Reformulating the American health care system is hard, to say the least. That reality is now setting in on Congressional Republicans as they gear up to quickly repeal President Barack Obama’s health care law. The catch? What’s already in place may look pretty appealing in hindsight, if not already.
Far from ready to learn from past blunders, the prevailing consensus among the majority of GOP lawmakers is the time bomb-like repeal of the besieged health care law to delay construction of a replacement program is the best way to go, according to Rachael Bade and Burgess Everett in Politico’s “GOP may delay Obamacare replacement for years.”
A cliff, if you will.
But insurance companies will get the message as soon as the law is repealed, Bade and Everett wrote, and could abandon their tens of millions of consumers no matter how slowly Republicans try to pull off the Band-Aid.
After regular chipping at the Affordable Care Act’s integral foundation, the full repeal may be delayed for as long as after the 2020 elections to portray the law as collapsing and to avoid as much political blowback as possible, Sahil Kapur wrote in Bloomberg’s “GOP Readies Swift Obamacare Repeal With No Replacement Ready.”
Or maybe that delay is because, even though many Republican replacements have been thrown out there, the only sustainable health care model based in conservative principles is already in place.
The conservative beginnings of Obamacare
Obamacare’s basic structure rests on conservative policies from the early 1990s that insurance companies have been discreetly lauding since 2010, J. D. Kleinke wrote in “Why Obamacare is a Conservative’s Dream” for The New York Times. The statute’s mandate and pro-market insurance marketplaces — distinctively conservative concepts hinging on personal responsibility and accountability — were originally devised in 1989 by the conservative Heritage Foundation think tank and Republican governors and state legislators in the subsequent decades, respectively, Kleinke reported.
“But perhaps the clearest indication of the conservative economic values underlying the (Affordable Care Act) is its reception by many Democrats,” Kleinke wrote. “The plan has few champions on the left precisely because it is not a government takeover of health care. It is not a single-payer system, nor ‘Medicare for all;’ it does not include a ‘public option,’ a health plan offered by a federal insurer. It is a ratification of market ideas, modified to address problems unique to health insurance.”
To make matters worse, the most popular provisions of Obamacare, such as allowing children under age 26 to stay on their parents’ health plan and the end of exclusions based on pre-existing conditions, can only exist with the less popular parts.
President-elect Donald Trump’s insistence that the protection of Americans with pre-existing conditions will continue reflects the conundrum Republicans are now in. To do so, some sort of individual mandate (which can preferably be subsidized for low-income households) has to be instated to keep insurers from going out of business, The Washington Post’s Steven Pearlstein reported in “Donald Trump is about to face a rude awakening over Obamacare.”
All together, Pearlstein wrote, “what you have, in a nutshell, is … Obamacare.”
“There’s a deep irony to all this,” Robert Reich, who served as Secretary of Labor under President Bill Clinton, wrote in The Christian Science Monitor’s “The irony of Republican disapproval of Obamacare.”
“Had Democrats stuck to the original Democratic vision and built comprehensive health insurance on Social Security and Medicare, it would have been cheaper, simpler, and more widely accepted by the public,” Reich wrote. “And Republicans would be hollering anyway.”
The political impact
All of this places the GOP on a track that at the very least looks precarious, if not fatal. Only 39 percent of Americans want the Affordable Care Act repealed, according to a December 2016 survey by the Pew Research Center, and while the nearly 30 million people Republicans will be taking insurance from is a significantly large body, it doesn’t come close to the 91.1 percent of Americans who have been receiving popular dependency benefits and other perks the law brought.
Democrats may be defending 25 Senate seats in the 2018 midterm election, including 10 in states won by Trump, including a handful by double-digits, however Republicans running for re-election shouldn’t view the upcoming contest as a cakewalk.
If history is any guide for the political consequences of health care reform (never mind a total removal without an immediate or fully operational replacement), significant backlash is almost guaranteed. The Republicans’ preparation for the upcoming session sets the stage for more than the usual referendum on the president’s party that midterm elections are known for.
The last time Republicans were in control of Congress and the White House after President George W. Bush’s slim re-election majority in 2004, their overestimation of public approval, combined with Bush’s handling of Hurricane Katrina and the Iraq War, was one of the reasons why the party lost both chambers of Congress in the Democratic wave of the 2006 midterm.
Considering the unapologetically-partisan behemoth that House Speaker Paul Ryan (R-Wis.) and the rest of the GOP are ready to bulldoze through Congress after six years of a Democratic president — a mandate that 71 percent of the American public doesn’t believe in — backlash to Republican overreach may be just around the corner.
Republicans campaigned for six years on “repeal and replace.” Now that they have their chance, a repeal may happen, but what comes next may not be the replacement they had in mind.
Alex Brase is a junior in journalism and mass communications. Send comments to firstname.lastname@example.org.