Republicans awoke on November 9 to the realization that their wet dream of almost eight years was about to come true: They were going to get to repeal Obamacare. But the question very quickly became how to do it. The GOP still doesn't have a filibuster-proof majority in the Senate, and unless those rules are changed Democrats would certainly block any attempt to dismantle President Obama's signature piece of legislation.
But never fear! If there is a way to screw over the American people Republicans are going to use it. And in the case of the Affordable Care Act, that way is via executive order.
On Wednesday The Hill reported Republicans intend to have a repeal bill on President Trump's desk by February 20. But they didn't say how they intend to get around a guaranteed Democratic filibuster. What incoming Vice President Mike Pence did say was that Trump would begin chipping away at the law via executive orders as soon as he takes office. Executive orders. You know, those things that, when used by President Obama, made him a "dictator."
Pence told reporters,
It will be an orderly transition to something better ... using executive authority to ensure it’s an orderly transition. We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for ObamaCare.
According to the report, Pence didn't say what parts of the law Trump will target with executive orders. But one thing is for certain: as soon as Republicans start messing with the law and dismantling its provisions, many of which are intertwined with one another, they are going to leave behind a mess.
For example, do away with the individual mandate that requires everyone to have insurance, and younger, healthier individuals will start bailing out of the program. That will cause rates to skyrocket on those who are dealing with serious illnesses and who need insurance. It will also cause insurers, no longer able to make a profit on the insurance exchanges, to end their participation in the ACA marketplace.
Meanwhile, Republicans, whose mantra has been "repeal and replace" since day one, still have not put forth a viable option for replacing the law. At least a few of them are concerned about that.
Kentucky is one of the places where Obamacare, known there as "KYnect," has worked best, thanks to the efforts of former Democratic Governor Steve Beshear. Since the election, a number of Kentuckians have been concerned about what will happen to them if the KYnect program is ended. That is almost certainly why Kentucky Senator Rand Paul wants his party to offer a replacement at the same time it repeals the current law.
Paul visited MSNBC's Morning Joe on Wednesday, where he said,
I think it's imperative that Republicans do a replacement simultaneous to repeal.
But many other Republicans want to repeal Obamacare with a built-in delay that would allow them to come up with a replacement as it is being phased out, instead of offering one before they touch the current law. Past history tells us what that would bring: an eventual end to the law, with no replacement offered.
In the 1990s, Republicans torpedoed what they derisively called "Hillarycare." There were several GOP proposals that were floated, including one from the Heritage Foundation that looked very similar to what became the ACA. But none of those proposals were ever brought to a vote in Congress.
From January 20, 2001 to January 2, 2006 Republicans had total control of the federal government. Yet, once again, nothing was ever done to fix health care, save for the Medicare Part D bill that was mainly a huge giveaway to big pharma.
So, why should we believe Republicans this time when they tell us they are going to replace Obamacare with something "terrific," to use Trump's words? In short, their past actions prove we shouldn't believe a word they say about health care.
The ACA isn't perfect. What complex law has ever come out of the box in flawless form? But instead of fixing the problems and leaving the basics of the law intact, the GOP, in their insane desire to eradicate every accomplishment of President Obama, is threatening to create brand new problems for health care along with reviving old ones.