Saturday

November 18th, 2017

Insight

How Republicans built their own ObamaCare trap

Rich Lowry

By Rich Lowry

Published May 2, 2017

How Republicans built their own ObamaCare trap Melina Mara for The Washington Post

Republicans have put on a clinic on over-promising over the last several years.

Even if you were paying only very little attention, you would have gotten the distinct impression over the last four election cycles that the GOP was unalterably committed to repealing and replacing ObamaCare.

It didn't matter what year the Republicans were running (2010, 2012, 2014 or 2016) or what presidential candidate (earnest, establishment-friendly Mitt Romney or bombastic outsider Donald Trump), repeal of ObamaCare remained the consistent theme.

The party didn't leave anything in doubt. It didn't rely on weasel words or escape hatches. Republicans pledged to, as Texas Sen. Ted Cruz put it, repeal "every blasted word of ObamaCare." And not in phases, not slowly over time, but ASAP.

Only exaggerating a little more than other Republicans, Trump said last year that "we will be able to immediately repeal and replace ObamaCare. Have to do it. I will ask Congress to convene a special session so we can repeal and replace, and it will be such an honor for me, for you, and for everybody in this country, because ObamaCare has to be replaced, and we will do it very, very quickly."

With the House on the verge perhaps of getting a repeal-and-replace bill through, it is worth recalling the years of sweeping promises. The House bill will roll back ObamaCare taxes and introduce a significant reform of Medicaid, but when it comes to the heart of ObamaCare - the regulations - it only makes it possible for states to get waivers, based on certain conditions.

This is a bill probably worth having, even if it would have earned the derision of Republicans back in the days when they were winning elections with Churchillian statements of resolve on ObamaCare. Then, it would have been considered a contemptible half-a-loaf - at best. Now, when Republicans actually have power, everything looks different.

First, there are the cold feet. As soon as Republicans were confronted with the possibility of writing law rather than making symbolic gestures, they lost much of their enthusiasm for the repeal-only bill they had sent to the president's desk for a ritual veto in January 2016. (Republican support for that bill at the time was near-unanimous, 239-3 in the House and 52-2 in the Senate).

Second, while think-tank types and a few officeholders seriously grappled with what a replacement bill would look like, the party had no consensus on replace. For much of the party it was merely the second part of the repeal-and-replace slogan.

Third, many Republican moderates in the House were highly reluctant to repeal ObamaCare, even though they hadn't bothered to let anyone know.

Finally, the highest profile ObamaCare regulations, especially the protections for people with pre-existing conditions, are politically potent. Whether to get rid of them and how has proved the main sticking point in the House, and even the carefully crafted waiver provision is vulnerable to distortion and stinging attack.

All of this means House Republicans have been hard-pressed to pass an incomplete and jury-rigged repeal-and-replace bill. To their credit, they didn't simply give up after the failure of the first version. And their work has been significantly complicated by taking into account what can ultimately survive under Senate rules bypassing the filibuster.

Checking the box of a health-care bill in the House, almost any health-care bill, will impart some momentum to the effort, although it's unclear what the prospects will be in the Senate, where the divisions over ObamaCare are as stark as in the House and the margin for error even smaller.

What is obvious is that this hasn't been the glorious triumph as advertised election after election. The cliché is that you campaign in poetry and govern in prose. Republicans campaigned for years in stark exaggerations and now are governing in flawed compromises.

Columnists

Toons

Lifestyles