Now that it’s clear they still don’t have a coherent plan to replace the Affordable Care Act, some Republicans are rethinking their strategy.
Instead of vowing to “repeal and replace” Obamacare – a rallying cry that dates back to March 2010, shortly before President Obama signed his historic health care plan for uninsured Americans – many prominent Republicans are now promising to “repair and fix” a program that is growing in popularity and now covers more than 20 million Americans.
Shaken by increasingly dire forecasts from major insurers, hospital administrators, GOP governors and mayors and consumer advocates that the health care insurance market could be in shambles by the beginning of 2018, Republican leaders for the moment are taking refuge in a semantics game suggesting that surgical changes in the law might be preferable to wholesale dismantling.
While die-hard heavyweights including President Donald Trump, House Speaker Paul Ryan (R-WI) and Senate Majority Leader Mitch McConnell (R-KY) continue to cling to the upbeat but misleading message that their party is on the verge of repealing and replacing the troubled health insurance program, second-tier Republicans stuck with the task of actually designing a replacement have begun ducking for cover.
Since returning from a three-day policy retreat in Philadelphia where many rank-and-file House and Senate members privately vented alarm that their party could end up being blamed by millions of voters for the loss of their insurance coverage, Republican lawmakers have been taking the “repair and fix” mantra out for a test run.
“Our goal is to repair the damage caused by Obamacare where we find the damage,” Sen. Lamar Alexander (R-TN), chair of the Health, Education, Labor, and Pensions Committee with jurisdiction over Obamacare, said at the start of a hearing Wednesday on the individual insurance market. “. . . No one is talking about repealing anything until there is a concrete alternative in its place.”
Sen. Susan Collins (R-ME), a moderate who has been promoting a Solomon-like compromise that would allow the states to choose whether to stick with the existing Obamacare law or opt for a different approach, said at the same hearing that “Regardless of who was elected President, we were going to have to do major repairs on the Affordable Care Act.”
Rep. Greg Walden (R-OR), the chair of the House Energy and Commerce Committee who has major responsibility for shaping new health care policy, offered a similar message to reporters the previous day, according to The Hill. “We’re going to fix things; we’re going to repair things,” he said.
But with Trump insisting that the Republican-controlled Congress simultaneously repeal and replace the Affordable Care Act to a radically different, more market-based approach, congressional Republicans are in no way off the hook. Conservative groups including the Heritage Foundation are pressing the GOP to make good on their campaign pledges to repeal Obamacare early this year, and some members of the House Freedom Caucus are behind that strategy.
Trump and GOP leaders have already acknowledged there are portions of the Obamacare law that they would like to preserve, most notably a ban on insurers discriminating against applicants who have pre-existing health problems and a provision allowing parents to keep their children on their health insurance plans until they turn 26.
Shortly after he was sworn in Jan. 20, Trump signed an executive order instructing the Department of Health and Human Services, the Internal Revenue Service and other agencies with jurisdiction to do everything they can within the law to “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”
Trump appears to have no understanding of the complexity and perils of designing a replacement for a major federal health care program – especially one that has grown in popularity even as the new administration moves aggressively to eviscerate it. A recent Fox News poll found that 50 percent of voters feel favorable about Obamacare – a nine-point uptick from last summer.
Meanwhile, a Kaiser Family Foundation poll released in early January found that 75 percent of Americans either are opposed to repealing the Affordable Care Act or want Congress to have an acceptable replacement in hand before they go ahead and repeal the current law.
“Republican leadership is moving to repeal the Affordable Care Act with no plan to replace it,” Rep. John Yarmuth of Kentucky, the ranking Democrat on the House Budget Committee, said today at a hearing. “Thirty-two million people will lose health coverage, premiums will double, and we will return to the days when insurance companies decide who lives and who dies.”
In recent days, there have been reports across the country of Republican lawmakers ducking meeting with constituents who are worried about losing their health insurance coverage. The Aurora Beacon News reported that staffers of Rep. Peter Roskam (R-IL) canceled a scheduled meeting Wednesday with 16 constituents concerned about the repeal of Obamacare after Roskam’s staff members realized a reporter was present.
Meaghan Smith, a spokesperson for the Protect Our Care Coalition, said in a statement that “People are scared about what will happen to their health care if Republicans blow up our health care system. And Republicans can’t hide from the reality that they simply have no plan.”
Congressional Republicans only have themselves to blame. After six years of denouncing Obamacare as a failed venture that has wasted billions of federal dollars and has fallen far short of Obama’s promise to provide affordable health insurance, Republicans have yet to agree on a replacement plan that would stand a good chance of working – or passing muster with Republicans and Democrats alike.
Joseph Antos, a health care expert with the conservative-leaning American Enterprise Institute, said today that the Republicans shift to a “repair and fix” theme marks their “realization at long last that they’re going to have to get Democratic votes in the Senate.”
“So this moderation of language – that’s a minimum first step,” Antos said.