Republicans’ pledge to “repeal and replace” Obamacare will never die, and yet it is not really alive. It is the undead—and it has risen again.
With the GOP about to take the Senate’s helm, a handful of lawmakers are once again touting plans to replace the Affordable Care Act. Sen. Marco Rubio and Rep. Paul Ryan are reportedly working on a new plan, and Sen. Orrin Hatch, soon to be the chairman of the powerful Finance Committee, used a USA Today op-ed Wednesday to tout a plan he released in January, along with Sens. Tom Coburn and Richard Burr.
Also on Wednesday, Rep. Tom Price plugged an Obamacare alternative he’s been pushing since 2009, but which has never come up for a vote. In fact, no “replace” proposal has ever come up for a vote in the House, despite four years of GOP control. The party has never seriously gotten behind any one proposal, and that’s unlikely to change now.
Why? It’s an exercise in futility. President Obama still holds the White House, and he will for another two years. He obviously is not going to sign off on repealing his signature domestic achievement, making any replacement a moot point.
However unlikely it might be, the only technically feasible way to repeal Obamacare is for Republicans to win the White House in 2016, get to 60 votes in the Senate, keep the House, and decide to use all of that political capital for Obamacare repeal.
It’s also an exercise in futility that comes with political costs.
If Republicans adopted a uniform replacement plan, they’d have to defend politically painful trade-offs—just as Democrats have had to do. Nothing in health care policy is free. Why would a political party looking to expand its power in 2016 want to face those trade-offs head-on, for two years, when it’s impossible to actually change the direction of federal health care policy?
The main criticism of Obamacare is that it has too many mandates, too many regulations driving up premiums. It’s equally easy to foresee the lines of attack over a proposal like Hatch’s: It would raise consumers’ out-of-pocket costs (that’s kind of the point), and popular provisions of Obamacare—such as requiring insurers to cover people with preexisting conditions—would go away. (One person’s burdensome mandates are another person’s consumer protections.)
Especially if Republicans are serious about describing their plan’s trade-offs frankly, they would be opening themselves up to two years of criticism despite being unable to pass the thing being criticized—and forcing their party’s presidential candidate to wrestle with those same thorny issues.
But the fact that the GOP plans are unlikely to get much traction does not mean they aren’t serious proposals.
Hatch’s plan is reasonably comprehensive, especially for something that’s just an idea. There are several components, but the underlying concept is to have Americans cover a bigger piece of their own health care costs, making them smarter and more conscientious consumers and, ideally, leveraging that into more price-based competition within health care industries.
Ryan has an even bigger health care plan: Partially privatize Medicare and shift Medicaid away from dedicated federal funding, into a block-grant program. And Price has had a health care plan for a long time, which he has reintroduced in the wake of his party’s midterm gains.
Inside Hatch’s “repeal and replace” op-ed was an insight into what Republicans are more likely to do regarding Obamacare in the next two years: “Conservatives should also take advantage of all opportunities to repeal any part of the law and replace it with better policies that empower Americans, not Washington,” he wrote.
There are small, targeted pieces of Obamacare where Republicans might be able to force Obama’s hand. The top priority is the law’s tax on medical devices. There’s already plenty of bipartisan support for repealing the tax, and once the the Congressional Budget Office said it would no longer estimate the total costs of all the law’s provisions, taken together, it got much easier for Obama to give up some of the law’s revenues.
The employer mandate also might be changed or even eliminated, which would be an even bigger win for the GOP.
Criticizing an unpopular law and holding bipartisan votes to actually change it have obvious political upsides and very little risk. As for “repeal and replace,” though, don’t hold your breath.
What We're Following See More »
"White House chief of staff John Kelly has tapped Chris Liddell, a senior White House aide and former executive at Microsoft and General Motors, as his deputy." Prior to his appointment, Kelly had just one deputy: "Joe Hagin, who focuses on the day-to-day operations" in the White House. "Up until now, the White House had not named a deputy chief of staff for policy, though several aides, including [DHS Secretary Kirstjen] Nielsen, had informally played that role."
The Supreme Court on Monday "rejected a plea to undertake a historic reassessment of the constitutionality of the death penalty nationwide. The court denied certiorari in Hidalgo v. Arizona, which challenged the constitutionality of that state’s death penalty statute but also attacked capital punishment generally 'in light of contemporary standards of decency.'" The Court did not act on another case, Evans v. Mississippi, which would have prompted a broader review of the death penalty. "Justice Stephen Breyer, joined by Justices Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan issued a separate statement agreeing that the Hidalgo case should be denied because the record in the case was not fully developed, but hoping a future case would be a better platform for reviewing capital punishment."
Saudi Crown Prince Mohammad Bin Salman begins his two-week visit to the U.S. this week, meeting with "political and business leaders in Washington, New York, Silicon Valley and elsewhere" in an effort to shore up financial support for his government and rehabilitate its image abroad. "The crown prince employed a similar public relations strategy on a three-day visit to the UK," where he met with "an array of British business and defense leaders." Bin Salman has been widely criticized for his alleged political chicanery in the Gulf, and for Saudi Arabia's devastating air campaign in neighboring Yemen.
A fourth package bomb injured two people in Austin on Sunday evening, "which the police chief says was caused by a tripwire and showed 'a different level of skill' than the package bombs used in the three prior attacks." The police are still searching for the perpetrator, and have warned residents to not pick up or approach suspicious packages. Previous explosions, which the police believe are connected, have killed two and wounded several others.
White House Lawyer Ty Cobb said that President Trump not considering firing special counsel Robert Mueller. Speculation swirled after Trump attacked the investigation on Twitter, and called out Mueller directly for the first time. “In response to media speculation and related questions being posed to the Administration," Cobb said, "...the President is not considering or discussing the firing of the Special Counsel, Robert Mueller." Several members of Congress, "including some top Republicans, warned Trump to not even think about terminating Mueller."