The most interesting part of the 56th time House Republicans voted to repeal the Affordable Care Act? The part of the GOP bill that separated it from the first 55 votes.
As expected yesterday afternoon, House Republicans approved yet another bill to eliminate the entirety of “Obamacare” and all of the benefits it’s providing to tens of millions of families, replacing the ACA with nothing. Republicans’ heart didn’t seem in it, but they went through the motions anyway, passing the bill on a 239-186 vote.
Literally zero Democrats went along this time – the Blue Dog Caucus has clearly shrunk – and three GOP members actually broke ranks and voted with the Democratic minority.
Republicans Bruce Poliquin of Maine, John Katko of New York and Robert Dold of Illinois were the lone three defections in either party on what’s being billed as the chamber’s 56th vote since 2011 to undo parts of the 2010 health law.The defectors’ rationale? They might hate Obamacare, but Republicans still haven’t put forward a legislative proposal that would act as a substitute in the event the law ever got repealed.“The people of the 10th District sent me to Congress to advance solutions, not sound bites, to the problems we face,” said Dold…. He continued, “Casting yet another symbolic vote for full repeal of the law, without any replacement legislation, simply distracts us from the work that must be done to drive costs down, restore access to care and make healthcare work for everyone.”
But that’s not the funny part. Rather, the most striking aspect of yesterday’s vote was the additional language included in the GOP bill in which Republicans established guidelines for the party’s new-and-currently-non-existent alternative to the Affordable Care Act.
To be sure, Republicans don’t yet have a plan, but they have a plan to write a plan, and yesterday’s proposal included specific parameters that GOP lawmakers will honor when putting their health care package together, Yesterday’s language specifically said:
Specified committees of the House of Representatives must report legislation within each committee’s jurisdiction with provisions that:* foster economic growth and private sector job creation;* lower health care premiums;* preserve a patient’s ability to keep their health plan;* provide people with preexisting conditions access to affordable health coverage;* reform the medical liability system to reduce unnecessary health care spending;* increase the number of insured Americans;* protect the doctor-patient relationship;* provide states greater flexibility to administer Medicaid programs;* expand incentives to encourage personal responsibility for health care coverage and costs;* prohibit taxpayer funding of abortions and provide conscience protections for health care providers;* eliminate duplicative government programs and wasteful spending; or* do not accelerate the insolvency of entitlement programs or increase the tax burden on Americans.
To the GOP’s credit, this is the first time I can recall Republicans laying the groundwork like this, spelling out exactly what they believe a good reform law must include. To the GOP’s detriment, if Republicans think their plan will actually achieve these results, they’re stark raving mad.
Indeed, Rep. Jim McGovern (D-Mass.) said the GOP plan would be “flown in on a unicorn sliding down a rainbow.”
I suspect Republicans don’t appreciate the mockery and want to be given a chance – after six years of delays – to meet their own goals. Fine. But reality tells us that if policymakers are going to craft a reform law that lowers premiums, extends protections to those with pre-existing conditions, reduces the uninsured rate, and strengthens Medicare finances, such a model will almost certainly need to include considerable public investments and government regulation of private insurers.
Republicans hate public investments and government regulation of private insurers.
If it were easy to create a conservative “Obamacare” alternative that does all of the same great stuff, but in a way that Republicans find ideologically satisfying, the GOP wouldn’t have waited six years to give this a try.
The question isn’t whether this gambit will fail; it’s when Republicans will realize their scheme won’t work – because it can’t.