Six years after its passage, the Affordable Care Act has demonstrated it’s far from perfect. But replacing such an immense, complicated law on an accelerated schedule is presenting enormous political, let alone practical, problems for the GOP.Repealing #Obamacare is presenting enormous political, let alone practical, problems for the #GOP Click To Tweet
Republican promises to shred Pres. Obama’s signature healthcare overhaul are the backbone of their curveball to voters since the law’s 2010 passage. With full control of Washington now at hand, however, the GOP must deliver. And the White House, in particular, is learning that replacing the elaborate, complex structure for one-sixth of the economy doesn’t just happen uttering more words to the effect that someday, really soon, it will happen…eventually.
President Trump is getting ready to unveil a plan to replace the Affordable Care Act with a clear goal: “Insurance for everybody.” Trump told the Washington Post that his plan will also not involve cuts for Medicare and will target pharmaceutical companies to lower drug prices.
“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” There’s no reason to be worried because those who will be covered under the new law “can expect to have great health care” that will be “much less expensive and much better.”
How does the President plan to do all this? He still won’t say. Trump hasn’t offered details on the plan itself or what it could cost. He also won’t say how he plans to persuade Congressional Republicans to get behind his plan, if one penned by HHS Secretary Tom Price ever gets to Congress.
But he did say he would be unveiling the plan–that is “very much formulated to the final strokes”–with House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell, suggesting he’s got support from key GOP leaders. Still, Trump’s words would appear to fly in the face of what many Republicans have been advocating while using the term “universal access” to describe their goals rather than “universal coverage,” says Daniel Politi for Slate.
Even as Trump suggests he’s in a rush to repeal and replace Obamacare, lawmakers appear increasingly skittish. And who wouldn’t be? Although Congress did take the first step to dismantle the Affordable Care Act, the harder part of putting together a plan is still to come. The reason for the concern is obvious: Some 20 million people now are covered, and many aspects of the law are quite popular.
“I’m very concerned on the policy side specifically, that the replacement occur either simultaneously or as close to simultaneously as possible,” Rep. Charlie Dent of Pennsylvania told CNN. “If we don’t provide a credible replacement plan, my main concern is that there would not be gaps in coverage for people who are currently subsidized. Also concerned about how the insurance markets might react.”
Republican lawmakers in Washington aren’t alone. At least five Republican governors are also pushing their colleagues on the federal level to think carefully about what their decisions could mean for health coverage in their states.
Trump, however, has said he won’t let Congress get in the way of his agenda:
“The Congress can’t get cold feet because the people will not let that happen.”
Donald Trump’s critics believe the new President is clueless (or worse), but he might be on track to avoid repeating former President Barack Obama’s biggest political mistake, says Nathan Gonzalez for RollCall.
He’s got an excellent point.
Let’s press the re-wind button, just to verify the exact wording. Trump’s pre-inaugural press conference was widely panned, but his comments on the future of healthcare legislation were instructive.
“The easiest thing would be to let it implode in ‘17 and believe me, we’d get pretty much whatever we wanted, but it would take a long time,” said Trump, flanked on one side by stacks of clandestine papers and folders. “We’re going to be submitting, as soon as our secretary’s approved, almost simultaneously, shortly thereafter, a plan.”
A little later, he added,
“So as soon as our secretary is approved and gets into the office, we’ll be filing a plan.”
The timetable, however, is crucial.
The biggest mistake of Obama’s presidency was lobbing health care “reform” to Congress, Gonzales says. While he wanted to remain chief executive after an historic campaign and stay out of the legislative battle, Democrats on Capitol Hill argued over the specifics and took more than a year to get something to his desk.
As the legislation mushroomed into its final format, one of Obama’s top advisers told Congressional Democrats to avoid bed-wetting and “have the guts to govern.” Later in 2010, dozens of vulnerable Democratic members put their political careers on the line and voted for the polarizing Affordable Care Act, only to later feel pushed out of an airplane without a parachute.
Democrats went on to lose 63 House seats and the House majority, as well as six Senate seats. Many of those Democrats forced into retirement felt deserted by Obama and believed he should have hit the campaign trail to sell the legislation to the American people after it passed, instead of waiting until he was up for re-election.
Some believe if Obama had been more assertive in the legislative process from the beginning and hit the campaign trail to highlight the benefits of Obamacare before the midterm elections, this particular chapter of history might’ve had another ending.
It wasn’t as if Obama was dedicating his time to improving his bowling game, considering he was dealing with the financial crisis, says Gonzales. But he can’t find a Democratic strategist focused on Congressional races who will defend how Obama and his team handled the Affordable Care Act and its aftermath.
Democrats will clearly benefit if the Republican replacement is a catastrophe and voters punish the GOP if they lose coverage or are dissatisfied and downright angry about the new alternative. And foreign affairs could keep Trump from focusing on his domestic priorities.
Of course, some Republicans say President Obama’s mistake was pushing the Affordable Care Act at all, just like most Democrats believe repealing it will be a disaster. Gonzales doesn’t mince words when he correctly says since Republicans are way beyond the point-of-no-return on repealing it, they are best served by,
“ripping off the Band-aid quickly, and spending most of the next two years convincing voters it was the right thing to do.”
The Affordable Care Act had been a target for Republican leaders like House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell since before the bill was even signed into law, Business Insider points out
But a month into Trump’s presidency and controlling both branches of Congress, Republicans are finding that repeal and replace is easier said than done. From disagreements over the future of US health care to unclear communication, cracks are forming in the overhaul. And people are starting to get twitchy.
“The House passed six Obamacare repeals when Obama was president and there was no chance of them being signed into law,” conservative author Ann Coulter wrote in a post on her blog. “Back then, Republicans were full of vim and vigor! But the moment Trump became President, the repeals came to a screeching halt.” Her post was titled, “The Silence of the Lambs Congress.”
So what’s next?
The GOP divergence on Obamacare has shown up not only in policy preferences, but also in how Republicans talk about the law.
For one thing, it is hard to get a grasp on just how long the process of repeal and replace is supposed to take.
While Ryan has said he hopes to complete the Obamacare replacement process by the end of the year’s first quarter, he has also said in interviews that it could be the end of the summer or the end of the year. (A Ryan spokesperson said in an email to Business Insider that the speaker plans to complete the process by March.)
Ryan said last Thursday that the House GOP was planning to roll out a bill on Obamacare when the body comes back from its week-long Presidents Day break.
Senate Majority Leader Mitch McConnell has been less definitive about a timeline. He said only Friday that repeal and replacement of the law would happen, “when we get the votes.”
Trump hasn’t made the communication any clearer. In an interview on January 10, Trump said he wanted the replacement done “next week,” says Business Insider. In an interview with Bill O’Reilly on February 6, however, the President it could take into 2018 to get the replacement done. (Ryan has said Trump was referring to implementation, not legislation.)
Even conservative groups are getting impatient. Heritage Action spokesperson Dan Holler told the New York Times that the delay is worrying.
“If the House has not passed a repeal bill and sent it to the Senate by mid-March, that would be serious cause for concern,” Holler said.
Finally, there’s the self-proclaimed politically incorrect David Leach at Redstate who says he can’t find any substantive difference between what Obama said while promoting the features of the ACA and what Trump has said for many months describing his replacement plan.
“This should come as no surprise to anyone not a member of the Trump Chorus Line,” Leach says.
Trump has a history of supporting single-payer healthcare, and even defended it by channeling his inner Obama during the primaries when he said he would not have people without healthcare “dying in the streets.”
Trump could get what he wants from the GOP-controlled Congress. Leach wrote about how the Republican promise to repeal Obamacare was fake, and how they are currently devising a scheme to renege on their commitment to destroy the Affordable Care Act “root and branch.”
It was a Democrat in the White House and majority in Congress that gave America the first version of government-run, socialized medicine. Now, a Republican President and a Republican Congress will give us their iteration, “Obamacare 2.0” we could call it.Steve's Take: A #Republican President and Congress want to give us #Obamacare 2.0 Click To Tweet
It may not be a perfect metaphor but I look at the GOP circus in Washington and am reminded of the unforgettable comedy routine made famous by Abbott and Costello–“Who’s on First?” I picture hapless White House Press Secretary Sean Spicer fielding questions from the press corps, trying mightily to identify the players on the Trump team, their nicknames, their roles, timeframes, next moves, who’s in charge of what, who’s been fired.
Regrettably, what we citizens don’t need or want is a circus, let alone a comedy of disastrous, politically inspired moves that undermine rather than safeguard our families’ health.