Now that the Republicans in Congress and the White House have been thoroughly shamed by their bungled efforts first to find a replacement for Obamacare and more recently to pass a full clean repeal that would give them a two-year grace period to cobble together a palatable replacement, the blame game is underway.
Yesterday, Vice Pres. Mike Pence read the riot act to the Republican caucus, ordering them to “do their job.” Pres. Trump was even more irate, telling a room full of service members who had been invited to the White House for lunch:
For seven years, I’ve been hearing “repeal and replace” from Congress, and I’ve been hearing it loud and strong. And then when we finally get a chance to repeal and replace, they don’t take advantage of it. So that’s disappointing.
The Washington Times’s Charles Hurt places the burden of guilt on the “dishonest Democrats who created Obamacare and lied about it.” It would comforting to agree with that assessment and move on, but I think it’s a little simplistic. Yes, the Democrats are responsible in the first place for redirecting one sixth of the U.S. economy into a half-baked, unsustainable experiment in government-run healthcare.
But as Trump said, the GOP has had plenty of time and opportunity to develop something better. So why haven’t they? A better, related, question is what happened to all the small-government, free market-driven features Republicans have been talking about since 2009? Back then, the GOP spoke of expanded health-savings accounts (HSAs) and of the ability to buy insurance across state lines — an idea that would increase competition and drive down prices. Expanded HSAs would also make it easier for the consumer to keep his insurance if he changes or lose his job.
What happened to talk of expanding association health plans and making it easier to join a group insurance plan? Or the promise of a less comprehensive insurance that would fit individuals’ needs instead of a one-size-fits-all plan that spread the costs of procedures like childbirth and abortion to families that didn’t need or want them?
As the Republicans flitted from the American Health Care Act to the Better Care Reconciliation Act to nothing, Congress seemed to lose site of this list of features. Some features of Obamacare that were earmarked for demolition — for instance its odious “essential health benefits” — were retained, handed off to states to figure out for themselves.
Republicans are at an unenviable crossroads. They can simply punt as the president intimated at the White House luncheon yesterday. “Let Obamacare fail,” he said at one point. “It will be a lot easier. And I think we’re probably in that position where we’ll just let Obamacare fail.”
But then he said something that is patently false:
We’re not going to own it. I’m not going to own it. I can tell you, the Republicans are not going to own it. We’ll let Obamacare fail and then the Democrats are going to come to us, and they’re going to say, “How do we fix it? How do we fix it? Or how do we come
up with a new plan?”
That’s wishful thinking on the president’s part. He and the Republicans in Congress will own this mess because the Americans who voted for Trump on the promise of repealing and replacing Obamacare now feel betrayed. For evidence of this, look at the president’s and House Speaker’s Paul Ryan ‘s low approval ratings.
Trump and the Republican-led Congress need to win back the trust not only of voters but of renegade senators like Shelley Moore Capito of West Virginia and Susan Collins of Maine. Both were singled out yesterday by conservative commentators , who called them traitors because they had voted symbolically for repeal in 2015 but said they would not vote for Mitch McConnell ‘s real repeal. Moore Capito explained her reason on Twitter:
MORE: I will only vote to proceed to repeal legislation if I am confident there is a replacement plan that addresses my concerns.
— Shelley Moore Capito (@SenCapito) July 18, 2017
Her position is not at all unreasonable. So far there has been no plan that all Republican Congress members have felt comfortable getting on board with. In fact, this is a trait that distinguishes them from the Democrats, many of whom blindly backed Obamacare, warts and all, and ended up losing their jobs.
The GOP needs to attack the health care conundrum fresh. They need to get back to their 2009 talking points and make sure all features are prominent in the new bill (which, ideally, should also include some form of tort reform). The president needs to become part of the process instead of the sideline observer he has been up till now.