Republicans are patting themselves on the back for “keeping their promise” and moving to repeal Obamacare with no replacement in sight. Is this really what they promised? Republicans ran on repeal and replace, not repeal and we’ll get back to you. They did not run on adding debt or on defunding coverage without an alternative.
At times it is almost comical. In a letter to the Senate majority leader, Sens. Marco Rubio (R-Fla.), Mike Lee (R-Utah) and Ted Cruz (R-Tex.) argue for repeal via reconciliation and simultaneously propose a balanced budget amendment. Repeal of Obamacare of course will cost money (as much as $350 billion, by one estimate), so how is this consistent with cries for a balanced budget? It isn’t. It makes you wonder if any of these folks have done their homework.
Anyone proposing repeal and delay should have to answer tough questions, including:
- How do you address the added deficit when Obamacare is repealed?
- What is your alternative?
- If you have an alternative why can’t we see it?
- What alternative to Obamacare can pass the Senate?
- If you eliminate subsidies, what about those priced out of the exchanges?
- How do you protect those with preexisting conditions once the subsidies disappear?
- If you repeal the individual mandate, what keeps the insurance companies in the exchanges?
- How are you going to pay for a replacement to Obamacare?
- How many people in your state will lose health-care coverage with a complete repeal?
- Will the alternative cover all of them and similarly situated people, or does the alternative offer just access?
- When you reverse the expansion of Medicaid, what happens to people below the poverty line who do not qualify for Medicaid?
Again, we have no problem with reworking Obamacare, and in fact prompt changes are needed, as one insurer after another has left the exchanges and young, healthy people still are not signing up in sufficient numbers. What we object to is Republican chest-thumping that they have “delivered” when they have no idea how to pass a better alternative. (As soon as Republicans exclude abortion from their plan or reverse Medicaid expansion — or any of dozens of other moves — they’ll lose virtually any Democratic support.)
Republicans in essence are gambling that Obamacare gets repealed and something else will, eventually, fill the gap. Make no mistake, they are proceeding with no agreed alternative. The Wall Street Journal reiterates, “Overall, Republicans and conservative policy groups have put forth about a half-dozen proposals they say could fully replace the ACA. But the party has yet to unify around any single plan.” Proceeding with nothing but the promise of some plan that is yet to be agreed upon is rotten policy and morally offensive.
Conservative healthcare gurus James Capretta and James Antos write:
We do not support this approach to repealing and replacing the ACA because it carries too much risk of unnecessary disruption to the existing insurance arrangements upon which many people are now relying to finance their health services, and because it is unlikely to produce a coherent reform of health care in the United States. The most likely end result of “repeal and delay” would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services.
“Repeal and delay” is certainly dumb politics. Hart Research Associates conducted a poll in late December for the liberal Center for American Progress Action Fund “among 1,206 voters across 14 key battleground states in which Democrats will be defending U.S. Senate seats in 2018.” Among the findings: 59 percent of voters are somewhat or strongly opposed to repealing Obamacare before a replacement is in place; only 32 percent somewhat or strongly favor that approach. The pollsters note that “even in the group of states that voted most overwhelmingly for Trump (IN, MO, MT, ND, and WV), a majority of voters oppose … repealing Obamacare before having any specific plan to replace it.”
Republicans are so desperate to chalk up a “win” that they don’t care about the consequences of jamming this through on a party-line vote (assuming they don’t have three or more defections in the Senate). Funny, that was their original complaint about Obamacare: a poorly devised bill, the full consequences of which were barely understood by members, filled with glitches that appeared only after it passed. Perhaps some sage senators will save Republicans from themselves and insist that repeal be accompanied by a comprehensive replacement plan.