None of this makes for a sustainable law. Republicans admit as much with their talk of a “three-prong” approach, an implicit concession of the inadequacy of Prong No. 1. If they pass their bill, Health and Human Services Secretary Tom Price will supposedly swoop in to deregulate and stabilize the individual market through administrative action and then Congress will pass additional free-market reforms with 60 votes in the Senate. Because it’s not clear what exactly Price can do, the second prong is a black box. And because 60 votes obviously means getting Democratic support, the third prong is a fantasy.
This fix-it-on-the-fly approach should sound familiar because it’s exactly the tack the Obama administration took on Obamacare. It’s just one of the discomfiting echoes of the health-care debate from 2009–10. After Republicans accused the Democratic Congress of jamming through an Obamacare bill in eight months, they have been trying to pass their own hugely consequential bill in four weeks.
If the Republican leadership hasn’t covered itself in glory, neither has the rank and file. The conservative Freedom Caucus says it wants a “full repeal” and laments that the party isn’t simply passing the repeal-only it sent to President Barack Obama’s desk in 2016. But that bill also left core Obamacare regulations in place. What many of these conservatives really mean when they say they want “full repeal” is that they don’t want a replacement, which is even less defensible than what the leadership has been trying to do.