Republicans are walking a tightrope with their plans to "repeal and replace" the Affordable Care Act, aka "Obamacare." On one side is their angry, racist base that wants to obliterate anything and everything connected with President Obama. On the other side are millions who have been helped by the law and, more importantly if you are a Republican, the health care providers and medical equipment companies that have been making a decent profit since the legislation went into effect.
It was the latter constituency that was addressed by former House Speaker John Boehner on Thursday morning. The retired Ohio congressman spoke to a health care conference in Orlando, where of course the status of the ACA was on many minds.
Boehner told the crowd of healthcare IT professionals at the HiMSS conference that the notion that an Obamacare repeal and replace bill would quickly and easily sail through Congress was little more than "happy talk."
"[Congressional Republicans are] going to fix Obamacare – I shouldn’t call it repeal-and-replace, because it’s not going to happen," the former Speaker said.
He added that he was amused by the post-election conversation about a rapid replacement for the law, saying,
"I started laughing. Republicans never ever agree on health care."
In the past, Republicans have largely been in agreement about health care, in that they haven't seen a need to address the issue at all. And once the Democrats got the power they needed to move forward on it, Republicans kicked and screamed and complained about it at every turn. Then they lied to the public, claiming Democrats had "rammed it down our throats" when in fact Democrats bent over backwards to accommodate GOP ideas, to the tune of including some 161 Republican-authored amendments in the bill.
But Boehner is right about the current situation. Republicans largely agree that they want to eliminate the ACA, but there are almost as many ideas about what a replacement should look like as there are GOP members of Congress. And swing-district Republicans who are facing an angry backlash over ACA repeal at town hall meetings are likely to be uncomfortable about destroying the program if it means putting their political careers at risk.
Boehner also soothed his audience by telling them that when all is said and done, most of the current health care law will still be in place. He is very likely correct. Republicans are already finding out that the ACA is like the "Jenga" game, where players take turns removing wooden blocks while attempting to keep the entire stack from falling down. You can tinker with the law and change things around the edges, but as soon as you start messing with the central features, such as the requirement for insurers to cover people with "pre-existing conditions," or the mandate requiring everyone to be covered, everything will fall apart, leaving a mess behind as millions once again are left with no health care coverage.
Look for Republicans to now do what they should have been doing all along -- fix what's broken with the law. No law as complex as the ACA has ever come out of the box in perfect condition. But what has hurt this law is the fact that the GOP has simply refused to do anything to make it better. Now they have the opportunity to do the fixes they should have done already, and you can bet they will attempt to rebrand the effort as something like "Republi-care" or, (the horror, the horror) "Trump-care."
Democrats need to be actively involved with Republican efforts to repeal or change the ACA, fighting a full repeal, but showing a willingness to work with the GOP to fix things that both sides agree are broken, if Republicans agree that the prudent course is to fix, rather than scrap the law. Otherwise they may succeed in creating a political disaster for Republicans if fixes don't come about or don't work as promised, but at the cost of a human disaster inflicted on millions of Americans.