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Republicans have no idea what they'd do if their ACA scheme succeeds

As one observer put it, "Neither in the White House nor on Capitol Hill are they prepared for the possibility that their lawsuit against Obamacare will succeed"
Image: U.S. President Trump celebrates with Republican House members after healthcare bill vote at the White House in Washington
U.S. President Donald Trump (C) celebrates with Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved...

Republicans failed spectacularly to pass health-care legislation when they controlled all of the levers of federal power in 2017 and 2018, and their prospects for legislative success on the issue are even worse now. Despite the partisan hyperventilating, Donald Trump and his GOP brethren will not "repeal and replace" the Affordable Care Act ahead of the 2020 elections.

Republicans do, however, have an alternate route in mind: the Texas v. U.S. lawsuit is ongoing, and its purpose is to destroy "Obamacare" altogether, eliminating all of its benefits for the American public.

And while this may seem far-fetched, a far-right judge in Texas ruled in the GOP's favor in December, and the 5th Circuit Court of Appeals appears likely to do the same. If the Republicans' gambit succeeds, 21 million people would lose their health coverage; 133 million Americans with pre-existing conditions would lose their protections; and the entire American health care system would be uprooted.

It led Sen. Chris Murphy (D-Conn.) to publish a striking tweet yesterday with a question for his GOP colleagues: "Hey Senate Republicans, oral arguments yesterday in your Obamacare case suggest you may get your way....'s your plan then?"

Ramesh Ponnuru wrote a notable piece on the subject, making clear that Republican officials haven't the foggiest idea how to answer that question.

There's an important bit of contingency planning that Republicans have neglected to do. Neither in the White House nor on Capitol Hill are they prepared for the possibility that their lawsuit against Obamacare will succeed.

After highlighting a series of possible scenarios, each of which pose dramatic challenges, Ponnuru concluded, "[T]he best political outcome for Republicans is probably for the lawsuit to fail, at which point they can complain about the judges who had just delivered them from a nightmare."

There's little doubt he's correct. Whether GOP officials realize this or not is far less obvious.

Asked this week, for example, about the pending litigation, Sen. Thom Tillis (R-N.C.), who's likely to face a tough re-election campaign next year, said, "I support anything that ultimately takes Obamacare off the table."

The North Carolina Republican's knee-jerk response was unsatisfying for a variety of reasons, not the least of which was the simple fact that many families in his state rely on the ACA for health security, and Tillis is wholly unprepared to protect them in the event that the existing American health care system is suddenly "off the table."

In recent years, Republicans confronted a simple metaphor when it came to the political fight over health care: GOP officials were the dog that caught the car, unsure what to do next. At the time, however, the metaphor was largely about access to political power: Republicans ranted and raved about health care when they were in the minority, unable to do any meaningful governing on the subject, and seemed lost and confused once they were in a position of authority.

But now the metaphor has even greater salience, because its implications run deeper. GOP policymakers said they wanted to erase the Affordable Care Act and its benefits from existence, and it's possible a group of like-minded judges may grant them their wish.

What would Republicans do then? They have no idea -- and by all appearances, they'd prefer not to even think about it.

Update: Igor Bobic talked to some GOP senators about this yesterday:

“I actually don’t think the courts are eventually ever going to strike it down,” Sen. Lamar Alexander (R-Tenn.) said Wednesday. He called the case, which was argued before an appeals court in New Orleans on Tuesday, “pretty far-fetched.”

Sen. Susan Collins (R-Maine), a supporter of the law who helped save it in 2017 when Republicans in Congress attempted to repeal it, agreed. 

“It’s my hope and belief that the Supreme Court won’t strike the law down,” Collins said.

Of course, hope is not a plan.