Granted, judging by their response to the results in Virginia, Republican spinners seem to have decided that actually winning those elections doesn’t count; it’s good enough, they want us to think, for them to do better than pre-election polls predicted and then credit it to Obamacare. But we can ignore that; Democrats have for years now proven that they’re not going to be baited by that sort of thing into abandoning reform. Republicans will actually have to win elections to supposedly implement “repeal and replace.”
So it bears repeating again: Republicans have been promising “replace” for three years now, and still haven’t bothered developing a “replace” bill. Ryan was one of a set of Republicans who pledged to develop a replacement bill back when the Republicans first voted to repeal the Affordable Care Act in 2011. Republicans decided it was far easier to stick to repeal votes, and more repeal votes, and ultimately to shutting down the government over Obamacare.
But never a replacement. Indeed: Ryan’s op-ed doesn’t even hint at what “a real alternative” might include.
One thing this really reflects is the absolute certainty Republicans have developed both that the entire nation is desperate to get rid of Obamacare (something neither polling nor election results show), and that the law itself is in the midst of falling apart. If the law’s collapse is inevitable, then Republicans can simply continue promising a “replacement” until that happens, and then move on to other things, right?
Another part of the inability to deliver on “repeal and replace” is the basic truth that the ACA is no socialist “government takeover” but rather a largely market-based reform. That makes it difficult for Republicans to develop an alternative that meets right wing activists’ demands that it contain absolutely no overlap at all with Obamacare. There isn’t any such alternative reform that would accomplish anywhere near as much.
At any rate: “Repeal and replace” as a slogan has now been overrun by events. Too much has already happened through reform, like it or not, that it’s impossible to just repeal the Affordable Care Act, return to a status quo ante which no longer exists, and then pretend to debate replacing it.
Which gets to the final point. Republicans are having a field day pointing to Senate Dems (some of whom met at the White House today) who are “running” from the law. But all of this is irrelevant to the future of the ACA. If the law works — if the website is repaired, if people sign up through the exchanges in sufficient numbers, if competition on the exchanges really does bring costs down without undermining the kind of care consumers want, if Medicaid expansion goes smoothly where Republican opposition allows — then there’s no chance that it’s going to be repealed, or delayed. If it really does collapse, then it’s certain that it will be delayed or even replaced, although again that would mean building on what’s been done.
So Republican spin doesn’t matter much at all. What does matter: As long as Republicans live in a fantasy world dominated by spin and phantom polling, they’re not going to be able to participate effectively at fixing whatever does need to be fixed in Obamacare. Perhaps they might want to consider repealing and replacing that strategy.