Politics & Policy

The Republican Retreat on Health Care

Every week brings fresh bad news about Obamacare. Many companies are considering dropping their health coverage as a result of the incentives the law creates. Small businesses are reporting that the law’s tax credits are encouraging them not to make new hires. Most people with preexisting conditions, who were supposed to be the chief beneficiaries of the law, will be left out from its high-risk pools: There are 4 million of them, but enough funding for only 200,000. The Department of Health and Human Services is already behind schedule in implementing the law. And the director of the Congressional Budget Office, appointed by Democrats, denies that the law will reduce the pressure of health spending on the budget.

Republicans ought to be seizing on each revelation to press the case for repealing Obamacare. It is, after all, the worst law the Democrats have enacted on Obama’s watch; and it is also the GOP’s best issue in this year’s elections. Instead Republicans have largely allowed the Democrats to switch the subject from their unpopular health-care legislation to financial regulation, oil spills, and immigration. They have been reacting to the news instead of trying to make it.

The most important step Republicans could take to promote repeal would be to launch a campaign to pressure House Democrats who voted against Obamacare to co-sponsor legislation to repeal it. On this crucial issue, though, House Republicans have whiffed. Some Republican congressmen are worried about being seen as having no health-care solutions of their own, and so the leadership has gotten behind a bill that both repeals Obamacare and replaces it with various conservative reforms.

We would, of course, be delighted to see such a bill enacted. But the principal effect of including conservative alternatives will be to make it easier for Democrats not to sign on to the bill. It thus sets back the biggest conservative health-care reform of all: the repeal of Obamacare. And it does so for no good reason. For one thing, all the House Republicans are already on record supporting conservative health solutions; there is no need for this piece of legislation to include them. For another, the number of incumbent Republican congressmen at risk of losing to a Democratic challenger this year is vanishingly small. The number of Republican congressmen at risk of losing their seats because they are not sufficiently vocal about their favored health reforms is zero. Is it really beyond the wit of House Republicans to say that they favor first repealing Obamacare and then enacting constructive legislation?

What is most worrisome about the party’s tactical mistake is the loss of nerve that explains it. That loss of nerve is apparent in the party’s other silences.

Most Americans believe that government should not fund abortion, and liberals’ insistence to the contrary nearly sank Obamacare. Republican congressman Roy Blunt, running for the Senate in Missouri, says he will fight to apply the Hyde amendment’s restrictions on abortion funding to Obamacare. Where are the rest of the Republicans?

Elena Kagan, Obama’s Supreme Court nominee, was solicitor general during the legislative debate over Obamacare. Her office may have been consulted about the legal issues it poses. Shouldn’t Republicans be asking about her role, if only to begin making the case that a Justice Kagan would have to recuse herself?

Obama has nominated Donald Berwick, a man who describes his attachment to the British single-payer model of rationing health care in nearly erotic terms, to head the Centers for Medicare and Medicaid Services. A few Republicans have, to their credit, objected — but not enough. A White House spokesman says that the opponents see the nomination as an “excuse to re-fight health care.” Who needs an excuse? Excessive government control of health care, the basic issue in the Obamacare fight, is the basic issue in this fight as well — if, that is, Republicans are prepared to put up a fight.

Failing to put advocates of Obamacare on the defensive arguably contributed to the Republicans’ loss of a special election in Pennsylvania. If their lassitude continues, Republicans will blow many more opportunities in the months to come.

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