Pedro Rojas holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare, before the February 15th deadline on Feb. 5, 2015 in Miami, Fla. 
Photo by Joe Raedle/Getty

On health care, Republicans are lost without a map

Updated
So, how’s that Republican plan to repeal, replace, and repair “Obamacare” going? Not well.
Senate Republicans have not yet begun to work in earnest on a replacement plan for the Affordable Care Act, Sen. Bob Corker (R-Tenn.) said on Tuesday. It was a rare public admission of what has become obvious from the outside, as Republicans find both the politics and the substance of Obamacare repeal more difficult in practice than in rhetoric.

“To be honest, there’s not any real discussion taking place right now,” Corker told reporters in the Capitol.
Last night, Sen. Ted Cruz (R-Texas) participated in a forum on the ACA where he was asked about his party’s plans. The far-right senator attacked the law, and committed to eventually repealing it, but Cruz otherwise dodged the question.

As for the president, who’s never seemed to understand the basics of the debate or the process, Donald Trump told Fox News’ Bill O’Reilly the other day that he and his team are putting together “a wonderful plan,” which Americans may be able to see “within the year and the following year.”

As the GOP repeal crusade hits a brick wall, let’s not lose sight of the fact that this wasn’t the way Republicans expected the process to go. As recently as Jan. 10, Trump said his party would repeal the health care reform law “probably sometime next week,” and he’d be ready to move forward on a replacement “very quickly or simultaneously, very shortly thereafter.” A few days earlier, Mike Pence said repealing the ACA would be the “first order of business” for Republican policymakers in 2017.

The entire campaign was going to snowball before Obamacare proponents even knew what hit them – right up until the snowball melted.

Even at the recent House Republican retreat, which was supposed to be a working meeting at which GOP lawmakers reached some important policy decisions about health care, we know from private recordings that Republicans are as confused behind the scenes as they are in public.

To be sure, the party knows where it wants to end up, but for now, it’s lost without a map. Republicans may hate “Obamacare” for reasons they’ve struggled to explain, but they have absolutely no idea what to replace it with, despite years of effort trying to figure this out. Trump’s assurances last month that his administration’s blueprint is nearly complete – they’re just crossing the t’s and dotting the i’s – were apparently fiction.

There’s more than one reason to explain how Republicans found themselves in this position. For one thing, they remain deeply divided among themselves, not only over strategy, but also over what their specific goals should be what an ACA alternative.

For another, while GOP officials assumed there was a broad public appetite for Obamacare repeal, Republicans are also discovering that the Affordable Care Act is (a) increasingly popular; (b) enjoys more support than Trump or Congress; and (c) inspiring activists to put up a fight that has caught Republicans completely off-guard.

Making matters much worse, GOP leaders – on both ends of Pennsylvania Avenue – vastly over-promised on what they could deliver, painting the party into a corner from which there is no easy escape.

What’s left is a party that has no plan, but does have some new buzzwords Paul Ryan seems to like. It seems oddly appropriate given the circumstances: when Republican policymakers were supposed to be working on substance, in classic post-policy fashion, they instead focused on public relations and talking points.

The core truths, however, remain the same: GOP officials have been working on an alternative to the Affordable Care Act since the summer of 2009, and they’ve produced nothing of significance because they can’t. Their ideology won’t allow them to craft an effective reform blueprint, and political considerations won’t allow them to unveil a bad one.

Health care proponents shouldn’t pop the champagne just yet; conditions can change quickly and the Trump administration can do real damage to the law even while Congress spins its wheels. But in the meantime, the Republican campaign is looking more pathetic than scary.


Affordable Care Act, Health Care and Obamacare

On health care, Republicans are lost without a map

Updated