The ongoing saga of the “replace” portion of repeal-and-replace has moved forward again. You’ll recall that Republicans campaigned on the idea that after they got rid of the dreaded “Obamacare” they would immediately move to replace it with Republican health care reform. But then they ignored that pledge for the next fifteen months. Then, last week, one key GOP Member of the House said that replace was dead.
This week, Republicans have yet another strategy in place. They have now leaked to Politico that a health care replacement will be unveiled soon after the Supreme Court acts, really truly for sure this time.
As Woody said, “Fool me once, Doctor Crain.”
The problem is that the new Republican “solution” consists of, apparently, keeping all the popular things in the Affordable Care Act, and getting rid of the unpopular bits. So we’re promised that the Republicans will support having people with pre-existing conditions get health care without that pesky individual mandate that makes it a workable policy. They will support closing the Medicare prescription drug donut hole without the taxes or Medicare Advantage spending cuts to pay for it.
The unpopular bits were there for a reason; without them, the policy just doesn't work.
I can think of three interpretations of the Politico story.
One is that the Republicans are floating this idea in the full knowledge that it will never go anywhere. They intend to pass these “replace” bits (apparently this would be done not in the form of a big bill, but several smaller ones) knowing that as long as Democrats have a Senate majority and Barack Obama is in the White House, there’s no chance that any of it will become law. If they win control of the Senate in November, “replace” would then simply be allowed to quietly fade away.
The second possibility is that Republicans really do hope to pass dessert-only set of policies — even if they know they’re unworkable. That was, after all, basically how they operated in the George W. Bush era.
Or, perhaps, the most obvious solution is that this is exactly as serious as every previous claim that “replace” was just around the corner. In other words, they’re just hoodwinking Politico. Indeed, Rep. Paul Ryan told the Washington Examiner today that Republicans would not submit actual legislation but would instead offer their own competing “vision” of health reform.
I have no idea which one is the truth, although my money would be on yet another bait-and-switch. The real moral of this latest turn in the story, however, is this: After all this time Republicans are still no closer to developing an alternative to Obama’s health law — one that would increase coverage and hold down costs — than they were were when the law passed in the first place. Perhaps more to the point, they’re still not willing to admit that they don’t have any alternative, and likely never will.