Politics & Policy

Repealing It Is Not Enough

Republicans: Talk less about “replacing” Obamacare, more about improving health care.

If Republicans are hoping to sweep to victories in November merely by standing against Obamacare, they will not succeed. They can win big, though, by opposing Obamacare and offering an alternative.

The good news is that, as Andrew Stiles has reported, the House Republican Study Committee (RSC), under the leadership of Representative Steve Scalise (R., La.), already has a near-perfect vehicle for replacing Obamacare. The key challenge, though, is to communicate the Republican reforms in a way readily graspable by the bulk of the public. Fortunately, that challenge is easily surmountable.

First, as for the need to offer something other than mere opposition to the Affordable Care Act: Polls and anecdotal evidence alike make it obvious that most Americans dislike Obamacare, and that the intensity (as opposed to the breadth) of the opposition far outstrips the intensity of the law’s supporters. The polls aren’t as friendly to Republicans, though, when it comes to how to fix the problem. By one account, at least, a strong plurality would actually prefer “implementing and fixing” Obamacare to “repealing and replacing it,” and other surveys show extreme skepticism about Republicans’ trustworthiness in replacing it altogether.

This tracks all sorts of survey and experiential evidence for several years now that Republicans are seen exactly as the Obamaites prefer to portray them, as the “Party of No.” While well-timed negativity may drive voters in particular elections to turn out in droves, it tends to drag down its practitioners in the long run. Ronald Reagan understood this — namely, that lasting majorities are built on hope and positive energy. The Music Man will always be more popular than Scrooge.

Applied to the U.S. health-care system, last autumn’s polls, taken together, seem to indicate that overlapping pluralities really do fear returning to “the old system” or “doing nothing” even as they think Obamacare is a mess. To attract combinations of those pluralities that together add up to well over 50 percent, the better language might be not to “replace” Obamacare but to “repair” or “improve” the delivery of “American health care.” Predicated on a manifestly apolitical goal — or one that transcends politics, rather than merely attacking Obama — a Republican alternative (or set of discrete alternatives) could lose the stench of partisanship and earn consideration on its merits.

Those merits are significant. Better yet, they entail not just better policy but also better politics. The proposals in the RSC bill, taken one by one, make sense almost immediately to just about anybody in ordinary conversation. Try it; ask a friend over lunch, if health care comes up, the following question: “Do you think we should be able to buy health insurance from a company in Delaware, or in Ohio, rather than only from [wherever you live], if you can find a better deal out of state?” It is a dead-cinch guarantee that the answer will be “yes.”

Or ask: “Should small businesses be able to combine with each other to get better group rates than they can get on their own?” Yes, of course. “Employers get a tax break if they subsidize insurance for their workers; should the workers be able to get a similar tax break if they buy insurance on their own?” Darn right they should.

And so on.

These are not complicated proposals. These are not ideas likely to generate confusion, fear, or opposition. These are solutions that, individually, are almost impossible for liberals to attack.

Most people are made nervous by complexity, by large systems, and by feeling boxed in by a one-size-fits-all rigidity. They prefer to consider things in bite-sized chunks. Experienced pols aplenty can tell stories of referenda lost, in overwhelming votes, when a proposal on the ballot had lots of moving parts — but of every one of those same moving parts easily passing in subsequent referenda when presented as individual propositions rather than in combination with each other.

If Republicans break down the RSC bill into two or three small groupings of constituent parts, Democrats are likely to feel severe public pressure not to oppose them. Meanwhile, Republicans will have nullified the Obamaite talking point accusing them of having “no ideas” on health care. Of course, the accusation always has been bogus, but Republicans have done a terrible job of publicly countering it. What’s needed is a decision by the joint House and Senate Republican leadership, backed by the Republican National Committee, to push the RSC proposals, or some that are very similar, in a concerted, strategic, consistent way.

Each proposal or small group of proposals should be accompanied by real-world examples — the plumber in Indiana, perhaps, who could get a very specific, better insurance plan for his needs from a Florida company, or the proprietor of the one-man yard-care business who desperately could use a personal tax credit for health care, of the sort his former employer provided when the man worked for a big-box garden-supply center.

Focusing on alternatives to Obamacare, and presenting them wisely, will reinforce the central theme (the disaster Obama foisted on us) that should carry Republicans to victory in November, whereas changing the subject to something like immigration “reform” will only muddy the message and let Obama’s Democrats off the hook. It would be a historic blunder for Republicans to allow this year’s elections to be the “one that got away.”

— Quin Hillyer is a contributing editor of National Review.


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We had substantial disagreements but recognize that he will be remembered for a long, consequential career of service to a country that he loved.