Tom Cotton on replacing ObamaCare: "I would much sooner get health-care reform right than get it fast"

The key bit starts at 4:05 below. Question: Is there any policy reason to prefer immediate replacement of ObamaCare to a replacement process that took, say, six months? I understand the political reason, that Trump and the GOP majority want to prove to the right that they’re willing to keep their biggest campaign promise as soon as possible. The longer they delay, the less confidence Republican voters will have that they’ll follow through on repeal. But Cotton’s response to that is insuperable, I think — if you’re taking on a project as momentous as reforming the U.S. health-care system, it’s more important to do it right than to do it fast. Why can’t Trump say that? His fans will give him the benefit of the doubt.

On the other hand, the party had seven years to come up with a consensus alternative. And here we are.

“This is a big issue. This is not like the latest spending bill that gets released on a Monday night, [passed] on Wednesday and everybody goes home for Christmas, and we live with it for nine months,” he said.

“We’re going to live with health care reform that we pass forever, or until it’s changed in the far distant future,” he said.

“So I don’t think we need to introduce legislation on Monday and have one chance to amend it on Wednesday,” he said. “I would much sooner get health care reform right than get it fast.

The counterargument, I guess, is that the policy is inextricable from the politics. The longer the House bill hangs out there, taking flak from the right and the left, undermined by alternative bills proposed by critics, and diluted by various amendments, the greater the chance that the fragile coalition that’s (sort of) behind it now will fall apart. (See, e.g., comprehensive immigration reform.) Result: The GOP wastes six months and ends up with nothing to show for it, leaving the party back at square one this fall. That is, if we try the Cotton approach and it fails, with no bill able to draw 51 votes, that’ll prove conclusively that there’s no compromise that can unite the different wings of the GOP, which means we’re stuck with ObamaCare until 2019 at least. And odds are, if the GOP chokes on repeal before the midterms, voters aren’t going to reward them for it by sending more Republicans to the Senate. The virtue, such as it is, of trying to pass the bill quickly right now is that it might succeed since Republican legislators are momentarily scared of defying Trump.

If you believe that anything is better than O-Care, then, even a bill that might do major damage politically to the GOP if it doesn’t work well in practice, then yeah, maybe you prefer the Ryan/McConnell “ram it through” approach. If you’re willing to risk ObamaCare surviving for another two years — at least — in exchange for a chance at a better bill, you’re on Team Cotton. Two further points, though. If we do it Cotton’s way and the GOP can’t get anything passed, that political disaster will be mitigated somewhat by the ongoing pain inflicted by ObamaCare. Trump has said repeatedly that the smart thing for the party to do from a standpoint of pure self-interest would be to sit on its hands and wait until so many consumers have complaints about the current system that they’re willing to elect as many Republicans as necessary to undo it. The politics of health care in the midterms would be unpredictable if the GOP passes nothing and costs continue to rise under O-Care: On the one hand, the GOP would have failed, on the other hand, is the solution to re-install ObamaCare architect Nancy Pelosi in the Speaker’s role? I assume the midterm health-care backlash would hit Republicans much harder than Democrats since they’ll have already proved themselves ineffective at containing the ObamaCare damage, but I don’t know.

The other point: If we do it Cotton’s way and take six months to try to pass a consensus GOP bill, the pressure on Republicans in both chambers this fall to suck it up and vote for whatever emerges will be tremendous. The pressure’s already high right now even though we’re less than seven weeks into Trump’s presidency; if the party momentarily chokes on repeal and then goes all out to produce a replacement system this year, with a do-or-die vote this fall knowing that failure would probably mean ObamaCare forever, they may very well fall in line and get it done. After seven years of fire-breathing about the evils of O-Care, they really have no choice but to cashier it before the midterms, one way or another. And if that’s true, what’s left of the argument against Cotton’s approach? If it’s very likely that the party would pass a bottom-up health-care bill with just a year to go before the midterms and the Trump White House screaming at them to make it happen, then chances are that doing this slowly and deliberatively will produce legislation and it’ll be better than “ObamaCare Lite” is. The only question is whether Trump and the party are willing to put the “repeal!” show on hiatus for several months while they work something up. Are they?

Exit quotation from a CNN source who was in the room yesterday when Trump met with House conservatives: “We cannot toss this out and start all over. We are too far down the road for that.”