That’s what’s happening right now. Some months ago, Republicans filed a lawsuit demanding that the entire Affordable Care Act be struck down on some ludicrously tendentious grounds; the lawsuit was supported by 20 Republican-controlled states and the Trump administration. They filed it in a very specific district in Texas so that it would be heard by Reed O’Connor, a federal judge with a well-earned reputation as a conservative partisan. On Friday, O’Connor did what everyone assumed he would and declared the entire ACA invalid. And now Republicans are aghast that they succeeded:
A federal judge’s ruling that the Obama health law is unconstitutional has landed like a stink bomb among Republicans, who’ve seen the politics of health care flip as Americans increasingly value the overhaul’s core parts, including protections for preexisting medical conditions and Medicaid for more low-income people.
This “stink bomb” is their own lawsuit. So why are they so unsettled? Because eight and a half years after the ACA passed, eight and a half years of crying “Repeal and replace!”, Republicans still have no idea what they want to do about health care.
Or it might be accurate to say that they know what they want to do, but they also know that the American public won’t stand for it.
What really changed the GOP’s outlook was the 2018 elections, in which Democrats absolutely hammered them over the lawsuit and their attempt to remove protections for those with preexisting conditions. While a few Republicans were able to spin their way into convincing voters that they were deeply upset by the prospect that their own suit would succeed, Democrats won a historic victory in no small part on this issue.
You may recall that when Republicans took total control of Washington after the 2016 election, they looked around and realized that they had completely forgotten to come up with a replacement plan for the ACA. After some rushed work behind closed doors and almost no public hearings, they passed a “plan” through the House but failed to get it through the Senate amid an enormous backlash from people with preexisting conditions and those who have benefited from Medicaid. At the time, many Republicans secretly breathed a sigh of relief that they had failed.
And right now, the consensus among observers seems to be that despite its conservative majority, the Supreme Court will wave away Judge O’Connor’s decision. At the very least, Chief Justice John G. Roberts Jr. — who knows when the GOP needs to be saved from itself — will likely vote with the liberals to overturn this ruling, and one or two of the other conservatives might join him as well. Meanwhile, conservatives are rushing to say what a terrible thing the ruling is, from the Wall Street Journal editorial page to National Review.
So what do Republicans actually want to do about health care? They’ve long wanted to privatize Medicare, under the theory that having people get insurance from the government is bad by definition, no matter how popular the program is. They want to stigmatize Medicaid and kick as many people off that program as possible, which they’ve now begun doing by requiring recipients to navigate bureaucratic mazes so they can be booted off when they make a mistake.
Republicans certainly agree that we should wind back the clock to the time before the ACA, which would mean millions losing their health coverage and no protections for people with preexisting conditions, among other things. On the latter question, however, they suddenly decided in the last year that they really do care about protecting those with preexisting conditions. Or at least saying they do, since the truth is that you can’t really provide those protections without getting everyone into the insurance pool through some kind of mandate or through a universal system, both of which they oppose.
And this is the one ray of light Republicans see. Okay, so they got destroyed on health care in 2018, and they just don’t care enough about the issue to bother coming up with a genuine plan for how to change the system. But if they can find a way to attack Democrats on the issue, then that’s good enough. Democrats are now having a serious internal debate about universal coverage — how to provide it, what form it should take and how to pay for it. Republicans, on the other hand, would like everyone to believe that providing affordable, secure coverage to everyone is simply beyond the reach of human ingenuity, like achieving faster-than-light travel or inventing a pill that will allow you to eat all you want without ever gaining weight.
That position is somewhat undercut by the fact that every advanced democracy on earth except for the United States has managed universal coverage. But as Democrats argue for it, Republicans will reply (as they began doing in 2018) that covering everyone will take away whatever you have now. This attack will be particularly aimed at senior citizens[ in the form of “Medicare for all means taking away your Medicare!”
Unfortunately for them, the leader of their party is the least credible spokesperson imaginable on this issue: the guy who promised, “I am going to take care of everybody. . . . Everybody’s going to be taken care of much better than they’re taken care of now,” but is now the one person celebrating the Texas ruling that would take coverage from so many. As long as he’s the one making their case, they won’t be able to convince voters that they take this issue seriously in the least. Which, of course, they don’t.