The decline and fall of Obamacare and the AHCA

The new Senate health care bill (not to be confused with the AHCA) was finally unveiled this week by Republicans in the upper chamber. It led to an immediate round of cheers and bipartisan support coming from… almost nobody. It was something of a given that not a single Democrat would support it, but with only a slim margin for victory available, the GOP couldn’t afford to lose more than two votes from their own caucus. At last count, with the addition of Dean Heller, we’re up to five. (The Hill)

Sen. Dean Heller (R-Nev.) announced Friday that he is opposed to the Senate Republican ObamaCare repeal bill in its current form.

“I’m announcing today that in this form I will not support it,” Heller said during a press conference.

He raised concerns about the bill’s phaseout of the Medicaid expansion. Heller joins GOP Sens. Rand Paul (Ky.), Ron Johnson (Wis.), Mike Lee (Utah) and Ted Cruz (Texas) in opposing the current bill.

There are some moderates like Susan Collins who are already “expressing concern” over issues such as Planned Parenthood funding as well. Odds are that once there is enough resistance to sink it they’ll jump ship as well. It’s a safer play for them in terms of their next election and if they can’t be pegged as “the vote that killed the bill” it’s an easier call to say no.

So is the fight to repeal Obamacare pretty much over? Let me take a saw to the limb I’m currently sitting on and say… yes. But really, the fight was over shortly after the original Affordable Care Act was passed. There’s an old maxim in American politics which tells us that any entitlement program or other initiative which gives away goodies to the public, once in place, is pretty much there forever. There have been a few rare exceptions, but for the most part this is a tradition which is written in stone.

We’ve got Senators from the more conservative side saying that this new bill isn’t going to do anything to reduce costs and premiums. Of course it won’t, because the government is entirely incapable of doing that through mandates and executive orders. Even if we ignore the fact that our bloated bureaucracy composed of career politicians was never exactly suited to manage something the size and complexity of the nation’s health insurance system, any effort to institute top-down socialization of something as inherently capitalist in nature as the health insurance industry was doomed to blow up in your face.

But that’s not even the core fault in our stars here. You see, even if the GOP manages to remove Obamacare, all they’ll be able to do is take out the parts which most conservatives hate (such as the mandates). Taking out the goodies is not only harder, but likely impossible. Obamacare was structured brilliantly in that the things everyone was going to like (mandatory coverage for preexisting conditions, parents keeping their kids on their plans longer) kicked in fast. It took years for the really ugly features to fully come on line (higher penalties for not having insurance, additional mandates driving up premiums). That means that people were already used to the candy being handed out before the flaws in the system ensured that it would begin to implode.

So who wants to be the one to take away those goodies now? Nobody. And this leaves the GOP in the position of trying to make it look like they can still play Santa and hand out all the sugar without the slug of bitter medicine to follow. In order to “fix” this system and make it solvent we would have to deliver bad news which is the political equivalent of blowing out the pilot light in your oven and sticking your head in.

But wait,” I can hear some of you saying. “If this doesn’t work, can’t we just go back to plan B and let Obamacare implode on it’s own?” Not really. Whoever is in charge will take the blame no matter whether they supported it originally or not. We now basically have a new entitlement theory in which more than 60% of American voters think that affordable health insurance (not Health Care, which is a critical distinction the media generally tries to ignore) is a human right and it’s the government’s job to make sure they get it. But the cost of health insurance isn’t dictated by the government… not for long, anyway. It’s dictated by the cost of actual health care and Washington still hasn’t the beginning of a clue as to how to bring that down.

So what’s the only solution left to keep delivering bread and circuses to the masses? Probably a completely top-down, socialist single payer program, which will rapidly bankrupt the entire system. (California is already finding that out the hard way.) You can expect to eventually see some Republicans going along with that line of thinking too, believe it or not. It’s that or the aforementioned head-in-the-oven scenario.