On Health Care, Congress Needs to Do Its Job
Republicans aren't playing like a team, and that's undermining their responsibility to repeal and replace ObamaCare.
Benjamin Franklin once wrote that “in this world nothing can be said to be certain, except death and taxes.” Had he been around today, he’d add a third: the propensity for Republicans to snatch defeat from the jaws of victory.
That has been on infuriating display in recent months as Republicans repeatedly fail to pass a free market alternative to ObamaCare. Even worse, rather than get credit for predicting the how and why of ObamaCare’s failure, Republicans look like a bunch of third-graders running in circles, unable to agree on the rules of the game, much less a strategy for victory.
First, let’s not allow a fundamental truth to be obscured by the disjointed efforts of Senate Republicans. Namely, ObamaCare was not sabotaged by Republicans; it is failing because it is a horrible law that ignores economic realities and human nature.
Long before Donald Trump announced his candidacy, ObamaCare was failing. Nineteen of the 23 co-ops are now bankrupt. Premiums, deductibles and co-pays have been skyrocketing ever since ObamaCare took effect. Doctors by the thousands refuse to accept patients with these policies. Insurers are pulling out of entire markets, leaving millions with only one insurer to choose from, or none at all. Republicans have yet to agree on a replacement bill, much less put one on President Trump’s desk, so it is ludicrous to claim that the failures of ObamaCare are Republicans’ fault — unless, as some Democrats have tried to do, you accept the idea that Republicans are responsible because they aren’t fixing the very problems they warned Democrats about in the first place.
For that reason, President Trump is absolutely right to declare that he and Republicans are not going to own the ObamaCare failure; that blame lies solely with Democrats.
At the same time, Vice President Mike Pence was right to blast Congress for failing to deliver the ObamaCare replacement bill promised for the last seven years. After a failure to pass the Better Care Reconciliation Act (BRCA) in the Senate, or bring an alternative bill to a floor vote, Senate Majority Leader Mitch McConnell (R-KY) announced he would bring back the 2015 full ObamaCare repeal bill for a vote, and deal with a replacement.
Senators Mike Lee (R-UT) and Jerry Moran (R-KS) announced earlier this week that they could not support the BCRA because it doesn’t repeal enough of ObamaCare or institute enough free market reforms. Then when McConnell announced the full repeal vote, moderate Republicans Susan Collins (R-ME), Lisa Murkowski (R-AK) and Shelley Moore Capito (R-WV) announced that they would not vote for a full repeal. Murkowski and Capito voted for repeal in 2015 when Barack Obama was there to veto it. Now that it can succeed, they oppose repeal. (To be fair, their position is the same as Trump’s — don’t touch entitlements — and other Republicans like Rob Portman and Dean Heller almost surely oppose straight-up repeal now too.)
Regardless of which bill came up for a vote, McConnell could not afford to lose more than two Republican votes.
A major hindrance is the inability to resolve diametrically opposed goals. As National Review’s Jim Geraghty explained, “Republicans (and by extension, much of the country) want contradictory changes, changes that Moran lists as his requirements. Americans want lower premiums, but they also want insurance companies to keep covering preexisting conditions. They want to see the cost of Medicaid go down, or at least rise slower, but they also don’t want to throw anyone off of Medicaid. They want the number of uninsured to go down, and they want the mandate repealed.”
This puts Republicans in a very precarious situation. Voters gave them the House in 2010, and the Senate in 2014, and then the White House in 2016. The American people expect results, not whining and complaining about intransigent Democrats. So Republicans need to play team ball instead of every player running his or her own play when the ball is snapped.
That means Republicans like Lee and Moran need to understand that ObamaCare is crumbling and that partisan brinksmanship will leave millions of Americans suffering. The Senate’s BRCA and the House’s AHCA (American Health Care Act) are imperfect bills but they’re a heck of a lot better than ObamaCare, and a very good starting point from which to enact additional conservative amendments going forward.
Likewise, Collins, Murkowski, Capito and any other opportunists who now oppose repeal need to understand that Republicans promised a repeal of ObamaCare if given power, and they are making a mockery of that promise by demanding major provisions of ObamaCare be retained in a replacement bill — provisions that sound laudable but that undermine market stability.
President Trump also needs to keep hammering home the point that Democrats own the disaster that is ObamaCare, and it is their fault that we are in this position. Their refusal to acknowledge that reality and work with Republicans is hurting average Americans. Their refusal to do so is transparently and cynically partisan, and it should come with a price at the polls.
At this point, the best option seems to be a full repeal, with replacement coming in sections. So-called “comprehensive” bills are usually needlessly complex, subject to legal challenge, and chock full of bribes and favors.
Or, as National Review’s Dan McLaughlin exhorted back in April, “Republicans should not hitch their wagon to any single, comprehensive bill, nor should they promise the voters a ‘Republican health-care plan.’ Instead, they should seek to roll out a series of improvements to the health-insurance system, each with its own voting coalitions.”
One way or another, Congress needs to heed the warnings of President Trump and Vice President Pence and do its job. The American people are increasingly frustrated and impatient, and failure will come with a steep price.