Republicans had seven years to plan Obamacare repeal and they've still failed

It’s easy to rant and rail when the levers of power are elsewhere, isn’t it?

David Usborne
New York
Tuesday 18 July 2017 17:49
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Republicans made destroying the Affordable Care Act a sort of blood-handshake with their supporters
Republicans made destroying the Affordable Care Act a sort of blood-handshake with their supporters

Let’s ponder how marvellous is the manure pile that the Republicans have built for themselves since taking control of the whole bag of tricks in Washington. If this is to suggest that they have no one to blame but themselves, well then so be it.

They didn’t have to begin their glorious new reign by focusing first on nuking the healthcare law Democrats pushed through in 2010. Apart from busying themselves dismantling assorted regulatory orders born in the dying days of Barack Obama’s presidency, they needed some big and noisy legislative accomplishment early on to show they could effectively govern.

Wisdom might have suggested tackling something that, first, they could all actually agree on and, second, would be well received by a wide spectrum of voters. Let’s say tax reform, which even some on the left agree is urgently needed, or the promise made by Donald Trump finally to throw big money at the country’s crumbling infrastructure. The latter would have had the added advantage of splitting Democrats – repairing roads, bridges, tunnels and schools creates jobs.

But no. For seven years, Republicans had picked obsessively at a single sore: the Affordable Care Act, derisively known as Obamacare. Most of them, and especially those to the right flank, made repealing it a sort of blood-handshake with their supporters. Upon finally taking charge in Washington – House of Representatives, Senate and White House – they would do it or die.

Well, now they are dying.

Paul Ryan hardly distinguished himself when this was in his lap. But what should we expect from “a limp-d**k motherf***** who was born in a petri dish at the Heritage Foundation”. Don't laugh. This is the considered and choice appraisal of the House speaker from Steve Bannon, the firebrand top advisor to Trump, according to a new book, Devil’s Bargain, by Bloomberg journalist Joshua Green. It’s good to see Republicans sticking together.

In early May, Ryan did finally grind out a House bill to repeal Obamacare and replace it with a new system to keep the country healthy. Trump invited him to the White House to celebrate only to tweet days later he thought his draft “mean”. By then, though, the action had moved to the Senate, where majority leader Mitch McConnell was vowing to move lickety-split towards passage of his own version of repeal-and-replace. Surely by early summer the exercise would finally be over. The new law would be on Trump’s desk to sign and it would be smiles all around.

Oh boy. Masterful McConnell has been exposed as Mangling Mitch. He had a Plan A. Then he had a plan B. Both foundered because he could not find a way to suppress rebellion either from the right, which considered what was on the table to be far short of actually obliterating Obamacare in the manner they crave, or from moderates who fretted that the end result would be, as Trump himself put it, too mean. A forecast from the non-partisan Congressional Budget Office said that Plan A would have robbed 23 million Americans of healthcare insurance, mostly by rolling back a huge expansion of insurance benefits for the poor known as Medicaid. We were about to hear their predictions for Plan B when McConnell decided it wouldn’t fly either.

Are we feeling sorry for the Republicans? They have always had real intellectual and ideological arguments for doing away with Obamacare which has at its heart a mandate that makes buying some form of health insurance obligatory. Folk who fail to do so are hit by a fine come tax day. This is anathema to the American right – it’s government intrusion incarnate – and so is the original broadening of Medicaid, essentially a welfare programme. But without the mandate, Obamacare crumbles. And no provision of Obamacare is more important to the main goal of reducing the numbers of Americans without health insurance than the expansion of Medicaid.

And the sins of the Republicans are hard to ignore. How is it possible that for seven full years they bleated about Obamacare without at the same time coming up with a viable alternative of their own? It’s easy to rant and rail when the levers of power are elsewhere, isn’t it?

McConnell accused the Democrats of ramming the original 2010 law through without input from their side. That’s fair, but he has proceeded to behave in exactly the same way. Plan A and his Plan B were concocted in secret. Even most of his own senators had no clue what was going on. No committee hearings, no open debate of any kind. That meant that no attempt has been made to sell what Republicans were proposing to the general public, never mind that this law that would impact one fifth of the nation’s economy and the lives of more or less every American.

This is especially unwise given the latest intelligence from the polls about Obamacare. It is more popular now than it ever was when Obama was actually in the Oval Office. A new Washington Post/ABC poll suggests that twice as many Americans favour keeping Obamacare rather than repealing and replacing it with what the Republicans eventually came up with.

Now every Senate plan has gone down in flames, a total humiliation for McConnell from which he may never recover and a political catastrophe for Trump also. For a brief moment on Tuesday McConnell suggested moving to Plan Z – simply repealing Obamacare with full effect in two years time and leaving for another time for finally figuring out how to replace it. That, however, would be an obvious recipe for disaster – even more millions would stand to loose coverage – and moderates in the party quickly made clear they would bolt from that option also. McConnell is now out of road.

It should dawn on Republicans at this point that their mission to consign Obamacare to history was always a dead-end proposition. If they'd been able to agree ahead of time on a viable, sellable alternative plan perhaps it would have been a different story. But that wasn't the case. Meanwhile, that poll – 50 per cent for keeping Obamacare, 25 per cent for the Republican alternative – should tell them that even their own constituents may be not as obsessed with the issue as they are. The big legislative win they so badly need will come from elsewhere – from bridges, tunnels or tax. Return to healthcare when you have calmed down. And if your mission then is to improve Obamacare – not simply to wreck it – maybe even Democrats will join you in trying.

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