Republican leadership gave no sign of punting on repealing and replacing ObamaCare at the GOP retreat this morning. Senate Majority Leader Mitch McConnell told the press that the system was “unsustainable” to such an extent that Democrats would have to start rewriting it if Hillary Clinton had won in November, and Chuck Schumer had his job. In that case, “we’d be moving toward a single-payer system,” McConnell noted, “and that’s not our vision of how this ought to be handled.”
In other words, full speed ahead:
McConnell also pointed out that Republicans won’t get much help this session from Democrats, perhaps even after repeal has been passed. In fact, McConnell says the same thing about tax reform, and stated that Republicans plan to move both through the reconciliation process:
House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell emphasized Thursday at a Republican retreat in Philadelphia that repealing and replacing Obamacare and tax reform remain the party’s top 2017 priorities.
And they expect to get little, if any, help from their colleagues across the aisle.
“Both of those we anticipate having little or no Democratic cooperation,” McConnell said. “That’s why you can anticipate two reconciliation measures in the first six months.”
It’s the lack of cooperation that has Matt Lewis concerned about the political risks that McConnell, Paul Ryan, and Donald Trump assume with a full repeal-replace strategy. Matt wrote yesterday at The Daily Beast that it might be time to compromise — or to punt:
Each of these plans consists of some good ideas. But it’s like a novice trying to solve a Rubik’s Cube. Every conceivable scheme or solution creates new problems. None of them solve the problem because this problem is simply too complicated to “solve.”
“The idea that in this new political era, Congress and this new administration are going to remake health care is not realistic,” says James C. Capretta, a resident scholar at the American Enterprise Institute (AEI). “There are no simple one-line solutions to the problems. The tentacles of the current system run very deep because the system has been built up over decades. And that means change will necessarily be incremental.”
In other words, instead of throwing a Hail Mary and risking a huge interception, Republicans might be better off just trying to gain a few yards and move the ball down the field. …
Should Republicans actually kick off a new administration by engaging in a fool’s errand that is almost guaranteed to backfire?
Sometimes you have to punt.
It’s too late for either approach, I argue in my column for The Fiscal Times today. McConnell’s correct — ObamaCare is unsustainable because of the inherent contradictions at its core, and nibbling around the edges won’t change anything. Failure to act is no longer an option, practically or politically:
Republicans don’t have that as a realistic option – either politically or practically. They have fought Obamacare in four successive national elections, winning three of four and sweeping the field in 2016 to return to single-party governance in Washington DC. Trump and almost every Republican who ran for the House and Senate explicitly cited Obamacare repeal as a top priority. Punting on repeal in favor of a few incremental changes would only deepen the hostility and suspicion that the populist-minded grassroots on the Right already have for Republican leadership. The potential backlash could cost the GOP a chance to gain a large Senate majority in 2018, or possibly even control of the House.
Practically speaking, a punt won’t work because of the increasing instability in Obamacare exchanges. Democrats insisted that the ACA would deliver near-universal health insurance coverage and that 23 million Americans would get insurance through the exchanges by 2017. Instead, a new projection from the Congressional Budget Office estimates that only 10 million will pay premiums for coverage this year, and that number will only go up to 13 million after another decade. On top of that, the number of uninsured Americans will “remain around 27 million or 28 million” each year under the current system.
That makes it rather difficult to pin a failure to achieve universal coverage on a repeal of Obamacare and calls into question whether it’s a worthwhile goal. The Affordable Care Act [has] missed the mark on universal coverage, and the attempts to achieve it have made insurance coverage more unaffordable than ever thanks to massive premium increases (averaging 25 percent this year alone) and skyrocketing deductibles that make accessing insurance benefits all but impossible anyway.
Thus, the crisis has reached a pitch to where a choice to avoid governance no longer exists. Add in the flight of insurers from the exchanges and the collapse of the government-backed co-ops, and the acute need for action becomes undeniable, regardless of the difficulty. Failure to act is simply not an option any longer.
Will it create some uncertainty? Of course, but we’ve had years of uncertainty and failure in the current system, and both are getting worse by the month. Now that Congress and the president can act, there is room for competing plans to come to the floor so that the relevant committees can craft the best alternative. This is not a bug — it’s a feature.
Republicans wanted to govern on their own. Punting is not governance, especially in the midst of a policy crisis.