Wednesday, July 06, 2011


Politico tells us today that Republicans don't seem to be trying very hard to get rid of the Affordable Care Act and replace it with a plan of their own:

When they took control of the House, Republicans could barely stop talking about their plans to "repeal and replace" the health care reform law.

Six months later, they hardly talk publicly about those plans at all. And they're nowhere close to "replacing" the law....

So what happened? ...

Steve Benen thinks that's because they don't have any smart ideas of their own for alternatives. Me, I don't know why that would stop them:

The key takeaway from all of this, to my mind, isn't just that the repeal push was a fool's errand, but also that congressional Republicans were always blowing smoke on the "replace" part of their campaign promise. The GOP finds it easy to tear down, but building up requires policy chops that Republicans frankly don't have.

Sure, the GOP could come up with some kind of health care reform alternative, but they know perfectly well that it would be awful compared to the Affordable Care Act -- rival Republican plans have always failed to cover the uninsured, failed to bring down costs, and failed to protect consumers against insurance-industry abuses.

What's more, Republicans also realize that many ideas that have traditionally been part of the GOP health care agenda -- most notably, the individual mandate -- have already been adopted by Democrats.

The result is a party that talked a good game on "repeal and replace," but couldn't even try to deliver.

I think that's giving them too much credit. If that could launch an easy assault on the law and cause maximum pain to Democrats by doing so, they'd do it in a heartbeat. In fact, I think that's what they're going to do if they win the White House and both houses of Congress next year.

For now, though, they don't have the votes to overturn the law -- but they do have the votes to create a hostage situation around the debt. So that takes priority. An immediate opportunity to hurt Democrats politically, damage the social safety net, and transfer more money to the rich? Of course it takes priority.

Now, if Republicans had any interest in effective governance, they might simultaneously work up a detailed health care plan that they sincerely believed would be effective, and then try to sell it to the voters, even if they couldn't get it passed with Obama as president. But they don't have any interest in that. (They tried that with Medicare, and look where it got them.)

When they're in power again -- i.e., in 2013 if they win back the White House and Senate -- I think they'll quickly try to ram through a repeal combined with their usual half-baked ideas (tort "reform," buying insurance across state lines), because that will be easy. That will be fun. That will make their contributors wealthy and make Democrats squeal.

And they won't need to sell it -- they'll just rush it through fast, like union-stripping in the states this year, and they'll give their bill a name like "the Health Care Freedom Act of 2013," so if anyone asks why it's better than the Affordable Care Act, why, silly, the answer is right there in the name! FREEDOM!

For now, of course, health care repeal (or at least nullification) is a tantalizing promise to the base. Michele Bachmann is obsessed with it. Even Mitt Romney promises a nationwide waiver, effectively nullifying the law.

So it's most useful to Republicans right now as a campaign issue. And who knows -- maybe I'm wrong about insta-repeal in 2013 (or maybe Obama will win and the Supreme Court won't declare the law unconstitutional), in which case health care might remain a GOP campaign issue forever, like abortion: Republicans will chip away at the law every chance they get, and keep running on total repeal, which will always be just around the corner.

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