One congressional GOP health aide, who was granted anonymity to speak candidly, said his party is as determined as ever to fight Obamacare, and will remain so as long as it exhibits failure. He said devising an alternative is fraught with the difficulty of crafting a new benefits structure that doesn’t look like the Affordable Care Act.“If you want to say the further and further this gets down the road, the harder and harder it gets to repeal, that’s absolutely true,” the aide said. “As far as repeal and replace goes, the problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act…To make something like that work, you have to move in the direction of the ACA. You have to have a participating mechanism, you have to have a mechanism to fund it, you have to have a mechanism to fix parts of the market.”
You don’t say! This is just one anonymous GOP aide, but when you take these comments alongside what Paul Ryan admitted to the other day, we’re really getting somewhere. Ryan forthrightly claimed that, once Obamacare is repealed, its popular provisions shouldn’t be replaced, because so doing would be too costly.
Before Obamacare’s benefits kicked in for millions, it was easier for Republicans to resort to “repeal and replace” rhetoric while remaining in a policy-free zone. But now that those benefits are no longer theoretical, it’s becoming harder and harder for Republicans to advocate “repeal and replace,” without getting forced into an uncomfortable choice. Either they offer an alternative that, under scrutiny, would be revealed to accomplish a fraction of what Obamacare would, meaning it would fall far short of the law’s popular goals. Or they can claim to support those goals, but that then invites questions as to whether they are willing to accept the tradeoffs necessary to accomplish them.
All signs are that House Republicans, if they ever do introduce an alternative, will opt for the former, sticking by tried-and-true GOP ideas like allowing insurance sales across state lines. But some GOP candidates are finding that they feel politically obliged to opt for the latter — indicate support for the law’s general, and expansive, goals. However, this is obliging them to remain vague on the tradeoffs they are willing to support. Hence North Carolina GOP Senate candidate Thom Tillis insists he supports protections for the sick, and Michigan GOP Senate candidate Terri Lynn Land insists she supports extending coverage to the poor, even as neither says how they’d accomplish such things.
Perhaps Obamacare will remain so unpopular in red states that Republicans will be able to get away with vague “anything but Obamacare” evasions. But it’s also possible that the intense scrutiny that Senate races bring will make them increasingly difficult to sustain. And this is how you can see Obamacare fading as an issue. As Brian Beutler explains, conservatives are slowly transitioning from “repeal and replace” to a broader recognition that the best way to move the health system in a conservative direction is to enter into relatively conventional negotiations over its future. Polls already show majorities want to move on from the Grand Obamacare Debate. If mounting enrollment and a general sense that the law is functioning adequately force Republican candidates to agree Obamacare’s goals are worthy — even as they don’t particularly want to discuss how they would accomplish them — is it all that fanciful to imagine the law getting neutralized as an issue, even as campaigns move on to other topics?