higher premiums because of a pre-existing condition, charge women more for health insurance than men, and stop paying claims when people have high-cost illnesses.
The Walker and Rubio plan would slash the tax credits that allow families to afford health coverage, driving millions of people back into the ranks of the uninsured. It would replace a tax credit based on person's income with a fixed amount, so that a millionaire would get the same tax credit as a working person who makes $25,000 a year.
The Walker and Rubio plan would force 8 million people off Medicaid immediately and then make enormous cuts in Medicaid coverage for families, children, seniors and people with disabilities, hundreds of billions of dollars over the next ten years.
The Walker and Rubio plans would take away health coverage from 3 million young adults who are now on their parents' plans.
The Walker and Rubio plans would make millions of seniors pay more for prescription drugs and visits to the doctor for check-ups. And the Rubio plan would replace today's Medicare with vouchers to buy private insurance.
And here's the kicker that killed McCain: The Walker plan (and it appears the Rubio plan, but it's not clear) would tax health benefits that people get at work.
If each of these statements sound like political poison, they are. For years, opinion polling have found that almost all of the core parts of the Affordable Care Act are politically popular, including with Republicans. In fact, the whole notion of repeal and replace is out of favor with the public. In June, Kaiser found that 27 percent wanted to repeal the law and another 12 percent were for scaling it back, for a total of 39 percent in the repeal and replace category. But 47 percent wanted to either keep it as is (22 percent) or expand it (25 percent). A Bloomberg poll taken in April found that 73 percent wanted to keep the law or include small modifications, while only 35 percent wanted to repeal it.
The relentless Republican campaign to demonize the Affordable Care Act has put their candidates in a political bind, with no escape hatch. With so many people now benefitting from the ACA, Republicans candidates are forced to propose a replacement plan. But it's literally impossible to propose a conservative plan that meets people's needs and therefore is politically palatable. Remember, the ACA itself was a huge compromise with traditional conservative ideas and liberal proposals.
All of which brings us back to the unfolding presidential debate and what the Obama campaign did to John McCain, when he proposed taxing employer health benefits. As Politico reported just before the 2008 election, "Democrat Barack Obama has spent $113 million in health care television advertising so far this year, eight times that of Republican rival John McCain - and investment that polls show are paying big dividends as the election enters its closing weeks."
A typical Obama had ended with the line, "John McCain, instead of fixing health care, he wants to tax it." Another ad showed a clip from a debate between Vice-Presidential candidates Joe Biden and Sarah Palin in which Biden quipped, "Taxing your benefits. I call that the ultimate bridge to nowhere."
We'll be seeing the same kind of ads in the fall of 2016 from Hillary Clinton or whoever the Democratic candidate is, pounding her Republican opponents on health care. And just as Obama raced to reelection standing up against Mitt Romney's pledge to repeal Obamacare, the third Republican presidential candidate in a row will lose in no small part because they don't get that Americans understand in a very personal way what access to affordable health coverage means for their families.