It took them four years longer than they were expecting, but the GOP finally took complete control of Washington, D.C. And with that control came the opportunity to do what they have been promising since before the ink dried on President Obama's signature legislation, the Affordable Care Act: "repeal and replace." But they now find themselves mired down in the mechanics of the issue, with major disagreements about how to proceed.
Last month House Speaker Paul Ryan said Republicans will repeal the ACA and offer up a replacement at the same time. While fixing, rather than repealing Obamacare, would be the easiest and wisest way to go, there is at least some merit in Ryan's plan. It would mitigate lapses in coverage, for example. It would also allow citizens to weigh in as the new legislation is crafted and allow everyone to compare the replacement to the ACA. But some Republicans don't like the idea.
Utah senator Mike Lee is one Republican who wants to uncouple repeal of Obamacare and the crafting of a replacement. On Wednesday he called the plan to include provisions for replacement in a repeal bill a "horrible idea."
According to Roll Call, Lee had this to say in a briefing sponsored by the Heritage Foundation:
"If we load down the repeal discussion with what comes next, I think it’s going to make it a lot harder to get either one of them done. We need to repeal it first before deciding what comes next. I think there is a lot of agreement among Republicans in Congress with regard to the repeal bill. There is a lot less agreement on what comes next."
With that statement Mike Lee left the door open for what many fear -- that Republicans will repeal Obamacare and simply never replace it. They'll just quietly allow the insurance market to return to the abuses of pre-ACA days.
The GOP has a history surrounding healthcare reform that makes that fear legitimate. In the 1990s they successfully stopped what they were calling "Hillarycare." But after taking control of Congress at the start of 1995 they offered no proposals of their own for a healthcare law.
Likewise during the George W. Bush administration. Healthcare and insurance costs had already begun to spiral out of control. Republicans held both houses of Congress from the 2003 to 2007, plus, this time, they also controlled the White House. Attempts at healthcare reform? Zero.
Knowing what we know about Republicans and the fact that they just don't seem to have helping ordinary people in their DNA, following Mike Lee's suggestion would probably result in something like this:
- Obamacare repeal passes Congress.
- If an election is close, the GOP makes a series of announcements that they are "working" on a replacement, maybe with a detail or two thrown in.
- If an election isn't close, or after it has passed, they announce that they can't come to an agreement on a replacement. The problem will need "more study."
- Another issue will come along that they can use to distract from their failure to replace the ACA.
- Healthcare reform will be dead unless and until Democrats return to absolute power in Washington.
Call that a cynical view if you wish, but it is a view informed by over thirty years of watching post-Reaganite Republicans function. And the fact that the call to first repeal, then begin to work on a replacement comes from Lee, one of the most conservative men in the Senate and certainly no friend to the working class, says it might be right on the money.